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Much has been written about why students engage in academic studies at university, with less attention given to the concept of disengagement. Understanding the risks and factors associated with student disengagement from learning provides opportunities for targeted remediation. The aims of this review were to (i) explore how student disengagement has been conceptualised, (ii) identify factors associated with disengagement, and (iii) identify measureable indicators of disengagement in previous literature. A systematic search was conducted across relevant databases and key websites. Reference lists of included papers were screened for additional publications. Studies and national published survey data were included if they addressed issues pertaining to student disengagement with learning or the academic environment, were in full text and in English. In the 32 papers that met the inclusion criteria, student disengagement was conceptualised as a multi-faceted, complex yet fluid state that has a combination of behavioural, emotional and cognitive domains influenced by intrinsic (psychological factors, low motivation, inadequate preparation for higher education, and unmet or unrealistic expectations) or extrinsic (competing demands, institutional structure and processes, teaching quality and online teaching and learning). A number of measurable indicators of disengagement were synthesised from the literature including those that were self-reported by students and those collected by a number of tertiary institutions. An examination of the conceptualisation, influences and indicators of disengagement could inform intervention programs to ameliorate the consequences of disengagement for students and academic institutions.

We describe the development of an evidence-based motor intervention and an implementation pilot study in ten primary schools, involving 515 children (4-11 years). 'Helping Handwriting SHINE' (HHS) is a novel, school-led, group-based handwriting intervention. Teaching staff delivered HHS and provided feedback through a questionnaire, reporting that: (i) the children found the tasks enjoyable; (ii) the background and booklet instructions were easy to understand, (iii) there was a need for more comprehensive staff training. The teaching staff made recommendations about session duration, group size, resource availability, and age differentiation of tasks. These suggestions are applicable to the development of any school-based group-led motor intervention, and we used this feedback to refine the HHS intervention. This study shows that implementing school-led motor interventions at scale is possible. Moreover, the work provides insights into the factors to consider when developing school-based motor interventions prior to conducting randomized controlled trials (RCT). The process outlined in this manuscript has led to an RCT to test the effectiveness of HHS within primary schools.

Evidence suggests that children struggle to acquire age-appropriate fundamental movement skills (FMS), despite their importance for facilitating physical activity. This has led to calls for routine school-based screening of children's FMS. However, there is limited research exploring schools' capacity to conduct such assessments. This study investigated what factors might affect the adoption and implementation of FMS assessments in primary schools. School staff (n = 853) completed an online questionnaire developed using the Capability, Opportunity, Motivation and Behavior (COM-B) model. A majority reported that knowledge of pupils' FMS ability would be beneficial (65.3%), and 71.8% would assess FMS if support was provided. Barriers included: Capability -- few possessed knowledge of FMS (15%); Opportunity -- teachers reported 30-60 minutes as acceptable for assessing a class, a substantially shorter period than current assessments require; Motivation -- 57.2% stated FMS assessments would increase workload stress. Solutions to these issues are discussed using the COM-B theoretical framework.

There has been recent interest in the relationship between socioeconomic status and the diagnosis of autism in children. Studies in the United States have found lower rates of autism diagnosis associated with lower socioeconomic status, while studies in other countries report no association, or the opposite. This article aims to contribute to the understanding of this relationship in the United Kingdom. Using data from the Born in Bradford cohort, comprising 13,857 children born between 2007 and 2011, it was found that children of mothers educated to A-level or above had twice the rate of autism diagnosis, 1.5% of children (95% confidence interval: 1.1%, 1.9%) compared to children of mothers with lower levels of education status 0.7% (95% confidence interval: 0.5%, 0.9%). No statistically significant relationship between income status or neighbourhood material deprivation was found after controlling for mothers education status. The results suggest a substantial level of underdiagnosis for children of lower education status mothers, though further research is required to determine the extent to which this is replicated across the United Kingdom. Tackling inequalities in autism diagnosis will require action, which could include increased education, awareness, further exploration of the usefulness of screening programmes and the provision of more accessible support services.

• 150 mock jurors viewed bloodstain pattern analysis evidence. • Split into two groups, the test group also viewed a 3D flythrough of the scene. • The test group had significantly better knowledge retention. • There was no significant difference in emotion and confidence between the groups. There are numerous crime scene investigation applications of 3D scanning that have been previously documented. This paper documents the application of a 3D point cloud in the presentation of Bloodstain Pattern Analysis evidence to mock jurors. 150 mock jurors viewed a presentation of Bloodstain Pattern Analysis evidence from a murder trial in the UK. After viewing the evidence, the participants were tested on their knowledge of the evidence and repeated the test again 2 weeks later; to simulate criminal trial conditions; whereby there is a time lapse between the initial viewing of evidential material and deliberation. This paper found that the mock jurors who additionally viewed a 3D flythrough of a point cloud of the crime scene, better retained knowledge of the evidence over time, reported a greater ability to visualise the crime scene and had higher levels of interest in the evidence. Crucially, the 3D flythrough group did not report different levels of confidence in the accuracy of their memories of the evidence, nor different levels of emotional arousal to the group that viewed the evidence without the 3D presentation. Together, these findings suggest that 3D scanning of crime scenes, and the resultant point cloud's presentation to jurors, could add further value to the justice system when spatial information, such as Bloodstain Pattern Analysis evidence, is presented. [ABSTRACT FROM AUTHOR]

Despite widely‐reported ethnicity disparities in pay and occupational attainment, little is known about how different ethnic groups fare in job control—a crucial component of job quality with significant implications for well‐being and health. Drawing on two large‐scale representative datasets in the United Kingdom (1992–2022), we find that workers from all Black, Asian, and Minority Ethnic (BAME) groups conditionally report significantly lower job control than their White British counterparts, although heterogeneity exists depending on the BAME group in question. Ethnicity penalties are also most pronounced for foreign‐born workers. Despite a slow trend towards convergence, ethnicity disparities have remained significant over the last three decades. We further show that disparities are largely unexplained by compositional factors such as pay and occupation, demonstrating ethnicity penalties in job control. By linking ethnicity to job control, this study contributes to the growing research on BAME workers in the labour market, as well as the literatures on job quality and multisegmented labour markets. [ABSTRACT FROM AUTHOR]

Old age is associated with poorer movement skill, as indexed by reduced speed and accuracy. Nevertheless, reductions in speed and accuracy can also reflect compensation as well as deficit. We used a manual tracing and a driving task to identify generalized spatial and temporal compensations and deficits associated with old age. In Experiment 1, participants used a hand-held stylus to trace a path. In Experiment 2, participants steered along paths in a virtual reality driving simulator. In both experiments, participants were required to stay within the boundaries while we manipulated task difficulty by changing path width or movement speed. The older group showed worse performance in the highly constrained conditions. Corner cutting effectively reduces the curvature of bends but yields a greater risk of error (i.e., clipping the path or road edge). Corner cutting is thus less risky on wider paths, and we found that corner cutting increased for both age groups in both tasks when paths were wider. Crucially, we observed a greater degree of corner cutting in the young group compared with the old, suggesting the old group compensated for decreased motor skill with "middle-of-the-road" behavior. Enforcing increased speed caused all participants to increase corner cutting. Thus, older participants showed spatial compensation for decreased skill by biasing their position toward the middle of the path in both a manual and steering task. External constraints (narrow paths and fast speeds) prevented this strategy and revealed age-related declines in skills central to manual control and driving. (Contains 5 figures, 2 tables and 2 footnotes.)

Combining existing knowledge of museum exhibition visitor experience with concepts of User Experience (UX), a model for Museum Exhibition User Experience (MEUX) is presented. The model was developed from research interviews and surveys with UK museum professionals and presents the museum exhibition experience from both museum and visitor perspectives. Its use as an evaluation tool for visitor experience is explored at Oxford University Museum of Natural History (OUMNH). In comparing results with those from staff, a disconnect emerged between museum and visitor preferences on motivations for visiting and what outcomes emerge from visits. The incorporation of the theoretical MEUX model into museum practice enables holistic conceptualization of the visitor experience through the pragmatic and hedonic qualities of an exhibition. With the development of further evaluation tools, this framework and methodology accurately captures institutional and visitor preferences and can evaluate how the development decisions of museums influence and impact the visitor experience. [ABSTRACT FROM AUTHOR]

Sociologists have long been interested in the meaning workers derive from their jobs. The issue has garnered increasing academic and policy attention in recent years with the concept of "meaningful work," yet little is known about how social stratification relates to access to it. This paper addresses this issue by exploring how the meaningfulness of jobs—as rated by their incumbents—is stratified across classes and occupations in a national survey of 14,000 working adults in the United Kingdom. It finds modest differentials between classes, with those in routine and manual occupations reporting the lowest levels of meaningfulness and those in managerial and professional occupations and small employers and own account workers reporting the highest levels. Detailed job attributes (e.g., job complexity and development opportunities) explain much of the differences in meaningfulness between classes and occupations, and much of the overall variance in meaningfulness. The main exception is the specific case of how useful workers perceive their jobs to be for society: A handful of occupations relating to health, social care, and protective services which cut across classes stand out from all other occupations. The paper concludes that the modest stratification between classes and occupations in meaningful work is largely due to disparities in underlying job complexity and development opportunities. The extent to which these aspects of work can be improved, and so meaningfulness, especially in routine and manual occupations, is an open, yet urgent, question. [ABSTRACT FROM AUTHOR]

Background: In England, the onset of COVID-19 and a rapidly increasing infection rate resulted in a lockdown (March-June 2020) which placed strict restrictions on movement of the public, including children. Using data collected from children living in a multi-ethnic city with high levels of deprivation, this study aimed to: (1) report children's self-reported physical activity (PA) during the first COVID-19 UK lockdown and identify associated factors; (2) examine changes of children's self-reported PA prior to and during the first UK lockdown. Methods: This study is part of the Born in Bradford (BiB) COVID-19 Research Study. PA (amended Youth Activity Profile), sleep, sedentary behaviours, daily frequency/time/destination/activity when leaving the home, were self-reported by 949 children (9–13 years). A sub-sample (n = 634) also self-reported PA (Physical Activity Questionnaire for Children) pre-pandemic (2017-February 2020). Univariate analysis assessed differences in PA between sex and ethnicity groups; multivariable logistic regression identified factors associated with children's PA. Differences in children's levels of being sufficiently active prior to and during the lockdown were examined using the McNemar test; and multivariable logistic regression was used to identify factors explaining change. Results: During the pandemic, White British (WB) children were more sufficiently active (34.1%) compared to Pakistani Heritage children (PH) (22.8%) or 'Other' ethnicity children (O) (22.8%). WB children reported leaving the home more frequently and for longer periods than PH and O children. Modifiable variables related to being sufficiently active were frequency, duration, type of activity, and destination away from the home environment. There was a large reduction in children being sufficiently active during the first COVID-19 lockdown (28.9%) compared to pre-pandemic (69.4%). Conclusions: Promoting safe extended periods of PA everyday outdoors is important for all children, in particular for children from ethnic minority groups. Children's PA during the first COVID-19 UK lockdown has drastically reduced from before. Policy and decision makers, and practitioners should consider the findings in order to begin to understand the impact and consequences that COVID-19 has had upon children's PA which is a key and vital behaviour for health and development. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to address the question of why organizations do not uniformly apply pay for performance (PFP) throughout the organization, focusing on the wider occupational structure in which they and the jobs they create are embedded. The authors propose a model of "occupational differentiation" whereby the probability of a job within a given organization having PFP increases with the levels of monitoring difficulty and requisite human asset specificity characterizing the occupation to which a job belongs, being highest in occupations characterized by high levels of both (generally managerial and professional occupations). Design/methodology/approach: Using the Workplace Employment Relations Survey (a nationally representative matched employer–employee dataset for Britain), this paper investigates this question for all 350 occupations delineated by the UK's Office for National Statistics using regression methods that adjust for other confounding factors such as demographic factors and workplace fixed effects. Findings: The authors find organizations "occupationally differentiate" the use of PFP in ways consistent with the model, i.e. PFP is most likely to be found in occupations characterized by both high monitoring difficulty and high requisite human asset specificity (mainly managerial and professional occupations) and least likely in occupations scoring low in both. The finding holds across PFP types (individual, group, organizational), whether organizations are large or small, and hold across most industrial sectors. Research limitations/implications: The main implication of this study is that organizations appear to be taking into consideration whether the wider profession to which a job belongs when implementing PFP, irrespective of their own human resource management strategies and organizational context. There are a few limitations to this study, with the main one being that this model is mainly confined to empirical support is only found in the private sector. The public sector appears to be beyond the reach of the model, where PFP implementation is generally rarer. A second limitation is that the dataset is from 2011 and only covers a single country. Practical implications: Given organizations appear to be implementing PFP based on occupation, this may lead to equity concerns, as different groups are being treated differently within organizations based upon their occupational group. Social implications: As PFP jobs tend to pay more than non-PFP jobs and PFP prevalence has been growing, by being more likely to implement it for generally high-paid groups (generally higher managerial and professional occupations), PFP may contribute to wider pay differentials within and between organizations. Originality/value: By introducing the occupational-level of analysis and the differential nature of tasks across occupational groups, the model offers a new midrange, sociological perspective to understanding intra-organizational dynamics in PFP use and potentially human resource practices more broadly. [ABSTRACT FROM AUTHOR]

Background: Fluid and vasopressor management in septic shock remains controversial. In this randomized controlled trial, we evaluated the efficacy of dynamic measures (stroke volume change during passive leg raise) to guide resuscitation and improve patient outcome.Research Question: Will resuscitation that is guided by dynamic assessments of fluid responsiveness in patients with septic shock improve patient outcomes?Study Design and Methods: We conducted a prospective, multicenter, randomized clinical trial at 13 hospitals in the United States and United Kingdom. Patients presented to EDs with sepsis that was associated hypotension and anticipated ICU admission. Intervention arm patients were assessed for fluid responsiveness before clinically driven fluid bolus or increase in vasopressors occurred. The protocol included reassessment and therapy as indicated by the passive leg raise result. The control arm received usual care. The primary clinical outcome was positive fluid balance at 72 hours or ICU discharge, whichever occurred first.Results: In modified intent-to-treat analysis that included 83 intervention and 41 usual care eligible patients, fluid balance at 72 hours or ICU discharge was significantly lower (-1.37 L favoring the intervention arm; 0.65 ± 2.85 L intervention arm vs 2.02 ± 3.44 L usual care arm; P = .021. Fewer patients required renal replacement therapy (5.1% vs 17.5%; P = .04) or mechanical ventilation (17.7% vs 34.1%; P = .04) in the intervention arm compared with usual care. In the all-randomized intent-to-treat population (102 intervention, 48 usual care), there were no significant differences in safety signals.Interpretation: Physiologically informed fluid and vasopressor resuscitation with the use of the passive leg raise-induced stroke volume change to guide management of septic shock is safe and demonstrated lower net fluid balance and reductions in the risk of renal and respiratory failure. Dynamic assessments to guide fluid administration may improve outcomes for patients with septic shock compared with usual care.Clinical Trial Registration: NCT02837731. [ABSTRACT FROM AUTHOR]

Higher managerial and professional occupations are now the most incentivized occupational class in Britain. It is not yet known whether the rise in pay for performance (PFP) signifies an erosion or enhancement in the 'service relationship' that purportedly characterizes these occupations. Taking an occupational class perspective, this article investigates the implications of the rise in PFP for the employment relationship and conditions of work across the occupational structure using two nationally representative datasets. In fixed-effects estimates, PFP is found to heavily substitute base earnings in non-service class occupations, but not in service class occupations. PFP jobs generally have no worse conditions relative to non-PFP jobs within occupational classes. The article concludes the rise in PFP should be conceptualized more as a form of 'rent sharing' for service class occupations, enhancing the service relationship, and as a form of 'risk sharing' for non-service class occupations. [ABSTRACT FROM AUTHOR]

Background: Severe iodine insufficiency in pregnancy has significant consequences, but there is inadequate evidence to indicate what constitutes mild or moderate insufficiency, in terms of observed detrimental effects on pregnancy or birth outcomes. A limited number of studies have examined iodine status and birth outcomes, finding inconsistent evidence for specific outcomes.Methods: Maternal iodine status was estimated from spot urine samples collected at 26-28 weeks' gestation from 6971 mothers in the Born in Bradford birth cohort. Associations with outcomes were examined for both urinary iodine concentration (UIC) and iodine-to-creatinine ratio (I:Cr). Outcomes assessed included customised birthweight (primary outcome), birthweight, small for gestational age (SGA), low birthweight, head circumference and APGAR score.Results: There was a small positive association between I:Cr and birthweight in adjusted analyses. For a typical participant, the predicted birthweight centile at the 25th percentile of I:Cr (59 μg/g) was 2.7 percentage points lower than that at the 75th percentile of I:Cr (121 μg/g) (99% confidence interval (CI) 0.8 to 4.6), birthweight was predicted to be 41 g lower (99% CI 13 to 69) and the predicted probability of SGA was 1.9 percentage points higher (99% CI 0.0 to 3.7). There was no evidence of associations using UIC or other birth outcomes, including stillbirth, preterm birth, ultrasound growth measures or congenital anomalies.Conclusion: Lower maternal iodine status was associated with lower birthweight and greater probability of SGA. Whilst small, the effect size for lower iodine on birthweight is comparable to environmental tobacco smoke exposure. Iodine insufficiency is avoidable, and strategies to avoid deficiency in women of reproductive age should be considered.Trial Registration: ClinicalTrials.gov NCT03552341. Registered on June 11, 2018. [ABSTRACT FROM AUTHOR]

Introduction: International clinical guidelines for Complex Regional Pain Syndrome recommend a wide range and variation of rehabilitation therapies as the core treatment. It is likely that most therapists employ a range of approaches when managing people with Complex Regional Pain Syndrome but a recent Cochrane review identified little evidence relating to the effectiveness of multi-modal rehabilitation. There is need for up to date trials of rehabilitation for Complex Regional Pain Syndrome, but in order to develop a clear model of best practice that can be rigorously evaluated we need to understand current practice. Method: An electronic survey was disseminated internationally to clinicians involved in the rehabilitation of individuals with Complex Regional Pain Syndrome. The survey aimed to establish which criteria are used for diagnosis and which modalities clinicians use to treat Complex Regional Pain Syndrome and which they consider ineffective or harmful. Results: 132 valid responses were received. A third of participants did not use any established criteria to diagnose Complex Regional Pain Syndrome. Current practice commonly included patient education, encouragement of self-management, and physical exercises. Cortically directed treatments such as graded motor imagery and psychological approaches were often incorporated into treatment whereas pain provocative therapies, splinting, contrast bathing, and cold and heat therapy were rarely used in the acute or chronic phase of Complex Regional Pain Syndrome. Conclusion: A broad range of modalities are currently used in Complex Regional Pain Syndrome rehabilitation. Practice appears to be characterized by educational and exercise based interventions delivered in a pain-contingent manner which largely echoes recommendations in international clinical guidelines. Implications for Rehabilitation:: Patients with Complex Regional Pain Syndrome suffer from a painful and disabling condition for which we still do not know the best treatment options. From our survey sample most clinicians use treatments recommended in the international guidelines. A large proportion of clinicians from our survey sample are not using internationally recognized diagnostic criteria and we therefore recommend that clinicians become familiar with these criteria and use them for all suspected Complex Regional Pain Syndrome cases. [ABSTRACT FROM AUTHOR]

There has been recent interest in the relationship between socioeconomic status and the diagnosis of autism in children. Studies in the United States have found lower rates of autism diagnosis associated with lower socioeconomic status, while studies in other countries report no association, or the opposite. This article aims to contribute to the understanding of this relationship in the United Kingdom. Using data from the Born in Bradford cohort, comprising 13,857 children born between 2007 and 2011, it was found that children of mothers educated to A-level or above had twice the rate of autism diagnosis, 1.5% of children (95% confidence interval: 1.1%, 1.9%) compared to children of mothers with lower levels of education status 0.7% (95% confidence interval: 0.5%, 0.9%). No statistically significant relationship between income status or neighbourhood material deprivation was found after controlling for mothers education status. The results suggest a substantial level of underdiagnosis for children of lower education status mothers, though further research is required to determine the extent to which this is replicated across the United Kingdom. Tackling inequalities in autism diagnosis will require action, which could include increased education, awareness, further exploration of the usefulness of screening programmes and the provision of more accessible support services. [ABSTRACT FROM AUTHOR]

Occupations traditionally played a central role in stratification accounts. In the wake of the Great Recession, debates regarding the extent and nature of occupational stratification have been reinvigorated. An exploration of occupational wage stratification patterns defined by both detailed occupational unit groups and the broader occupational class categories of the National Statistics Socio-Economic Classification (NS-SEC) reveals the proportion of wage inequality between occupations and occupational classes has remained broadly stable 1997 to 2015. No compelling evidence is found for growing wage inequalities between detailed occupations within NS-SEC categories. This article underlines the continued utility of occupations and particularly the NS-SEC grouping of them in describing the structure of stratification in contemporary Britain. [ABSTRACT FROM AUTHOR]

Most of the literature on strikes has addressed one of four issues: causation, variation between sectors and countries, trends over time and the relationship between strikes and other forms of collective and individual protest. Very little research has addressed the equally important questions of strike outcomes and trade union membership despite the substantial body of research on the causes of trade union membership decline and strategies for membership growth. In this paper we reverse the usual sequence of trade union membership as a causal factor in the genesis of strikes and examine the impact of strikes on trade union membership levels. After setting out the relevant theory and hypotheses, we use a unique seven-year dataset of trade union membership joiners and leavers from a major British trade union with a substantial record of strike activity. Controlling for other possible determinants of trade union membership, we find that months in which there is strike action, whether national or local, are associated with a significantly higher rate of membership growth, measured both by the number of joiners and by the ratio of joiners to leavers. Data from new union members suggest that perceived injustice and perceived union effectiveness both motivate the decision to join. [ABSTRACT FROM AUTHOR]

Background: The anatomy of the anterior cruciate ligament (ACL) has become the subject of much debate. There has been extensive study into attachment points of the native ligament, especially regarding the femoral attachment. Some of these studies have suggested that fibers in the ACL are of differing functional importance. Fibers with higher functional importance would be expected to exert larger mechanical stress on the bone. According to Wolff's law, cortical thickening would be expected in these areas. Purpose: To examine cortical thickening in the region of the ACL footprint (ie, the functional footprint of the ACL). Study Design: Descriptive laboratory study. Methods: Using micro-computed tomography with resolutions ranging from 71 to 91 μm, the cortical thickness of the lateral wall of the intercondylar notch in 17 cadaveric knees was examined, along with surface topography. After image processing, the relationship between the cortical thickening and surface topology was visually compared. Results: A pattern of cortical thickening consistent with the functional footprint of the ACL was found. On average, this area was 3 times thicker than the surrounding bone and significantly thicker than the remaining lateral wall (P < .0001). This thickening was roughly elliptical in shape (with a mean centroid at 23.5 h :31 t on a Bernard and Hertel grid) and had areas higher on the wall where greater thickness was present. The relationship to previously reported osseous landmarks was variable, although the patterns were broadly consistent with those reported in previous studies describing direct and indirect fibers of the ACL. Conclusion: The findings of this study are consistent with those of recent studies describing fibers in the ACL of differing functional importance. The area in which the thickening was found has been defined and is likely to represent the functional footprint of the ACL. Clinical Relevance: This information is of value to surgeons when determining the optimal place to position the femoral attachment site of the reconstructed ACL. [ABSTRACT FROM AUTHOR]

Motor coordination impairments frequently co-occur with other developmental disorders and mental health problems in clinically referred populations. But does this reflect a broader dimensional relationship within the general population? A clearer understanding of this relationship might inform improvements in mental health service provision. However, ascertainment and referral bias means that there is limited value in conducting further research with clinically referred samples. We, therefore, conducted a cross-sectional population-based study investigating children's manual coordination using an objective computerised test. These measures were related to teacher-completed responses on a behavioural screening questionnaire [the Strength and Difficulties Questionnaire (SDQ)]. We sampled 298 children (4-11 years old; 136 males) recruited from the general population. Hierarchical (logistic and linear) regression modelling indicated significant categorical and continuous relationships between manual coordination and overall SDQ score (a dimensional measure of psychopathology). Even after controlling for gender and age, manual coordination explained 15 % of the variance in total SDQ score. This dropped to 9 % after exclusion of participants whose SDQ responses indicated potential mental health problems. These results: (1) indicate that there is a clear relationship between children's motor and mental health development in community-based samples; (2) demonstrate the relationship's dimensional nature; and (3) have implications for service provision. [ABSTRACT FROM AUTHOR]

The move from IP-based authentication to that of federated access has seen the sector support single sign-on to web-based resources, but the simplified user experience is at risk due to the rapid growth of mobile platforms and increasing variety of accompanying access methods for such devices. The user authentication experience on mobile devices is often further complicated by the poor discovery and delivery design of websites. While the introduction of tools such as Raptor permit accurate tracking of usage statistics via the UK Access Management Federation, the variety of mobile authentication methods such as native apps on devices and device paring pose additional challenges to librarians trying to gather a complete picture of resource use within their institution. In this article we examine the access challenges posed by the explosion of mobile device use. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to evaluate the reproducibility of the cervical range of motion device when measuring both active and passive range of motion in a group of individuals with sub-acute Whiplash Associated Disorders (WAD). Methods: Participants were recruited as part of a large multi-centre Randomised Controlled Trial from UK emergency departments. Experienced research physiotherapists measured active and passive cervical spine movements in all directions. Both intra- and inter-observer reliability and agreement were assessed using the intra-class correlation coefficient, standard error of measurement and limits of agreement methods. Results: Different groups of 39 and 19 subjects were included in the intra and inter-observer studies, respectively. The CROM device demonstrated substantial intra- and inter-observer reliability and agreement for all the active and passive half-cycle movements (ICC range 0.82-0.99) with the exception of one (passive right lateral flexion for inter-observer; ICC 0.77). Conclusions: The CROM device has proven to be a reproducible measurement method for a symptomatic WAD population using the measurement protocol described and can be used with confidence to differentiate individuals according to a single measurement. [ABSTRACT FROM AUTHOR]

Interest in curricula addressing alternative agricultural production and marketing systems has grown among students and faculty at post-secondary institutions. In 2005, an interdisciplinary team from the University of Kentucky (UK) received a USDA Higher Education Challenge Grant to establish a curriculum in sustainable agriculture. In doing so, UK sought to join the growing number of postsecondary institutions with courses, concentrations and majors in alternative agricultural production and marketing systems. Some of these academic offerings arose as areas of specialized study within productionoriented agricultural science disciplines. More recent courses and programs tend to reflect a more holistic approach that incorporates social, economic, and natural resource management considerations. The UK team blended these approaches to produce a curriculum that would appeal to students within and beyond the College of Agriculture and support the transition of the state's small farmers to a posttobacco economy. Combining the core elements of an agricultural science degree with requirements in the cultural dimensions of sustainability demanded clear definitions and priorities. The UK team adopted the USDA Sustainable Agriculture Research and Education Program's definition of sustainability as a management system that optimizes environmental, economic, and social resources to improve a farm's performance over time. Introduced in 2007, the curriculum combined requirements in agricultural, natural, and social sciences with an apprenticeship on an organically managed community supported agriculture project. [ABSTRACT FROM AUTHOR]

Abstract: Microfossils recovered from chalk tesserae in mosaics from the Roman town of Calleva Atrebatum, modern Silchester, southern England, are used to suggest a provenance for the source-rock. The microfossils include foraminifera characteristic of late Cretaceous (Campanian) foraminiferal biozone BGS20 (quadrata macrofaunal biozone) and foraminiferal subzone BGS21i (basal mucronata macrofaunal biozone). Calcareous nannofossil assemblages from the same tesserae are poorly preserved, preventing precise age determination, but confirm an age of Santonian to Campanian. As indurated chalk beds of this age are not normally present in the stratigraphically higher chalks of southern England, it is probable that calcretised chalk, formed by secondary calcification beneath Palaeogene rock cover, was used to manufacture the tesserae. This suggestion is supported by a comparative analysis of chalk tesserae from the Norden Roman site in Dorset. Although the provenance of the chalk in some of the Silchester tesserae can be placed only within a broad geographical area of downland in southern England, others may have originated in the Dorchester–Swanage area, some 100km to the southwest of Silchester, or the Portsdown area of southern Hampshire. None of the tesserae have been constructed from chalk found near Silchester. [Copyright &y& Elsevier]

The article presents the study which examined the results and cost effectiveness analysis of the fast track pathway in giant cell arteritis (GCA) that was introduced in 2012. The pathway is intended to lessen multiple referral routes, delayed review and treatment, as well as improve outcomes. In the study, the incremental cost effectiveness ratio (ICER) was used to compare the cost of fast-track pathway against the standard referral route.

Background: The aim of this study was to assess the acceptability, reliability, validity and responsiveness of the Short-Form Health Survey (SF-12) and its preference-based derivative (SF-6D), the EQ-5D and the Neck Disability Index (NDI) in patients recovering from acute whiplash injury.Methods: Data from the Managing Injuries of the Neck Trial of 3,851 patients with acute whiplash injury formed the basis of this empirical investigation. The EQ-5D and SF-12 were collected at baseline, and all three outcome measures were then collected at 4 months, 8 months and 12 months post-randomisation. The measures were assessed for their acceptability (response rates), internal consistency, validity (known groups validity and discriminant validity) and their internal and external responsiveness.Results: Response rates were broadly similar across the measures, with evidence of a floor effect for the NDI and a ceiling effect for the EQ-5D utility measure. All measures had Cronbach's α statistics of greater than 0.7, indicating acceptable internal consistency. The NDI and EQ-5D utility score correlated more strongly with the physical component scale of the SF-12 than the mental component scale, whilst this was reversed for the SF-6D utility score. The smaller standard deviations in SF-6D utility scores meant there were larger effect sizes for differences in utility score between patients with different injury severity at baseline than for the EQ-5D utility measure. However, the EQ-5D utility measure and NDI were both more responsive to longitudinal changes in health status than the SF-6D.Conclusions: There was no evidence of differences between the EQ-5D utility measure and NDI in terms of their construct validity, discriminant validity or responsiveness in patients with acute whiplash injury. However, both demonstrated superior responsiveness to longitudinal health changes than the SF-6D. [ABSTRACT FROM AUTHOR]

Background: Educational attainment in children with congenital heart disease (CHD) within the UK has not been reported, despite the possibility of school absences and disease-specific factors creating educational barriers., Methods and Results: Children were prospectively recruited to the Born in Bradford birth cohort between March 2007 and December 2010. Diagnoses of CHD were identified through linkage to the congenital anomaly register and independently verified by clinicians. Multivariable regression accounted for relevant confounders. Our primary outcome was the odds of 'below expected' attainment in maths, reading, and writing at ages 4-11 years.Educational records of 139 children with non-genetic CHD were compared with 11 188 age-matched children with no major congenital anomaly. Children with CHD had significantly higher odds of 'below expected' attainment in maths at age 4-5 years [odds ratio (OR) 1.64, 95% confidence interval (CI) 1.07-2.52], age 6-7 (OR 2.03, 95% CI 1.32-3.12), and age 10-11 (OR 2.28, 95% CI 1.01-5.14). Odds worsened with age, with similar results for reading and writing. The odds of receiving special educational needs support reduced with age for children with CHD relative to controls [age 4-5: OR 4.84 (2.06-11.40); age 6-7: OR 3.65 (2.41-5.53); age 10-11: OR 2.73 (1.84-4.06)]. Attainment was similar for children with and without exposure to cardio-pulmonary bypass. Lower attainment was strongly associated with the number of pre-school hospital admissions., Conclusion: Children with CHD have lower educational attainment compared with their peers. Deficits are evident from school entry and increase throughout primary school., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Objective: To describe early educational attainment and special educational needs (SEN) provision in children with major congenital anomaly (CA) compared with peers., Design: Analysis of educational data linked to the ongoing Born in Bradford cohort study. Confounders were identified via causal inference methods and multivariable logistic regression performed., Setting: Children born in Bradford Royal Infirmary (BRI), West Yorkshire., Patients: All women planning to give birth at BRI and attending antenatal clinic from March 2007 to December 2010 were eligible. 12 453 women with 13 776 pregnancies (>80% of those attending) were recruited. Records of 555 children with major CA and 11 188 without were linked to primary education records., Outcomes: Key Stage 1 (KS1) attainment at age 6-7 years in Maths, Reading, Writing and Science. SEN provision from age 4 to 7 years., Results: 41% of children with major CA received SEN provision (compared with 14% without), and 48% performed below expected standards in at least one KS1 domain (compared with 29% without). The adjusted odds of children with CA receiving SEN provision and failing to achieve the expected standard at KS1 were, respectively, 4.30 (95% CI 3.49 to 5.31) and 3.06 (95% CI 2.47 to 3.79) times greater than their peers. Those with genetic, heart, neurological, urinary, gastrointestinal and limb anomalies had significantly poorer academic achievement., Conclusions: These novel results demonstrate that poor educational attainment extends to children with urinary, limb and gastrointestinal CAs. We demonstrate the need for collaboration between health and education services to assess and support children with major CA, so every CA survivor can maximise their potential., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Disadvantage in early childhood (ages 0-5 years) is associated with worse health and educational outcomes in adolescence. Evidence on the clustering of these adverse outcomes by household income is scarce in the generation of adolescents born since the turn of the millennium. We aimed to describe the association between household income in early childhood and physical health, psychological distress, smoking behaviour, obesity, and educational outcomes at age 17 years, including the patterning and clustering of these five outcomes by income quintiles., Methods: In this population-based, retrospective cohort study, we used data from the Millennium Cohort Study in which individuals born in the UK between Sept 1, 2000, and Jan 1, 2002, were followed up. We collected data on five adverse health and social outcomes in adolescents aged 17 years known to limit life chances: psychological distress, self-assessed ill health, smoking, obesity, and poor educational achievement. We compared how single and multiple outcomes were distributed across early childhood quintile groups of income, as an indicator of disadvantage, and modelled the potential effect of three income-shifting scenarios in early childhood for reducing adverse outcomes in adolescence., Findings: We included 15 245 adolescents aged 17 years, 7788 (51·1%) of whom were male and 7457 (48·9%) of whom were female. Adolescents in the lowest income quintile group in childhood were 12·7 (95% CI 6·4-25·1) times more likely than those in the highest quintile group to have four or five adverse adolescent outcomes, with poor educational achievement (risk ratio [RR] 4·6, 95% CI 4·2-5·0) and smoking (3·6, 3·0-4·2), showing the largest single risk ratios. Shifting up to the second lowest, middle, and highest income groups would reduce multiple adolescent adversities by 4·9% (95% CI -23·8 to 33·6), 32·3% (-2·7 to 67·3), and 83·9% (47·2 to 120·7), respectively. Adjusting for parental education and single parent status moderately attenuated these estimates., Interpretation: Early childhood disadvantage is more strongly correlated with multiple adolescent adversities than any of the five single adverse outcomes. However, shifting children from the lowest income quintile group to the next lowest group is ineffective. Tackling multiple adolescent adversities requires managing early childhood disadvantage across the social gradient, with income redistribution as a central element of coordinated cross-sectoral action., Funding: UK Prevention Research Partnership., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licence. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Survivors of critical illness frequently experience long-term physical impairment, decreased health-related quality of life and low rates of return to employment. There has been limited investigation of the underlying problems affecting physical function post-intensive care unit (ICU) admission. Musculoskeletal (MSK) conditions may be complex in presentation, with ICU survivors potentially at greater risk of their development due to the rapid muscle mass loss seen in ICU. The MSK health state of ICU survivors and its impact on physical function remain largely unknown. The aim of the MSK-ICU study is to determine and characterise the MSK health state of ICU survivors 6 months following admission to ICU, in order to inform development of targeted rehabilitation interventions., Methods and Analysis: The MSK-ICU study is a multicentre prospective longitudinal cohort study, evaluating the MSK health state of ICU survivors 6 months after admission to ICU. The study consists of a primary study and two substudies. The primary study will be a telephone follow-up of adults admitted to ICU for more than 48 hours, collecting data on MSK health state, quality of life, employment, anxiety and depression and symptoms of post-traumatic stress disorder. The planned sample size is 334 participants. Multivariable regression will be used to identify prognostic factors for a worse MSK health state, as measured by the MSK-Health Questionnaire. In substudy 1, participants who self-report any MSK problem will undergo a detailed, in-person MSK physical assessment of pain, peripheral joint range of movement and strength. In substudy 2, participants reporting a severe MSK problem will undergo a detailed physical assessment of mobility, function and muscle architecture., Ethics and Dissemination: Ethical approval has been obtained through the North of Scotland Research Ethics Committee 2 (21/NS/0143). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media., Trial Registration Number: ISRCTN24998809., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Research informed by practice is more likely to have a greater impact on society. However, forensic cases are confidential and thus, real-life data regarding the details of violent crime is usually withheld from the public and academia. Through a partnership between the authors institution and a UK police service, casefiles from 78 criminal investigations from 2012 to 2020 involving Bloodstain Pattern Analysis (BPA) were examined and quantified. The most common methods of assault and weapons used were identified as well as the frequency of different bloodstain pattern classifications. The results of this study will help inform researchers and supply forensic training providers with data derived from forensic practice. Despite a significant body of literature exploring impact patterns and software for calculating the Area of Origin (AO), impact pattern was classified at only 22% of scenes, with sharp-force trauma being the most prevalent form of assault. This paper recommends a review of the BPA terminology, to include additional commonly encountered patterns that are not defined by the current standard., Competing Interests: Declarations of Interest The authors declare that they have no conflict of interest., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective: To describe the prevalence of factors related to well-being among primary school children in a deprived multiethnic community in the UK., Design and Participants: Cross-sectional survey of 15 641 children aged 7-10 years in Born in Bradford's Primary School Years study: whole-classroom samples in 89 Bradford primary schools between 2016 and 2019., Main Outcome Measures: Prevalence estimates by ethnicity (%, 95% CI) of single and multiple vulnerabilities in child well-being within and across four domains (Home, Family, Relationships; Material Resources; Friends and School; Subjective Well-being)., Results: Only 10% of children had no vulnerabilities in any domain of well-being; 10% had one or more vulnerabilities in all four domains. The highest prevalence estimates were for being bullied some or all of the time (52.7%, 95% CI: 51.9% to 53.4%), keeping worries to oneself (31.2%, 95% CI: 30.5% to 31.9%), having no park near home (30.8%, 95% CI: 30.1% to 31.5%) and worrying all the time about how much money their family has (26.3%, 95% CI: 25.6% to 27%). Boys were consistently significantly more likely than girls to report all of the vulnerabilities in the Home, Family and Family Relationships domain, and the majority of indicators in the other domains, and in all domains except Friends and School, boys were significantly more likely to have at least one vulnerability. Girls were significantly more likely to report not having many friends (16.7%, 95% CI: 15.9% to 17.6% vs 12.5%, 95% CI: 11.8% to 13.2%), being bullied some or all of the time (55.8%, 95% CI: 54.7% to 56.9% vs 49.7%, 95% CI: 48.6% to 50.8%) and feeling left out all the time (12.1%, 95% CI: 11.4% to 12.8%) versus (10.3%, 95% CI: 9.7% to 11.0%). Variations in vulnerabilities by ethnicity were complex, with children in black, Asian and minority ethnic groups sometimes reporting more vulnerabilities and sometimes fewer than white British children. For example, compared with children of Pakistani heritage, white British children were more likely to say that their family never gets along well (6.3%, 95% CI: 5.6% to 7.1% vs 4.1%, 95% CI: 3.6% to 4.6%) and to have no access to the internet at home (22.3%, 95% CI: 21% to 23.6% vs 18%, 95% CI: 17% to 18.9%). Children with Pakistani heritage were more likely than white British children to say they had no park near their home where they can play with friends (32.7%, 95% CI: 31.6% to 33.9% vs 29.9%, 95% CI: 28.6% to 31.3%), to report not having three meals a day (17.9%, 95% CI: 16.9% to 18.8% vs 11.9%, 95% CI: 10.9% to 12.9%) and to worry all the time about how much money their families have (29.3%, 95% CI: 28.2% to 30.3%) vs (21.6%, 95% CI: 20.4% to 22.9%). Gypsy/Irish Traveller children were less likely than white British children to say they were bullied some or all of the time (42.2%, 95% CI: 35.4% to 49.4% vs 53.8%, 95% CI: 52.3% to 55.3%), but more likely to say they were mean to others all the time (9.9%, 95% CI: 6.3% to 15.2% vs 4%, 95% CI: 3.5% to 4.7%) and can never work out what to do when things are hard (15.2%, 95% CI: 10.6% to 21.2% vs 9%, 95% CI: 8.2% to 9.9%). We considered six vulnerabilities to be of particular concern during the COVID-19 pandemic and associated national and local lockdowns: family never gets along well together; no garden where child can play; no nearby park where they can play; not having three meals a day; no internet at home; worried about money all the time. Pre-pandemic, 37.4% (95% CI: 36.6% to 38.3%) of Bradford children had one of these vulnerabilities and a further 29.6% (95% CI: 28.9% to 30.4%) had more than one., Conclusions: Although most primary school children aged 7-10 in our study had good levels of well-being on most indicators across multiple domains, fewer than 10% had no vulnerabilities at all, a worrying 10% had at least one vulnerability in all the four domains we studied and two-thirds had vulnerabilities of particular concern during the COVID-19 lockdowns., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Background: Maternal iodine requirements increase during pregnancy to supply thyroid hormones critical for fetal neurodevelopment. Iodine insufficiency may result in poorer cognitive or child educational outcomes but current evidence is sparse and inconsistent., Objectives: To quantify the association between maternal iodine status and child educational outcomes., Methods: Urinary iodine concentrations (UIC) and iodine/creatinine ratios (I:Cr) were measured in 6971 mothers at 26-28 weeks' gestation participating in the Born in Bradford cohort. Maternal iodine status was examined in relation to child school achievement (early years foundation stage (EYFS), phonics, and Key Stage 1 (KS1)), other learning outcomes, social and behavioural difficulties, and sensorimotor control in 5745 children aged 4-7 years., Results: Median (interquartile range) UIC was 76 µg/L (46, 120), and I:Cr was 83 µg/g (59, 121). Overall, there was no strong or consistent evidence to support associations between UIC or I:Cr and neurodevelopmental outcomes. For instance, predicted EYFS and phonics scores (primary outcomes) at the 25th vs 75th I:Cr percentiles (99% confidence intervals) were similar, with no evidence of associations: EYFS scores were 32 (99% CI 31, 33) and 33 (99% CI 32, 34), and phonics scores were 34 (99% CI 33, 35) and 35 (99% CI 34, 36), respectively., Conclusions: In the largest single study of its kind, there was little evidence of detrimental neurodevelopmental outcomes in children born to pregnant women with iodine insufficiency as defined by World Health Organization-outlined thresholds. Alternative functional biomarkers for iodine status in pregnancy and focused assessment of other health outcomes may provide additional insight., (© 2020 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.)