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Purpose: We investigated the effectiveness of a highly individualized morphosyntactic intervention using the SHAPE CODING™ system delivered at different dosages. Method: Eight children with developmental language disorder aged 8;0-10;10 (years;months) received 10 hr of explicit individualized intervention for morphosyntax delivered in 30-min individual sessions once per week for 20 weeks. Following at least four baseline probe tests, two grammatical targets per session received explicit instruction until they reached criterion (90%), when the next target was introduced. To control for session length and teaching episode density, either both targets received 20 teaching episodes per session or one target received 10 teaching episodes and the other 30. Maintenance testing of completed targets was also carried out. Results: Scores on probe tests post-intervention were significantly higher than during the baseline phase (d = 1.6) with no change during the baseline or maintenance phases. However, progress during the intervention phase was highly significant. One participant showed significantly faster progress with intervention, while one (with the lowest attention score) made little progress. When considering progress relative to cumulative intervention sessions, progress was faster with 30 teaching episodes per session and slower with 10. However, when cumulative teaching episodes were used as the predictor, all three within-session dosages showed very similar rates of progress, with the odds of a correct response increasing by 3.9% for each teaching episode. The targets that were achieved required an average of 40-60 teaching episodes. Conclusions: With the exception of one participant, the individualized intervention was highly effective and efficient. Thus, the individualized target identification process and intervention method merit further research in a larger group of children. The cumulative number of teaching episodes per target provided across sessions appeared to be key. Thus, clinicians should aim for high teaching episode rates, particularly if the number of sessions is constrained. Otherwise, intervention scheduling can be flexible.

Feedback can be powerful, but its effects are dependent on what students do. There has been intensive research in recent years under the banner of 'feedback literacy' to understand how to help students make the most of feedback. Although there are instruments to measure feedback literacy, they largely measure perceptions and orientations rather than what learners actually do. This paper documents the development and validation of the Feedback Literacy Behaviour Scale (FLBS), which is a self-report instrument intended to measure students' feedback behaviours. A framework for feedback literacy was constructed with five factors: Seek Feedback information (SF), Make Sense of information (MS), Use Feedback information (UF), Provide Feedback information (PF), and Manage Affect (MA). An initial set of 45 questions were reviewed in an iterative process by feedback experts, resulting in 39 questions that were trialled with 350 student participants from four countries. Our final survey of 24 questions was generally supported by confirmatory factor and Rasch analyses, and has acceptable test-retest reliability. The FLBS provides a more robust way for educators and researchers to capture behavioural indicators of feedback literacy and the impact of interventions to improve it.

Critical reflective practice is a foundation of socially just pedagogy. This paper focuses on the informal STEM (science, technology, engineering, and maths) learning sector, where there is an acute shortage of support for critical reflective practice despite long-standing, entrenched issues of inequity. We analyse how practitioners used a new reflective tool, the Equity Compass, co-developed by researchers and practitioners through a five-year partnership. We report on multimodal qualitative data (interviews, ethnographic observations, group discussions, partner site visits, and workshops) from 12 practitioners in four settings in the UK: a community zoo, regional science centre, digital arts centre and an initiative supporting girls and non-binary young people into STEM. We discuss how using the Equity Compass: (i) increased and deepened practitioners' knowledge and understanding of equity issues; (ii) supported personal and institutional critical reflection, helping practitioners move beyond 'gut instinct' to interrogate their own positionality, ask new questions, and critically evaluate the effectiveness of attempts at inclusive practice; and (iii) fostered more intentional equitable planning and practice, such as participatory approaches that shared authority with learners and introduced more inclusive forms of representation. We conclude by discussing the challenges, limitations, and implications for supporting critical reflective practice among educators.

Understanding equitable practice is crucial for science education since science, technology, engineering, and mathematics (STEM) fields and STEM learning practices remain significantly marked by structural inequalities. In this paper, building on theories of discourse and situated meaning developed by Foucault, Gee, and Sedgewick, we explore how educators navigated discourses about social justice in informal science learning (ISL) across four UK sites. We draw on qualitative, multimodal data across 5 years of a research--practice partnership between a university, a zoo, a social enterprise working to support girls and nonbinary youth in STEM, a community digital arts center, and a science center. We identify three key discourses that shaped social justice practices across all four practice--partner sites: (1) "inclusion" for STEM, (2) "inclusion" for the institution, and (3) "inclusion" for minoritized youth. We discuss how educators (n = 17) enacted, negotiated, resisted, and reworked these discourses to create equitable practice. We argue that while the three key discourses shaped the possible meanings and practices of equitable ISL in different ways, educators used their agency and creativity to develop more expansive visions of social justice. We discuss how the affordances, pitfalls, and contradictions that emerged within and between the three discourses were strategically navigated and disrupted by educators to support the minoritized youth they worked with, as well as to protect and promote equity in ISL. This paper contributes to research on social justice in ISL by grounding sometimes abstract questions about power and discourse in ISL educators' everyday work.

Emotion is closely associated with language, but we know very little about how children express emotion in their own writing. We used a large-scale, cross-sectional, and data-driven approach to investigate emotional expression via writing in children of different ages, and whether it varies for boys and girls. We first used a lexicon-based bag-of-words approach to identify emotional content in a large corpus of stories (N>100,000) written by 7- to 13-year-old children. Generalized Additive Models were then used to model changes in sentiment across age and gender. Two other machine learning approaches (BERT and TextBlob) validated and extended these analyses, converging on the finding that positive sentiments in children's writing decrease with age. These findings echo reports from previous studies showing a decrease in mood and an increased use of negative emotion words with age. We also found that stories by girls contained more positive sentiments than stories by boys. Our study shows the utility of large-scale data-driven approaches to reveal the content and nature of children's writing. Future experimental work should build on these observations to understand the likely complex relationships between written language and emotion, and how these change over development.

While there are many different frameworks seeking to identify what benefits young people might derive from participation in informal STEM (Science, Technology, Engineering and Mathematics) learning (ISL), this paper argues that the sector would benefit from an approach that foregrounds equity and social justice outcomes. We propose a new model for reflecting on equitable youth outcomes from ISL that identifies five key areas: (1) Grounded fun; (2) STEM capital; (3) STEM trajectories; (4) STEM identity work; and (5) Agency+. The model is applied to empirical data (interviews, observations and youth portfolios) collected over one year in four UK-based ISL settings with 33 young people (aged 11-14), largely from communities that are traditionally under-represented in STEM. Analysis considers the extent to which participating youth experienced equitable outcomes, or not, in relation to the five areas. The paper concludes with a discussion of implications for ISL and how the model might support ongoing efforts to reimagine ISL as vehicle for social justice.

Increasing pressure is being placed on governments and legislators in different countries to take action against assignment outsourcing in higher education. Global discussions focus on prohibiting commercial outsourcing providers, such as contract cheating services. Despite evidence to suggest that outsourcing behaviours by students are increasing, and the number/reach of companies is increasing, little research has been undertaken to explore whether legislation will deter or prevent students from engaging in these dishonest behaviours. We investigated the issue of legality with higher education students, asking about their peers and their own assignment outsourcing behaviours, whether they believed such companies were already illegal, or whether they thought they should be illegal. Using quantitative analysis, responses from 7126 international participants were considered. We found that some students outsourced their assignments whether they thought it was illegal or not. Further, the majority of respondents argued that students should be impacted by any legislation, as well as the companies that provide outsourced work. The study presents evidence which should be considered in determining whether any law may have an effect to reduce assignment outsourcing behaviours in higher education students.

Aims: This paper details the evaluation of a reflective learning programme developed by educational psychologists for school leaders in exploring the implementation of compassionate, relational approaches in schools, using an integrated whole school framework. Rationale: Whole school approaches have been highlighted as central to improving the mental health and wellbeing of children and young people. The Compassionate Schools Framework (CSF) brings together current research and thinking in promoting wellbeing into an integrated and coherent whole school approach. It is based on an understanding of the power of attuned relationships, the potential impact of prolonged and unpredictable stress and trauma, and the role of positive psychology in building psychological resources through embracing strengths and hopeful futures. Findings: The evaluation highlighted key themes in relation to nine areas of school practice detailed in the CSF. School leaders shared insights into current strengths, newly developing approaches and challenges, highlighting the complexity of building on compassionate, relational approaches across school systems. A number of research priorities are identified. Limitations: Findings capture the reflections of school leaders during the initial phase of developing thinking and planning in relation to the CSF and longer term follow up is needed to gain insight into issues related to implementation and impact over time. Conclusions: The paper highlights the value of a research-informed integrated framework where school leaders can reflect collaboratively on areas of strength and school development as part of a coherent whole school approach. There is need for ongoing collaboration through a multi-agency community of practice to continue to deepen understanding and share learning on implementation and impact within a supportive network.

The value of students publicly sharing and discussing their solutions to unstructured problems is widely recognized. This can, however, be pedagogically challenging. The solutions may be partial, unclear and unpredictable. For many teachers, particularly those new to working with such problems with their students, the improvisation needed to orchestrate productive discussions can be unmanageably high. In this paper we present a pedagogical tool to help teachers. Specifically, teachers orchestrate discussions of "designed, worked-out solutions" to unstructured problems. The worked-out solutions have been carefully pre-designed for teachers to use in lessons. Knowing the range of distinct solutions students are to work with supports teachers' planning. The reduced need for improvisation means they are better placed to learn and practice new ways of probing students' reasoning. These acquired practices may then be applied to discussions of students' own responses to a problem. In the study we explore the question: for a teacher new to working with unstructured problems, how do discussions of worked-out solutions (called in this paper designed student responses) differ from discussions of students' own solutions? Our findings indicate that discussions of authentic student solutions tend to focus on procedural descriptions, whereas the discussions of designed solutions stimulated student explanation and evaluation. The work reported here represents the initial part of an on-going study.

Objective: Evaluate the prevalence and risk factors associated with depression symptoms at 10 years after traumatic brain injury (TBI) and compare with results at 10 weeks and 1 year. Methods: A large cohort of prospective admissions with TBI were followed up for 10 years. Depression using HADS (Hospital Anxiety and Depression Scale) score > 8 was measured. Several injury and demographic features were examined for association with depression. Results: Over 4 years, 1130 individuals were recruited of whom 916 attended at 1 year; after 10 years, 552 attended and 210 had died. 154 (17%) of the cohort was lost to follow-up. The prevalence of depression at 10 weeks was 56.3% [95%CI 52.2–60.5], at 1 year was 42.4% [95%CI 38.3–46.5] and 10 years 38.4% [95%CI 34.3–42.5]. There was considerable change in individual scores over time in both directions. A multivariable analysis identified the independent predictors of 10-year depression score as lower GCS, social deprivation, female gender, past psychiatric history, alcohol intoxication and unemployment. Age, ethnicity, social support, TBI etiology, CT abnormality and medical comorbidity were insignificant. Conclusions: While the overall level of symptoms at 10-year post-TBI remains high, there is considerable change in individual depression status over time. The predictors identified may allow the targeting of vulnerable sub-populations. [ABSTRACT FROM AUTHOR]

Background: Advance care planning can improve patient and family outcomes; however, minoritised ethnic communities experience access barriers. Co-production offers a way to design culturally appropriate information and support, but evidence is needed to understand its implementation in palliative care. Aim: To explore and describe how two charities used co-production to develop and deliver community-based advance care planning workshops for South Asian elders. Design: Workshops were co-produced by two charities. In parallel, a multi-component qualitative study was conducted comprising workshop observations, semi-structured interviews with charity staff and focus groups with workshop participants, facilitated by community co-researchers in English, Hindi, Urdu and Punjabi. Data were analysed using thematic analysis. Setting/participants: Four workshops were held in a London (UK) community setting (each with 5–30 participants); four interviews were conducted with charity staff members, and three focus groups with 16 workshop participants. Results: We describe three main themes: Co-production in action: organic origins and trusted foundations; Co-production processes embedded in equal partnership; and Impact of the workshops. Fundamental to co-production processes was the community-led approach of the local charity, the trust of the local South Asian community and the relationship between the charities, including transparent communication and mutual respect. The workshops were reported to be useful and enjoyable, engendering a sense of agency and connection and helped disseminate awareness and knowledge through the community, benefitting the wider system. Conclusions: Co-production can help widen access to advance care planning. Findings offer an in-depth example of co-production-in-action to inform intervention development and research. [ABSTRACT FROM AUTHOR]

Introduction: There are many recognised benefits of public involvement, including more relevant research. The COVID‐19 pandemic highlighted the existing health inequalities and disparities in access to care and treatment for under‐served groups, necessitating meaningful and sustainable approaches to engaging them in health research. However, there is limited guidance to suggest what groundwork and processes are necessary for initiating such projects. This paper outlines the practical approaches taken to initiate a community involvement project scheme and offers key recommendations from this work. Methods: The National Institute for Health and Care Research (NIHR) Health Protection Research Unit established a community involvement scheme in 2021, funding four community involvement projects enabling researchers to engage with under‐served communities. Reflections were captured through regular quarterly meeting group discussions, meeting notes and email correspondence. Results: The paper presents the steps taken to initiate a scheme that provided funding for a diverse range of projects working with under‐served communities. The projects demonstrated the value of allocating time to build relationships and trust, maintaining flexibility, and providing short‐term benefits such as remuneration and training to the community. Discussion: This paper has highlighted the need for research organisations to allocate funding and resources within their infrastructures for building trusting relationships with community leaders and communities. Conclusion: This paper has outlined the steps undertaken to engage with under‐served communities to bridge the gap between public health research and those communities. We present key recommendations to guide future initiatives aspiring to engage under‐served communities in health research. Patient or Public Contribution: Public contributors have been involved in all of the four community involvement projects mentioned in this paper. Two public contributors are also co‐authors and have provided input to the writing and review of this manuscript. [ABSTRACT FROM AUTHOR]

Background: The true burden of acute lower respiratory tract disease (aLRTD; includes acute lower respiratory tract infection [aLRTI] and presumed non-infective exacerbations of chronic lung disease and heart failure) among adults presenting to primary care, and the proportion that are potentially vaccine preventable is unknown. Aim: To describe aLRTD incidence in adults presenting to primary care; estimate proportions caused by respiratory syncytial virus (RSV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and Streptococcus pneumoniae (SP); and investigate disease burden from patient and NHS perspectives. Design & setting: Primary care prospective cohort study conducted in six representative general practices (total ~86 000 registered adults) in Bristol, UK. Method: Adults (aged =18 years) registered at participating general practices and presenting to primary care (in-hours or out-of-hours) or emergency department (if not admitted) with aLRTD will be eligible. They will be identified by real-time primary care record searches. Researchers will screen electronic GP records, including free text, contact patients to assess eligibility, and offer enrolment in a surveillance study and an enhanced diagnostic study (urine, saliva, and respiratory samples; physical examination; and symptom diaries). Data will be collected for all aLRTD episodes, with patients assigned to one of three arms: surveillance; embedded diagnostic; and descriptive dataset. Outcome measures will include clinical and pathogen-defined aLRTD incidence rates, symptom severity and duration, NHS contacts and costs, health-related quality-of-life changes, and mortality (=30 days post-identification). Conclusion: This comprehensive surveillance study of adults presenting to primary care with aLRTD, with embedded detailed data and sample collection, will provide an accurate assessment of aLRTD burden due to vaccine-preventable infections. [ABSTRACT FROM AUTHOR]

Empowering families of children with autism spectrum disorder through education and training is best practice. A wide range of Parent Education and Training programmes are delivered around the globe, but there is limited knowledge about the characteristics of these programmes, or about the research methods and outcomes used to evaluate them, particularly in countries outside the United States. We, therefore, performed a scoping review of all peer-reviewed Parent Education and Training publications outside the United States. A search was conducted between March and May 2017. Four reviewers extracted data and performed a mixed-methods quality appraisal of publications. Thirty-seven publications representing 32 unique programmes were identified. Publications described a highly diverse range of Parent Education and Training programmes across 20 countries and all continents except South America. The majority were group-based, but varied significantly in goals, modalities and duration. The majority of studies (86.4%) reported positive outcomes in relation to the core study objectives and only two studies reported some negative findings. Quality appraisal rated only 27% of studies to have met all the methodological quality criteria. Implementation factors such as manualisation, fidelity and cost were commented on infrequently. In spite of the clear need for Parent Education and Training programmes, our findings show that the research evidence-base in autism spectrum disorder outside the United States is relatively small, non-representative and in need of methodological quality improvements.

Background: Identity provides a useful conceptual lens for understanding educational inequalities in science, technology, engineering and mathematics (STEM). In this paper, we examine how paying attention to physical and digital 'materiality' enriches our understanding of identity work, by going beyond the spoken, written and embodied dimensions of identity performances that currently dominate the area of STEM identity scholarship. We draw on a multimodal ethnographic study with 36 young people aged 11-14 carried out over the course of one year at four UK-based informal STEM learning settings. Data collection included a series of interviews, observations and youth-created portfolios focused on STEM experiences. Illustrative case studies of two young men who took part in a community-based digital arts centre are discussed in detail through the theoretical lenses of Judith Butler's "identity performativity" and Karen Barad's "intra-action." Results: We argue that physical and digital materiality mattered for the performances of 'tech identity' in that (i) the focus on the material changed our understanding of tech identity performances; (ii) digital spaces supported identity performances alongside, with and beyond physical bodies, and drew attention to new forms of identity recognition; (iii) identity performances across spaces were unpredictable and contained by the limits of material possibilities; and (iv) particular identity performances associated with technology were aligned with dominant enactments of masculinity and might thus be less accessible to some young people. Conclusions: We conclude the paper by suggesting that accounting for materiality in STEM identity research not only guides researchers in going beyond what participants say and are observed doing (and thus engendering richer insights), but also offers more equitable ways of enacting research. Further, we argue that more needs to be done to support the translation of identity resources across spaces, such as between experiences within informal and online spaces, on the one hand, and formal education, on the other.

A large and growing population of students with autism is increasingly pursuing higher education. Yet, the field has a remarkably small literature base from which to glean actionable insights that might enhance postsecondary success for this population. The examination of 13,000 items published in sixteen journals over a sixteen-year period revealed only 21 articles on the topic; none were published in mainstream higher education journals. The explication of this literature maps the contours of the emerging body of literature on college students with autism, uncovers problematic patterns within that literature, identifies important questions that remain unanswered, and provides explicit guidance for future research on the topic.

EarlyBird and EarlyBird Plus are parent education and training programmes designed by the UK National Autistic Society in 1997 and 2003, having been delivered to more than 27,000 families in 14 countries. These group-based programmes aim to (1) support parents immediately after diagnosis of autism spectrum disorder, (2) empower parents, encouraging a positive perception of their child's autism spectrum disorder and (3) help parents establish good practice. In the absence of any previous comprehensive review, we performed a scoping review of all peer-reviewed publications on EarlyBird/EarlyBird Plus. A search was conducted between February and June 2016 using EbscoHost, Sabinet, SAGE Journals, Directory of Open Access Journals, BioMed Central, Scopus, ScienceDirect and grey literature. Two reviewers independently screened titles and abstracts for inclusion. In total, 18 articles were identified: 16 from the United Kingdom and 2 from New Zealand. We reviewed the context, study populations, design, outcome measures, whether focus was on parental perception, parental change or child changes and programme feasibility. Strong parental support for the acceptability but lower level evidence of efficacy of EarlyBird/EarlyBird Plus was found. Future research should consider randomised controlled trials. There is no research on EarlyBird/EarlyBird Plus in low-resource settings; therefore, we recommend broader feasibility evaluation of EarlyBird/EarlyBird Plus including accessibility, cultural appropriateness and scalability.

This article describes how a homework task on climate change is being developed as part of a larger project on sustainability issues -- Urban Science. The ultimate aim of this European project is to improve the teaching of scientific enquiry so that students develop the competences to actively contribute to creating sustainable cities, to understand how cities consist of linked systems that affect each other and to gain scientific skills for employment, thereby becoming more motivated to study science. It was found that students can research and present information in spider diagrams and relate this to everyday life. Although this was at a relatively high level, they were not linking different aspects of climate change. The idea of creating a 'messy wall' from the students' work during stage 1 of the Urban Science project is discussed.

Drawing on my research of Luton Fair Trade Town, in this article I argue that faith communities, working in partnership with Fair Trade Towns, are well-placed to raise awareness of sustainable development. I will discuss the ability of faith communities to raise awareness and bring about change towards sustainable development, utilizing both social and spiritual capital. An analysis focusing on social capital highlights the ability of faith communities to bridge different sections of society, issues and geographies. Spiritual capital concentrates on the motivation to action and this can provide a challenge to the status quo and a vision of how society can work differently, offering a necessary contribution to working towards a sustainable future. [ABSTRACT FROM AUTHOR]

This article proposes an innovative analytical framework for understanding memory work in oral history interviews with migrants who experienced the Troubles in Northern Ireland before migrating to Britain. Integrating theories of diasporic subjectivity from migration studies with conceptual developments in oral history and current research on memory, temporality and the history of emotions, it focuses on transnational dynamics in 'travelling memories' of the Troubles brought to Britain by first-generation migrants; the long temporal 'afterlife of feelings' attached to conflict memories; and the process of 'associative diffraction' whereby chronologically sequential memories are interrupted, fragmented and recombined in achronological sequences linking diverse temporal moments and spatial locations. The utility of these concepts is explored in an intensive analysis of memory dynamics and subjectivity in a single interview, with Siobhán O'Neill, who grew up Catholic, working-class and queer in nationalist/republican West Belfast at the epicentre of conflict violence, and moved to London in 1986. The article argues that the specificities of individual migration stories such as Siobhán's resist conventional generalisation, and offers a new theoretical and methodological framework for the systematic investigation of quotidian experiences, memories and silences that are unexplored in the established historiographies of the Troubles and the Irish diaspora in Britain. [ABSTRACT FROM AUTHOR]

A core goal for most learning analytic projects is to move from small-scale research towards broader institutional implementation, but this introduces a new set of challenges because institutions are stable systems, resistant to change. To avoid failure and maximize success, implementation of learning analytics at scale requires explicit and careful consideration of the entire TEL [technology-enhanced learning] technology complex: the different groups of people involved, the educational beliefs and practices of those groups, the technologies they use, and the specific environments within which they operate. It is crucial not only to provide analytics and their associated tools, but also to begin with a clear strategic vision, assess institutional culture critically, identify potential barriers to adoption, develop approaches that can overcome these, and put in place appropriate forms of support, training, and community building. In this paper, we offer tools and case studies that will support educational institutions in deploying learning analytics at scale with the goal of achieving specified learning and teaching objectives. The ROMA [RAPID Outcome Mapping Approach] Framework offers a step-by-step approach to the institutional implementation of learning analytics and this approach is grounded here by case studies of practice from the UK and Australia.

Going via Bernard Stiegler's theorisation of technology, and his response to Chris Anderson's claim that the era of hyper-networked, algorithmically driven digital technologies signals the end of theory, this paper aims to place the educational practice of networked learning as a space to think the edge, excess or limit of this proposed algorithmic dominance. The author discusses how networked learning can negotiate the border between educational theory, the practice of teaching and learning, and the processes and systems of educational technology, but suggests that to do this it must engage these disciplines through a thinking of technology which does not decide upon its status in advance. He argues that affirming this particular relation to technology is increasingly urgent given we are at a moment in which educational institutions are asking how to prepare our students for an age of continuing technological disruption.

Nature-based solutions are increasingly advocated to mitigate climate change and biodiversity loss, while improving ecosystem resilience and providing additional ecosystem services. In Scotland, woodland expansion and restoration of degraded peatlands are expected to play a major role in meeting net-zero emissions by 2045 and have prompted debates about the impact of increased woodland cover and prescribed fire on the biodiversity and ecosystem services provided by upland landscapes. In alignment with national policy, the Cairngorms National Park, the UK's largest national park, has committed to an ambitious programme of woodland expansion and peatland restoration in a landscape dominated by heather moorlands that is predominantly managed through prescribed burning for game management. Using the Native Woodland Model and the InVest modelling platform, we assessed the effects of five land cover and land use change scenarios, with different levels of prescribed fire regulation and woodland expansion, to evaluate their benefits and costs on biodiversity and carbon sequestration. Results show that changing the extent and management of habitats will result in different carbon sequestration pathways, as well as biodiversity winners and losers. The scenario presenting greater benefits for the conservation of biodiversity also has lower above-ground carbon sequestration potential and a larger negative impact on red grouse habitats, thus being less profitable to sporting estates. Hence, trade-offs will be necessary to achieve optimal carbon sequestration and biodiversity gains, with a potential role played by the continuation of prescribed fires and traditional moorland management practices as well as complementary grants and support measures based on biodiversity benefits rather than carbon sequestration. The results from this study could support discussions regarding future management of the uplands, trade-offs between loss of carbon in soils, carbon sequestration in woodlands and conservation of biodiversity, as well as stakeholders likely to be affected. [ABSTRACT FROM AUTHOR]

Aims With an ageing population, the presence of asymptomatic valvular heart disease (VHD) in the community remains unknown. The aim of this study is to determine the prevalence and associated factors of asymptomatic VHD in individuals ≥60 years old and to evaluate the feasibility of echocardiographic screening for VHD in this population. Methods and results This was a prospective cohort study conducted between 2007 and 2016 in the UK. Asymptomatic patients with no prior indication for echocardiography were invited to participate and evaluated with a health questionnaire, clinical examination, and transthoracic echocardiography. A total of 10,000 individuals were invited through their general practices. A total of 5429 volunteered to participate, of whom 4237 were eligible for inclusion. VHD was diagnosed in more than a quarter of patients (28.2%). The most common types of VHD were regurgitation of the tricuspid (13.8%), mitral (12.8%), and aortic (8.3%) valves (trivial regurgitation was not included). The rate of prevalence of clinically significant VHD was 2.4% (2.2% moderate and 0.2% severe), with mitral and aortic regurgitation being the most common. The only parameter associated with significant VHD was age (odds ratio 1.07 per 1 year increment, 95% confidence interval 1.05–1.09, P < 0.001). The number needed to scan to diagnose one clinically significant case of VHD is 42 for individuals ≥60 and 15 for those ≥75 years old. Conclusion Asymptomatic VHD is present in a significant proportion of otherwise healthy individuals without known VHD over 60 years old. Age is strongly associated with an increased incidence of significant VHD. [ABSTRACT FROM AUTHOR]

The article reviews the development and purpose of the Great Britain Multidisciplinary Head and Neck Cancer Guidelines, highlighting their role in standardizing care and improving outcomes through a multidisciplinary approach. It also discusses the nature of head and neck cancers, the impact of HPV on cancer incidence, and the organization of head and neck cancer services and patient management.

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease for which signs and symptoms have a negative impact on a patient's quality of life (QoL) and mental health. Here, we assess the impact of lebrikizumab on QoL and mental health after 16 weeks of treatment in patients with moderate-to-severe AD. Methods: Data were analyzed over 16 weeks from two separate phase 3, randomized, placebo-controlled, monotherapy trials (ADvocate1 and ADvocate2). Patient-reported outcomes were assessed using the following measures: Dermatology Life Quality Index (DLQI), EQ-5D-5L visual analogue scale (VAS), EQ-5D-5L index scores (UK and US), Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, and PROMIS Depression. Results: Treatment with lebrikizumab 250 mg every 2 weeks in two studies led to statistically significant improvements (based on nominal p values) versus placebo in DLQI since week 4 (the first timepoint assessed) for the following measures: change from baseline in DLQI total score (ADvocate1 − 7.8 vs − 2.8; ADvocate2 − 7.3 vs − 3.9), proportion of patients with DLQI ≥ 4-point improvement (ADvocate1 69.5% vs 36.2%; ADvocate2 60.5% vs 42.6%), DLQI total score ≤ 5 (ADvocate1 36.7% vs 8.8%; ADvocate2 29.6% vs 10.8%), and DLQI (0, 1) (ADvocate1 12.3% vs 1.7%; ADvocate2 9.2% vs 1.7%). Improvements in DLQI measures, EQ-5D-5L index scores (UK and US), and EQ-5D-5L VAS were sustained through week 16. Additionally, lebrikizumab improved PROMIS Anxiety and PROMIS Depression scores, and improvements were higher in patients with at least a mild score (≥ 55) versus placebo for PROMIS Anxiety (ADvocate1 − 7.43 vs − 1.51; ADvocate2 − 4.95 vs − 0.82) and PROMIS Depression (ADvocate1 − 7.42 vs − 2.46; ADvocate2 − 4.28 vs − 2.00). Conclusions: Treatment with monotherapy 250 mg lebrikizumab for 16 weeks provided clinically meaningful improvements in outcomes related to QoL and mental health for patients with moderate-to-severe AD. Lebrikizumab-treated patients reported improvements in DLQI as early as week 4, the first measure since baseline. Trial Registration: ClinicalTrials.gov Registration NCT04146363 (ADvocate1) and NCT04178967 (ADvocate2). [ABSTRACT FROM AUTHOR]

Recent river studies in the United Kingdom have observed an increase in riparian vegetation and its potential impact on river channel change and sedimentation. Here, we quantify changes in floodplain and riparian vegetation during the first two decades of the 21st century along reaches of eight gravel‐bed rivers in England and Wales that exhibit varied active and stable, single and multi‐thread planforms. The analysis employs information drawn from open‐access sources including national LiDAR surveys and the photographic analysis of repeat aerial and satellite imagery. Most reaches show an increase in woody vegetation across their floodplains reflecting both natural colonisation and deliberate planting, and all but one of the reaches show an increase in woody riparian vegetation cover along their riverbanks. Of the six reaches that have exposed riverine sediments, five show a reduction in exposed sediment area as a result of vegetation encroachment. Contrasts in the rate, extent and location of riparian change were associated with the stability of the channel planform, with differences seen between stable and more active reaches. The significance of riparian woodland in promoting riverbank stability is demonstrated. Riparian vegetation development varies between river reaches, largely in response to differing rates of channel movement but also because of multiple and diverse local decisions regarding the management of in‐channel and channel‐adjacent vegetation by landowners rather than a single national policy. We consider the relevance of our findings and the value of remote monitoring for future river management interventions. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the effectiveness of a highly individualized morphosyntactic intervention using the SHAPE CODING™ system delivered at different dosages. Method: Eight children with developmental language disorder aged 8;0–10;10 (years;months) received 10 hr of explicit individualized intervention for morphosyntax delivered in 30-min individual sessions once per week for 20 weeks. Following at least four baseline probe tests, two grammatical targets per session received explicit instruction until they reached criterion (90%), when the next target was introduced. To control for session length and teaching episode density, either both targets received 20 teaching episodes per session or one target received 10 teaching episodes and the other 30. Maintenance testing of completed targets was also carried out. Results: Scores on probe tests post-intervention were significantly higher than during the baseline phase (d = 1.6) with no change during the baseline or maintenance phases. However, progress during the intervention phase was highly significant. One participant showed significantly faster progress with intervention, while one (with the lowest attention score) made little progress. When considering progress relative to cumulative intervention sessions, progress was faster with 30 teaching episodes per session and slower with 10. However, when cumulative teaching episodes were used as the predictor, all three within-session dosages showed very similar rates of progress, with the odds of a correct response increasing by 3.9% for each teaching episode. The targets that were achieved required an average of 40–60 teaching episodes. Conclusions: With the exception of one participant, the individualized intervention was highly effective and efficient. Thus, the individualized target identification process and intervention method merit further research in a larger group of children. The cumulative number of teaching episodes per target provided across sessions appeared to be key. Thus, clinicians should aim for high teaching episode rates, particularly if the number of sessions is constrained. Otherwise, intervention scheduling can be flexible. [ABSTRACT FROM AUTHOR]

Recent scholarship has highlighted the heterogeneity of second-generation Irish identities in Great Britain, yet the varieties of self-identification espoused by the English-raised children of Northern Irish parents remain almost wholly unexplored. This article redresses this neglect by examining the relationship between parentally transmitted memories of the Northern Ireland Troubles (c.1969–1998) and the forms of identity and self-understanding that such children develop during their lives in England. Drawing on original oral history testimony and using the concepts of narrative inheritance and postmemory as interpretive tools, it demonstrates the complex correlation that exists between parents' diverse approaches to memory-sharing and their children's negotiation of inherited conflict memory as they position themselves discursively within contemporary English society. Based on a close reading of five oral history interviews, the analysis reveals a spectrum of creative postmemory practices and identity enactments, whereby narrators agentively define themselves in relation to the meanings they attribute to inherited memories, or the dearth thereof, as they navigate their tangled transnational affinities and allegiances. The article also explores how these practices and enactments are subtly responsive to narrators' changing relationships to their narrative inheritances as their experience and awareness of their own and their parents' lives deepen over the life course. [ABSTRACT FROM AUTHOR]

Understanding equitable practice is crucial for science education since science, technology, engineering, and mathematics (STEM) fields and STEM learning practices remain significantly marked by structural inequalities. In this paper, building on theories of discourse and situated meaning developed by Foucault, Gee, and Sedgewick, we explore how educators navigated discourses about social justice in informal science learning (ISL) across four UK sites. We draw on qualitative, multimodal data across 5 years of a research–practice partnership between a university, a zoo, a social enterprise working to support girls and nonbinary youth in STEM, a community digital arts center, and a science center. We identify three key discourses that shaped social justice practices across all four practice–partner sites: (1) "inclusion" for STEM, (2) "inclusion" for the institution, and (3) "inclusion" for minoritized youth. We discuss how educators (n = 17) enacted, negotiated, resisted, and reworked these discourses to create equitable practice. We argue that while the three key discourses shaped the possible meanings and practices of equitable ISL in different ways, educators used their agency and creativity to develop more expansive visions of social justice. We discuss how the affordances, pitfalls, and contradictions that emerged within and between the three discourses were strategically navigated and disrupted by educators to support the minoritized youth they worked with, as well as to protect and promote equity in ISL. This paper contributes to research on social justice in ISL by grounding sometimes abstract questions about power and discourse in ISL educators' everyday work. [ABSTRACT FROM AUTHOR]

Infants, children and young people with life-limiting or life-threatening conditions often experience acute, transient pain episodes known as breakthrough pain. There is currently no established way to assess breakthrough pain in paediatric palliative care. Anecdotal evidence suggests that it is frequently underdiagnosed and undertreated, resulting in reduced quality of life. The development of a standardised paediatric breakthrough pain assessment, based on healthcare professionals' insights, could improve patient outcomes. This study aimed to explore how healthcare professionals define and assess breakthrough pain in paediatric palliative care and their attitudes towards a validated paediatric breakthrough pain assessment. This was a descriptive qualitative interview study. Semi-structured interviews were conducted with 29 healthcare professionals working in paediatric palliative care across the UK. An inductive thematic analysis was conducted on the data. Five themes were generated: 'the elusive nature of breakthrough pain', 'breakthrough pain assessment', 'positive attitudes towards', 'reservations towards' and 'features to include in' a paediatric breakthrough pain assessment. The definition and assessment of breakthrough pain is inconsistent in paediatric palliative care. There is a clear need for a validated assessment questionnaire to improve assessment, diagnosis and management of breakthrough pain followed by increased healthcare professional education on the concept. [ABSTRACT FROM AUTHOR]

There are growing levels of abuse toward match officials in sport as well as general problems of their recruitment and retention. Purpose: This study analyzes the role that physical and nonphysical abuse has on association football referees' intentions to quit and their personal well-being. Methods: Drawing on pooled survey data of association football referees from the UK and Canada, this paper employs probit, ordinary least squares, and treatment effects regression analyses to explore the casual relationship between the physical and nonphysical abuse faced by referees, their intention to quit and their well-being. Results: Although physical abuse is less common than nonphysical abuse both affect the intention to quit and well-being of officials. Moreover, those that do not contemplate quitting also face reductions in their well-being. Conclusion: The research recommends a zero-tolerance approach to all forms of abuse of officials in sport and identifies that organizations have a duty of care for the well-being of their officials. [ABSTRACT FROM AUTHOR]

Introduction: Pre‐exposure prophylaxis (PrEP) is an effective medication to reduce the risk of acquiring HIV. PrEP is available free of charge in the UK from sexual health clinics. Expanding PrEP delivery to community pharmacies holds promise and aligns with UK government goals to eliminate new cases of HIV by 2030. The aim of this scoping review was to describe the existing evidence about the barriers to and facilitators of community pharmacy oral PrEP delivery, for pharmacists and pharmacy clients, as aligned with the Capacity Opportunity, Motivation Behaviour (COM‐B) Model. Methods: Five bibliographic and five review databases were searched from inception to August 2023. Literature of any study design was included if it discussed barriers and facilitators of community pharmacy PrEP delivery. Trial registrations, protocols and news articles were excluded. Results: A total of 649 records were identified, 73 full texts were reviewed and 56 met the inclusion criteria, predominantly from high‐income/westernized settings. Most of the included literature was original research (55%), from the United States (77%) conducted during or after the year 2020 (63%). Barriers to PrEP delivery for pharmacists included lack of knowledge, training and skills (capability), not having the necessary facilities (opportunity), concern about the costs of PrEP and believing that PrEP use could lead to risk behaviours and sexually transmitted infections (motivation). Facilitators included staff training (capability), time, the right facilities (opportunity), believing PrEP could be a source of profit and could reduce new HIV acquisitions (motivation). For clients, barriers included a lack of PrEP awareness (capability), pharmacy facilities (opportunity) and not considering pharmacists as healthcare providers (motivation). Facilitators included awareness of PrEP and pharmacist's training to deliver it (capability), the accessibility of pharmacies (opportunity) and having an interest in PrEP (motivation). Discussion: To effectively enhance oral PrEP delivery in UK community pharmacies, the identified barriers and facilitators should be explored for UK relevance, addressed and leveraged at the pharmacy team, client and care pathway level. Conclusions: By comprehensively considering all aspects of the COM‐B framework, community pharmacies could become crucial providers in expanding PrEP accessibility, contributing significantly to HIV prevention efforts. [ABSTRACT FROM AUTHOR]

Background: Long-term sickness costs businesses in the United Kingdom (UK) approximately £7 billion per annum. Most long-term sickness absences are attributed to common mental health conditions, which are also highly prevalent in people with acute or musculoskeletal health conditions. This study will pilot the IGLOo (Individual, Group, Leaders, Organisation, overarching context) intervention which aims to support workers in returning to and remaining in work following long-term sickness absence. The potential impact of the intervention is a timely return to work (main trial primary outcome) and prevention of a further episode of long-term sick leave. The intervention will be piloted in a randomised controlled trial (RCT) to examine the feasibility of the intervention (pilot trial primary outcome) and to inform a fully powered definitive trial to evaluate sustainable return to work (RTW) in people with primary or secondary mental ill-health who go on long-term sick leave. Methods and design: A two-arm feasibility randomised controlled trial (with a 30-month study period including 12-month follow-up) of the IGLOo intervention will be conducted in large organisations (≥ 600 workers) from the Yorkshire and Humberside regions, in the UK. Eight consenting organisations will be recruited and randomised to the intervention or control arms of the study (1:1 ratio), with a minimum recruitment target of 13 workers eligible to participate from each. Organisations assigned to the control group will continue with their usual practice. Feasibility data will include data collected on recruitment, retention and attrition of participants; completion of research outcome measures; and intervention compliance. Measurements of mental health, RTW, work outcomes, quality-of-life, workplace support and communication and other demographic data will be taken at baseline, 3, 6, 9 and 12 months in all participants. Qualitative interviews and survey data with all participants will explore the experiences of participants, acceptability of the intervention components and evaluation measures. Exploratory economic evaluation will be conducted to further inform a definitive trial. Discussion: The findings from this pilot study will help to inform the development of a definitive cluster RCT designed to examine the efficacy of this intervention on health and work-related outcomes in UK workers on long-term sick leave. Trial registration: ISRCTN11788559 (prospectively registered, date registered 6 October 2022) [ABSTRACT FROM AUTHOR]

Application of an integrated spatial approach combining several sources of remote sensing data to include both channel and floodplain morphological and sedimentological impacts has identified the geomorphological effects of three extreme flood events during a single flood season (2019–2020) along a 16‐km reach of the River Teme, UK. This combined approach allowed the assessment of in‐channel pattern development, incision and aggradation; lateral bank migration; and overbank sedimentation and scour by out‐of‐channel flows. Rates of change during the event period were compared with those in the previous 10 years. The approach also allowed the role of vegetation and cultivation, both bankside and out on floodplains, to be assessed with variations in the extent of riparian wood and channel slope driving contrasts in the extent of the response. The spatial impacts from such extreme events are highly localised, varied in kind, and can be considered for both rivers and floodplains together. Erosional effects were distinctively distributed and not simply contributions to ongoing meander development; channel aggradation was localised, and overbank sedimentation explicably patchy. In reaches without woody vegetation, differences in channel and floodplain slope, local floodplain relief as created by prior events, and the impact of man‐made structures were factors that drove variations in flood response. This study strongly underlines the role of continuous riparian vegetation in maintaining bank stability and constraining lateral channel migration, but also to the potential influence of floodplain vegetation and planting for 'natural engineering' in the context of floodplains as well as channels in comparable environments. Maintenance of riparian vegetation in the context of landowner and Natural England conflict and management of future flood risk is important, but also highlighted is the need to consider the role of hedgerows and wider planting for constraining soil and riverbank erosion during flood events. [ABSTRACT FROM AUTHOR]

Exhaled human breath can contain small, elevated concentrations of methane (CH4) and nitrous oxide (N2O), both of which contribute to global warming. These emissions from humans are not well understood and are rarely quantified in global greenhouse gas inventories. This study investigated emissions of CH4 and N2O in human breath from 104 volunteers in the UK population, to better understand what drives these emissions and to quantify national-scale estimates. A total of 328 breath samples were collected, and age, sex, dietary preference, and smoking habits were recorded for every participant. The percentage of methane producers (MPs) identified in this study was 31%. The percentage of MPs was higher in older age groups with 25% of people under the age of 30 classified as MPs compared to 40% in the 30+ age group. Females (38%) were more likely to be MPs than males (25%), though overall concentrations emitted from both MP groups were similar. All participants were found to emit N2O in breath, though none of the factors investigated explained the differences in emissions. Dietary preference was not found to affect CH4 or N2O emissions from breath in this study. We estimate a total emission of 1.04 (0.86–1.40) Gg of CH4 and 0.069 (0.066–0.072) Gg of N2O in human breath annually in the UK, the equivalent of 53.9 (47.8–60.0) Gg of CO2. In terms of magnitude, these values are approximately 0.05% and 0.1% of the total emissions of CH4 and N2O reported in the UK national greenhouse gas inventories. [ABSTRACT FROM AUTHOR]

Context The adrenocorticotropin hormone stimulation test (AST) is used to diagnose adrenal insufficiency, and is often repeated in patients when monitoring recovery of the hypothalamo–pituitary–adrenal axis. Objective To develop and validate a prediction model that uses previous AST results with new baseline cortisol to predict the result of a new AST. Methods This was a retrospective, longitudinal cohort study in patients who had undergone at least 2 ASTs, using polynomial regression with backwards variable selection, at a Tertiary UK adult endocrinology center. Model was developed from 258 paired ASTs over 5 years in 175 adults (mean age 52.4 years, SD 16.4), then validated on data from 111 patients over 1 year (51.8, 17.5) from the same center, data collected after model development. Candidate prediction variables included previous test baseline adrenocorticotropin hormone (ACTH), previous test baseline and 30-minute cortisol, days between tests, and new baseline ACTH and cortisol used with calculated cortisol/ACTH ratios to assess 8 candidate predictors. The main outcome measure was a new test cortisol measured 30 minutes after Synacthen administration. Results Using 258 sequential ASTs from 175 patients for model development and 111 patient tests for model validation, previous baseline cortisol, previous 30-minute cortisol and new baseline cortisol were superior at predicting new 30-minute cortisol (R 2 = 0.71 [0.49-0.93], area under the curve [AUC] = 0.97 [0.94-1.0]) than new baseline cortisol alone (R 2 = 0.53 [0.22-0.84], AUC = 0.88 [0.81-0.95]). Conclusion Results of a previous AST can be objectively combined with new early-morning cortisol to predict the results of a new AST better than new early-morning cortisol alone. An online calculator is available at https://endocrinology.shinyapps.io/sheffield%5fsst%5fcalculator/ for external validation. [ABSTRACT FROM AUTHOR]

Increasing evidence suggests that individuals develop their understanding of science concepts in and out of school, using varied community resources and networks. Thus in contrast to historic research approaches that focus exclusively on single organizations and/or educational events, the current paper presents exploratory research in which we utilized specific community ecology analytical tools and approaches to describe and analyze the U.K. science education community as a whole. Data suggest that overall the U.K. science education community is highly interconnected, and collaborative within individual sectors and moderately interconnected and collaborative between sectors; schools and to a lesser degree universities were outliers to this pattern. An important conclusion was that management to maximize the effectiveness of science education the U.K. science education community would involve support for continued diversification of the number of science education entities in the system and encouragement of reciprocally collaborative, synergistic relationships. We posit that systemic research enables a broader, more comprehensive view of a system's strengths and weaknesses, offering useful insights into the structure and functioning of science education activities; insights that could help researchers, practitioners, and policy makers improve the overall quality of science education delivery for all.

On June 23rd 2016 the UK voted to leave the European Union. The period leading up to the referendum was characterized by a significant volume of misinformation and disinformation. Existing literature has established the importance of cognitive ability in processing and discounting (mis/dis) information in decision making. We use a dataset of couples within households from a nationally representative UK survey to investigate the relationship between cognitive ability and the propensity to vote Leave / Remain in the 2016 UK referendum on European Union membership. We find that a one standard deviation increase in cognitive ability, all else being equal, increases the likelihood of a Remain vote by 9.7%. Similarly, we find that an increase in partner's cognitive ability further increases the respondent's likelihood of a Remain vote (7.6%). In a final test, restricting our analysis to couples who voted in a conflicting manner, we find that having a cognitive ability advantage over one's partner increases the likelihood of voting Remain (10.9%). An important question then becomes how to improve individual and household decision making in the face of increasing amounts of (mis/dis) information. [ABSTRACT FROM AUTHOR]

Systematic differences in the attitudes of men and women towards risk is well established. In this paper, we investigate the joint role of two prominent psychological characteristics in explaining this difference. Our starting point is that risk assessments can be thought of, in general terms, to combine beliefs about the probability of negative outcomes occurring with a subjective valuation of how painful that negative outcome would be. Exploiting large‐scale panel data from the United Kingdom, we find that gender differences in financial optimism and financial loss aversion – the stronger psychological response to monetary losses than monetary gains – explain a substantial proportion of the parallel gender difference in willingness to take risks. This result prevails even after controlling for the Big Five personality traits, suggesting that the prominent psychological characteristics capture different aspects of behaviour than the Big Five. [ABSTRACT FROM AUTHOR]

Objectives Glucocorticoids (GCs) ('steroids') are used to treat rheumatic diseases but adverse effects are common. We aimed to explore the impact of GC therapy on health-related quality of life (HRQoL), to inform the development of a treatment-specific patient-reported outcome measure (PROM) for use in clinical trials and practice. Methods Semi-structured qualitative interviews were conducted with patients from the UK, USA and Australia, treated for a rheumatic condition with GCs in the last 2 years. Purposive sampling was used to select participants with a range of demographic and disease features. An initial conceptual framework informed interview prompts and cues. Interviews elicited GC-related physical and psychological symptoms and salient aspects of HRQoL in relation to GC therapy. Interview data were analysed inductively to develop initial individual themes and domains. Candidate questionnaire items were developed and refined. Results Sixty semi-structured qualitative interviews were conducted (UK n  = 34, USA n  = 10, Australia n  = 16). The mean age was 58 years; 39/60 were female; and 18 rheumatic diseases were represented. Some 126 individual themes were identified and organized into six domains: physical symptoms; psychological symptoms; psychological impact of steroids; impact of steroids on participation; impact of steroids on relationships; and benefits of steroids. Candidate questionnaire items were tested and refined by piloting with patient research partners, iterative rounds of cognitive interviews and linguistic translatability assessment, informing a draft questionnaire. Conclusion We describe an international qualitative study to develop candidate items for a treatment-specific PROM for patients with rheumatic diseases. A future survey will enable the validation of a final version of the PROM. [ABSTRACT FROM AUTHOR]

Purpose: At the outset of the COVID-19 pandemic the United Kingdom Government implemented a policy to rapid discharge hospital patients into care homes. This study aimed to examine how the media in the United Kingdom portrayed hospital discharge to care homes during the COVID-19 pandemic. Design/methodology/approach: This study was a qualitative document analysis. Four sources (Daily Mail, The Independent, The Guardian and BBC News) were selected to represent political orientations encompassing right-wing, centrist and left-wing perspectives, and were searched for mention of hospital discharge, care homes and Covid-19 pandemic between 1st January 2020 and 24th February 2022. Article text was copied verbatim into Microsoft Word documents prior to analysis. Data were thematically analysed, followed by coding the sentiment in the included articles as well as coding the sentiment of themes and sub-themes. Findings: Of 722 identified articles, 133 were eligible for inclusion as the final corpus. Data represented a moralistic narrative consisting of four themes: (1) Government as villain, (2) care homes as antiheroes, (3) patients as ideal victims and (4) moral outcomes. Most of the corpus had a negative sentiment (78.1%). One theme, moral outcomes, had considerably more positive sentiment (32.4%) than others (range 15.1%–21.9%). Originality/value: A moralistic argument for improving cross-boundary interactions between health and social care services is provided, and the media can play a role pushing cross-boundary working higher up the policy agenda. Future work should examine how direct stakeholders, including those working in healthcare and care home settings, perceived the discharge policy. [ABSTRACT FROM AUTHOR]

Background: The British Association of Critical Care Nurses (BACCN) published its first position statement on non‐medical prescribing (NMP) in critical care in 2009 (Bray et al., Nurs Crit Care. 2009;14:224‐234). Over the years, more nurses and other health care professionals have become non‐medical prescribers, and the BACCN have thus revisited and updated the statement. Aim: To update the 2009 position statement on NMP in critical care to reflect contemporary guidance and practice. Study design: A working group was established following an expression of interest to BACCN members, and the original BACCN position statement and literature review were updated using key databases. An electronic questionnaire was developed by the working group to describe current NMP practises and the authorization and prescribing of blood and blood components. It was distributed via email to 1861 BACCN members and on BACCN social media in October and November 2021. Results: Two hundred and fifty nine health care professionals from the four countries of the United Kingdom completed the survey, and of these 136 (52.5%) respondents were BACCN members. One hundred and five (40.4%) of the respondents described themselves as non‐medical prescribers, and of these, 57 (54.8%) were independent prescribers and 47 (45.2%) were supplementary and independent prescribers, with one respondent not revealing. The remaining 154 (59.4%) respondents were not registered as non‐medical prescribers. Ninety‐one (86.7%) of the respondents who were non‐medical prescribers reported making prescribing decisions on every clinical shift, and 67 (64.4%) of these audited their prescribing practises. Of the 105 who described themselves as non‐medical prescribers, 71 (67.6%) had been in their area of practice for more than 5 years before they became non‐medical prescribers, with 3 (2.8%) being in the practise area for less than 1 year. All seven statements from Bray et al's (2009) position statement were revised and updated following the survey results and review of the literature search. Conclusions: The updated position statement is based upon new policy documents from a range of sources, including the Nursing and Midwifery Council, the Faculty of Intensive Care Medicine, the Royal College of Emergency Medicine and the Royal Pharmaceutical Society. It takes account of the adult critical care patient pathway before, during and after an admission to critical care. Relevance to clinical practice: Non‐medical prescribing (NMP) should only be implemented to improve the safety and quality of care for the critically ill or deteriorating patient. The requirement for NMP needs to be determined locally by organizations, ensuring that the care of the critically ill and deteriorating patient is the main reason. NMP must not be used as a substitute for unsafe medical practice or poor medical prescribing practice. Non‐medical prescribers must adhere to the current Royal Pharmaceutical Society's Prescribing Competency Framework and must be registered with their professional regulatory body. Non‐medical prescribers must audit and evaluate their practice as well as ensuring continuing professional development. Non‐medical prescribers in critical care must consider how their own professional codes of conduct, scope of practice, standards and guidelines impact their prescribing decisions. Non‐medical prescribers must work collaboratively to ensure that continuity and transfer of care between care settings consider deprescribing and medicines reconciliation. [ABSTRACT FROM AUTHOR]

A wide range of work has reported on the outcomes of public engagement activities and the views expressed by public participants towards specific areas of science and technology. Such work has rarely gone on to explore with public participants their attitudes to the engagement experienced itself, often focusing instead on more practical or quantifiable aspects. This article draws on public participants' reactions to 11"'engagement" events, occurring across the UK in 2007-2008. Reporting on 33 semi-structured interviews, we focus on their views of participation and engagement in terms of motivations, expectations and expertise. The results suggest that participants have considerable expectations in terms of information and interaction, operate with critical but respectful notions of other "publics" and expertise, and may develop habitual tendencies regarding engagement.

Purpose: The purpose of this paper is to propose meta-synthetic ideas and knowledge asset management approaches to build a comprehensive strategic framework for Beijing City in China. Design/methodology/approach: Methods include a review of relevant literature in both English and Chinese, case studies of different types of support frameworks in the UK, the USA, Singapore and Hong Kong, formulation of a meta-synthetic support framework for Beijing City, and justification of its application to policy development by various studies. Three stages of meta-synthetic support frameworks are proposed. Findings: The suggested meta-synthetic support frameworks are highly appropriate for the optimisation of, and innovation in, management and services systems of government information resources. The proposed knowledge asset management approaches offer significant practical value in improving the competence and capabilities of service-oriented government, providing a set of solutions to identified, urgent problems, including a joint administration system for creating value, a release and distribution management system for sharing and protecting value, and a licensing and authorisation management system for adding value. Research limitations/implications: This paper focuses on the formulation of a theoretical support framework for the reuse of government information resources and the justification of its effectiveness to guide policy development at strategic level. Case studies of its application at operational level are ongoing and will be discussed in future papers. Practical implications: The suggested meta-synthetic support frameworks support the efficiency, effectiveness and economy of intelligent traffic administration, good governance of value-added services based on government information resources, and intellectual activity around city travel and traffic. The study has wide implications for the improvement of service-oriented government performance, public satisfaction and the image of government. Originality/value: The paper presents the adaptation of meta-synthetic ideas and knowledge asset management approaches to collaboration, optimisation, innovation and compliance management issues in the reuse of government information resources. The advantages of different types of support systems and frameworks are integrated as a coherent whole for a strategic framework of legal, regulatory and standards support to China and Beijing. (Contains 3 figures and 3 tables.)

Despite the burgeoning rhetoric from political, social and educational commentators regarding creativity and learning and teaching, there is a paucity of scalable and measurable examples of creativity-centric pedagogical practice. This paper makes an argument for the application of social network visualisations to inform and support creativity-enabling pedagogical practice. This paper first describes social networks and how they relate to creative capacities and learning as a social process. It then provides an initial case study of how social network analysis may be meaningfully applied to evaluate students' learning networks and creative capacities, and elaborates on how such an evaluative resource can allow educators to design and implement creativity-enabling pedagogical practice. In so doing, this paper contributes conceptual, methodological and empirical advances that can take learning and teaching for creativity, particularly in higher education, beyond rhetoric towards more observable and measurable mainstream pedagogical practice. (Contains 1 figure and 5 tables.)

This article presents one English local authority's educational psychology service's approach to supporting children and young people's psychological well-being. Evidence for the effectiveness of the therapeutic approaches adopted by one intervention (the Child Behaviour Intervention Initiative [CBII]) is presented. The statistical analysis indicates positive impact and suggests the interventions are highly effective. The local authority is a pathfinder for the Targeted Mental Health in School Project (a United Kingdom government funded initiative to support children with developing mental health difficulties). The interventions being run through this programme are outlined and early impact indicated. The paper uses these examples to demonstrate how educational psychology services can practically support children's mental health and psychological well-being outside the classroom. (Contains 5 notes and 5 tables.)

In this paper we critically review recent developments in policies, practices and philosophies pertaining to the mediation between science and the public within the EU and the UK, focusing in particular on the current paradigm of Public Understanding of Science and Technology (PEST) which seeks to depart from the science information-transmission associated with previous paradigms, and enact a deliberative democracy model. We first outline the features of the current crisis in democracy and discuss deliberative democracy as a response to this crisis. We then map out and critically review the broad outlines of recent policy developments in public-science mediation in the EU and UK contexts, focusing on the shift towards the deliberative-democratic model. We conclude with some critical thoughts on the complex interrelationships between democracy, equality, science and informal pedagogies in public-science mediations. We argue that science and democracy operate within distinct value-spheres that are not necessarily consonant with each other. We also problematize the now common dismissal of information-transmission of science as inimical to democratic engagement, and argue for a reassessment of the role and importance of informal science learning for the "lay" public, provided within the framework of a deliberative democracy that is not reducible to consensus building or the mere expression of opinions rooted in social and cultural givens. This, we argue, can be delivered by a model of PEST that is creative and experimental, with both educational and democratic functions.