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Decolonisation is a socio-political movement which challenges Eurocentrism and post-colonial notions of power. This has numerous implications for higher education institutions (HEIs), where the content and delivery of curricula may be seen as products of colonial legacy. The decolonisation agenda has increasing support from students, the academy, and regulatory bodies, which together are invoking HEIs to act. This paper reports on research undertaken within a UK HEI, which benchmarked the extent to which programmes followed characteristics of (de)colonised curricula. A survey, based on existing open access resources, was completed by 99 staff and 290 students across four schools. Findings suggest differences in how curricula are perceived by staff and students, and between white and minority ethnic student groups. Given growing global interest in decolonisation and associated social justice themes, this research has important applications for other HEIs.

Development of key practical skills is fundamental to bioscience courses in higher education. With limitations on access to laboratory time due to the COVID-19 pandemic, a "Bioskills at home" kit was developed to create opportunities for first year undergraduate students to develop these skills using online support resources to guide their activities and build communities of learning. Equipment and activities in this kit enabled students to practice key skills such as pipetting, data handling, experimental design and microscopy, as well as build an online peer learning community through the use of discussion boards and microscopy competitions that encouraged students to explore their local environment. Students who engaged with these activities reported increased confidence in key practical skills. Practical assessment of skills showed that that there was no reduction in the proportion of students who succeeded in achieving the pipetting learning objective compared to previous years, despite a significantly reduced on-campus provision. Although the celebration event to choose the microscopy competition winners was well attended, there was limited use of the discussion boards by students to build a community of learning during the term. Refinement of this initiative will focus on providing greater scaffolding to encourage greater engagement with activities and enhance community building.

This paper draws on material generated from a qualitative study of educational impacts of a British welfare reform affecting housing rent subsidy, size and location commonly known as "the bedroom tax" (Bragg et al., 2015), which was partly taken as a topic for study specifically because of its iconic status as a controversial and unpopular welfare "reform" (or cut). The analysis draws on Foucauldian understandings of subjectification or subject-formation--as elaborated both from within and in relation to the social (Foucault, 1970; 1983; Ball, 1990; Olssen, 2006; Popkewitz & Brennan, 1998), read through new and newly available perspectives (Allen, 2015; Pêcheux, 2014). This approach is applied to discuss how those addressed by educational policy, and also as research participants, are both subject to prevailing political and practice-oriented discourses (of educational "problems", and of the neoliberal frameworks by which poverty and welfare cuts are discussed), but also--at times--how they can become the subject of--in the sense of reformulating--these discourses in their accounts of everyday activities. After outlining our approach and the context for the study, we focus on four examples drawn from the narratives of the various stakeholders in the study--parents/carers, school staff and other community-based organisations as illustrations of how this discursive approach can provide rich readings of relevance to educational policy debates. From these we not only take further discussions of the production and regulation of subjectivities via social and educational policy practices, but also offer indicative glimpses of resistance to this as expressed by those who are its primary subjects, and where in one case such resistance brings our own research commitments under critical scrutiny. As such, the contribution of this article is both topic-related (concerning the educational impacts of policy) but, crucially, also conceptual and methodological, in motivating for a Foucauldian-influenced discursive approach that is sensitive to struggle and resistance.

Background/Aims: Molar pregnancy is a rare complication of pregnancy. Patients face surgery, human chorionic gonadotropin monitoring and potentially systemic treatment, resulting in unique support needs. This study's aim was to explore the impacts of gestational trophoblastic disease on embodied and emotional experience. Methods: This qualitative study considered stories of molar pregnancy from 20 women in the UK, US, Canada and Australia. These were drawn from 18 publicly available online blogs and eight semi-structured interviews, and analysed thematically. Results: Three themes were developed: 'loss', describing women's responses to their pregnancy ending; 'isolation', comprising 'rarity', 'lack of awareness' and support seeking; and 'alienation', capturing the unfamiliarity of diagnosis, 'failure' and barriers to 'moving forward'. Conclusions: Experiences are shaped by wider narratives of 'typical' pregnancy. Patient care requires an individualised and responsive approach, and non-specialist practitioners should feel confident in discussing molar pregnancy and have access to up-to-date guidance. [ABSTRACT FROM AUTHOR]

Background High-quality antenatal care is important for ensuring optimal birth outcomes and reducing risks of maternal and fetal mortality and morbidity. The COVID-19 pandemic disrupted the usual provision of antenatal care, with much care shifting to remote forms of provision. We aimed to characterise what quality would look like for remote antenatal care from the perspectives of those who use, provide and organise it. Methods This UK- wide study involved interviews and an online survey inviting free- text responses with: those who were or had been pregnant since March 2020; maternity professionals and managers of maternity services and system- level stakeholders. Recruitment used network-based approaches, professional and community networks and purposively selected hospitals. Analysis of interview transcripts was based on the constant comparative method. Free-text survey responses were analysed using a coding framework developed by researchers. Findings Participants included 106 pregnant women and 105 healthcare professionals and managers/ stakeholders. Analysis enabled generation of a framework of the domains of quality that appear to be most relevant to stakeholders in remote antenatal care: efficiency and timeliness; effectiveness; safety; accessibility; equity and inclusion; person- centredness and choice and continuity. Participants reported that remote care was not straightforwardly positive or negative across these domains. Care that was more transactional in nature was identified as more suitable for remote modalities, but remote care was also seen as having potential to undermine important aspects of trusting relationships and continuity, to amplify or create new forms of structural inequality and to create possible risks to safety. Conclusions This study offers a provisional framework that can help in structuring thinking, policy and practice. By outlining the range of domains relevant to remote antenatal care, this framework is likely to be of value in guiding policy, practice and research. [ABSTRACT FROM AUTHOR]

This paper presents a novel conceptualisation of the school context by examining the 'personal' (emotional wellbeing), the 'political' (everyday political actions and power relations) and the 'Political' (the Political system, including electoral politics and governmental policy) and how these interrelate. Informed by literatures from a range of disciplines, the authors use this conceptual lens to consider data from two projects which explored the impact of austerity on schools. In their qualitative analysis of data from interviews with 82 participants they illustrate connections between the personal, the political and the Political. They conceptualise the work schools are doing in response to the impacts of the Political as quiet political activism, which appears to have knock-on effects for staff wellbeing. They consider the implications of this, concluding that the 'quiet politics' occurring in schools may bring a sense of control and create opportunities for community activism, but also has potentially worrying consequences.

With increasing moves globally towards the professionalisation of teaching in Higher Education, there is growing interest in the role of accredited professional recognition schemes that provide professional development for established university teaching staff. In the UK, There are now over 120 professional recognition schemes, resulting in institutionally focused evaluation studies examining their impact. This article contributes to this emerging body of work; it draws on cross-institutional data and Foucauldian theorising to address two important questions. In what ways does engagement with an institutional professional recognition scheme impact on participants' teaching development, and "how" does institutional culture influence that engagement? The data illustrate that whilst institutional culture drives engagement, it did little to promote teaching development. Across the case-study institutions, neo-liberalism agendas were apparent. Some staff felt pushed to achieve professional recognition in response to the increasing use of metrics to measure the student experience and to inform institutional standing in league tables. Whilst evidence shows the process of seeking accreditation "can" lead to an enhancement in teaching practices, caution must be taken to ensure that the professional development opportunities offered by accreditation schemes are fully realised.

Learning and teaching on physical university campuses have been enhanced by digital technology both in formally scheduled learning and teaching events and in the less formal spaces in which the higher education experience unfolds. The digital skills and know-how with which students arrive at university will arguably develop throughout the academic journey, though the extent to which they will underpin students' growth into digital citizens, that is, confident and competent participants in a broader range of digitally enhanced social and professional communities, is likely to vary. The present article is the outcome of a research project which explored how students experience learning, teaching and communicating through digital technologies on a range of undergraduate courses at a UK university. Focus groups with fifty-five students in different years of study across twenty-three undergraduate courses revealed a nuanced understanding of the notion of 'digital native', yet a lack of readiness to link participation in digital spaces to digital citizenship and to articulate attributes of an effective participant in digital communities. The focus groups highlighted inconsistent alignment between personal, academic and professional digital spaces. They clearly signalled a need to explore further the commonalities and points of intersection between the three, moving beyond a skills mindset, and paying particular attention to the way in which participants in higher education construct and take up virtual identities, how they negotiate access to digital environments, the degree of control they are able and ready to exercise over digital spaces, and the contribution that universities can make to facilitate the complex developmental journeys towards digital citizenship.

An editorial is presented on broad range of UK professionals involved in the care of patients with head and neck cancer. Topics include underpinning the basis of care of patients with head and neck cancer, which apply across the spectrum of management; and guidelines can be also used as an educational resource for clinicians, and for insight into head and neck cancer care for non-clinicians.

Background Problems in intrapartum electronic fetal monitoring with cardiotocography (CTG) remain a major area of preventable harm. Poor understanding of the range of influences on safety may have hindered improvement. Taking an interdisciplinary perspective, we sought to characterise the everyday practice of CTG monitoring and the work systems within which it takes place, with the goal of identifying potential sources of risk. Methods Human factors/ergonomics (HF/E) experts and social scientists conducted 325 hours of observations and 23 interviews in three maternity units in the UK, focusing on how CTG tasks were undertaken, the influences on this work and the cultural and organisational features of work settings. HF/E analysis was based on the Systems Engineering Initiative for Patient Safety 2.0 model. Social science analysis was based on the constant comparative method. Results CTG monitoring can be understood as a complex sociotechnical activity, with tasks, people, tools and technology, and organisational and external factors all combining to affect safety. Fetal heart rate patterns need to be recorded and interpreted correctly. Systems are also required for seeking the opinions of others, determining whether the situation warrants concern, escalating concerns and mobilising response. These processes may be inadequately designed or function suboptimally, and may be further complicated by staffing issues, equipment and ergonomics issues, and competing and frequently changing clinical guidelines. Practice may also be affected by variable standards and workflows, variations in clinical competence, teamwork and situation awareness, and the ability to communicate concerns freely. Conclusions CTG monitoring is an inherently collective and sociotechnical practice. Improving it will require accounting for complex system interdependencies, rather than focusing solely on discrete factors such as individual technical proficiency in interpreting traces. [ABSTRACT FROM AUTHOR]

Decolonisation is a socio-political movement which challenges Eurocentrism and post-colonial notions of power. This has numerous implications for higher education institutions (HEIs), where the content and delivery of curricula may be seen as products of colonial legacy. The decolonisation agenda has increasing support from students, the academy, and regulatory bodies, which together are invoking HEIs to act. This paper reports on research undertaken within a UK HEI, which benchmarked the extent to which programmes followed characteristics of (de)colonised curricula. A survey, based on existing open access resources, was completed by 99 staff and 290 students across four schools. Findings suggest differences in how curricula are perceived by staff and students, and between white and minority ethnic student groups. Given growing global interest in decolonisation and associated social justice themes, this research has important applications for other HEIs. [ABSTRACT FROM AUTHOR]

The International Federation of Gynecology and Obstetrics (FIGO) scoring system uses the sum of eight risk-factors to predict single-agent chemotherapy resistance in Gestational Trophoblastic Neoplasia (GTN). To improve ease of use, this study aimed to generate: (i) streamlined models that match FIGO performance and; (ii) visual-decision aids (nomograms) for guiding management. Using training (n = 4191) and validation datasets (n = 144) of GTN patients from two UK specialist centres, logistic regression analysis generated two-factor models for cross-validation and exploration. Performance was assessed using true and false positive rate, positive and negative predictive values, Bland-Altman calibration plots, receiver operating characteristic (ROC) curves, decision-curve analysis (DCA) and contingency tables. Nomograms were developed from estimated model parameters and performance cross-checked upon the training and validation dataset. Three streamlined, two-factor models were selected for analysis: (i) M1, pre-treatment hCG + history of failed chemotherapy; (ii) M2, pre-treatment hCG + site of metastases and; (iii) M3, pre-treatment hCG + number of metastases. Using both training and validation datasets, these models showed no evidence of significant discordance from FIGO (McNemar's test p > 0.78) or across a range of performance parameters. This behaviour was maintained when applying algorithms simulating the logic of the nomograms. Our streamlined models could be used to assess GTN patients and replace FIGO, statistically matching performance. Given the importance of imaging parameters in guiding treatment, M2 and M3 are favoured for ongoing validation. In resource-poor countries, where access to specialist centres is problematic, M1 could be pragmatically implemented. Further prospective validation on a larger cohort is recommended. • The FIGO scoring system in GTN patients can be streamlined from eight risk factors to two. • Three logistic regression models containing two risk factors match FIGO performance across several performance measures. • Models favoured for ongoing validation are: • Model 2 (M2): pre-treatment hCG + site of metastases; and • Model 3 (M3): pre-treatment hCG + number of metastases. [ABSTRACT FROM AUTHOR]

Plain language summary: Over one‐quarter of women in the UK have a caesarean birth (CB). More than one in 20 of these births occurs near the end of labour, when the cervix is fully dilated (second stage). In these circumstances, and when labour has been prolonged, the baby's head can become lodged deep in the maternal pelvis making it challenging to deliver the baby. During the caesarean birth, difficulty in delivery of the baby's head may result – this emergency is known as impacted fetal head (IFH). These are technically challenging births that pose significant risks to both the woman and baby. Complications for the woman include tears in the womb, serious bleeding and longer hospital stay. Babies are at increased risk of injury including damage to the head and face, lack of oxygen to the brain, nerve damage, and in rare cases, the baby may die from these complications. Maternity staff are increasingly encountering IFH at CB, and reports of associated injuries have risen dramatically in recent years. The latest UK studies suggest that IFH may complicate as many as one in 10 unplanned CBs (1.5% of all births) and that two in 100 babies affected by IFH die or are seriously injured. Moreover, there has been a sharp increase in reports of babies having brain injuries when their birth was complicated by IFH. When an IFH occurs, the maternity team can use different approaches to help deliver the baby's head at CB. These include: an assistant (another obstetrician or midwife) pushing the head up from the vagina; delivering the baby feet first; using a specially designed inflatable balloon device to elevate the baby's head and/or giving the mother a medicine to relax the womb. However, there is currently no consensus for how best to manage these births. This has resulted in a lack of confidence among maternity staff, variable practice and potentially avoidable harm in some circumstances. This paper reviews the current evidence regarding the prediction, prevention and management of IFH at CB, integrating findings from a systematic review commissioned from the National Guideline Alliance. [ABSTRACT FROM AUTHOR]

The professionalisation of teaching is of increasing importance in UK higher education due to converging processes including the proliferation of managerialism, increasing quality agendas and changes to student fee structures. These have brought into sharp relief the need for greater understanding of how quality teaching evolves in university settings. One key element of this involves academic development and its impacts on teaching and learning. Current literature suggests that a plethora of ideas, frameworks and instruments claiming best practice exist but that take-up of these is inconsistent. This prompted a UK national research project which produced an evidence-based toolkit for evaluating academic development. As part of the toolkit augmentation, academic development representatives from across the sector were asked to create, review and test uniquely tailored evaluation instruments. These instruments were then piloted on university teachers who had participated in teaching-related continuing professional development activities. This paper reports on these individuals' reflections of using the toolkit. It suggests that academic developers are interested in evaluating the impact of their work on teachers, students and on the wider institutional culture but that confidence and expertise varies. Using the toolkit generated 'traditional' evaluation data including satisfaction with the development activity and changes to lecturers' conceptions and behaviours. However, it also prompted critical discussions around current evaluation practice. This included the need for transformational reform of institutional culture to support links between evaluation and good standing; and making explicit the thorny issue of evidencing student learning. This paper will be of interest to those with an interest or responsibility for evaluating teaching in higher education. The paper offers an important contribution to the international literature at a time when global higher education is faced with questions about teaching, learning and quality. Evaluation, and how to do it well, is timely and important business.

In recent years there has been increased discussion of the subjective, emotional and sociological factors influencing student choice of university. However, there is a dearth of information exploring what constitutes these feelings. This exploratory paper uses the conceptual model of the servicescape to provide insight into the emotional factors driving student choice. In-depth interviews with prospective students revealed that first impressions really do count. Students are deterred by poor physical environments and excited by enthusiastic staff and students. Most significantly, the study revealed the necessity of a restorative servicescape to provide both a sense of escape and feeling of belonging. This paper contributes to broadening the application of the servicescape model and to a greater understanding of the impact of the environment on prospective students, and creates an opportunity to inform policy by providing university marketing decision makers with a better understanding of what constitutes the university environment and what makes it appealing to prospective students.

Continuing professional development (CPD) for HE academic staff, through accredited courses for new lecturers, teaching innovation grants, peer review, mentoring and conference attendance, is firmly established practice, engagement with these activities may be essential to career progression. The input of students to CPD, student awareness of, or active engagement with these activities is limited despite the growing emphasis on agendas such as "student engagement" and "students as partners". In this paper, we examine their perceptions of teaching-oriented CPD and the potential contributions of students through interview data collected from eight elected Student Union (SU) Officers. This informs a discussion of the mechanisms by which SU officers can influence teaching-related developments in HE and provide recommendations to enhance future working relationships between SU and providers of CPD.

The fiercely competitive HE market has led HEIs to invest significant resources in building a distinct identity. An HEI's location forms an inherent part of its identity and the uniqueness of location offers an opportunity to differentiate. However there has been limited examination of how location is used by HEIs and little consideration of how location can provide an effective means of differentiation. Through the lens of place marketing, this exploratory paper provides insight into the way HEIs portray location and discusses whether location can offer a source of differentiation.Using a content analysis of prospectuses and interviews with marketing decision makers, this paper contributes a deeper understanding of the way in which a place brand is constructed by a stakeholder. The study reveals that HEIs portray a location to simultaneously excite and reassure the student which ultimately leads to the commodification of location. As such, differentiation is not possible.

In this paper we report the outcomes of a national survey of academic development staff in a range of UK HE Institutions to consider the approaches adopted to evaluate teaching-related continual professional development (CPD). Despite the increasing drive towards accountability, the majority of respondents undertook no benchmarking to establish existing knowledge, there was minimal use of existing data sets, and few evaluated provision longitudinally. We argue that in order to arrive at an evidence-informed approach, evaluation and teaching-related CPD must be clearly conceptualised, and aligned with institutional priorities. The involvement of students with staff CPD could also be usefully explored.

In this article, Jane Winter describes a pilot project that uses a simple and engaging science activity to raise children's science capital, as well as increasing understanding of the potential of science to combat world problems. "Potatoes to plastics" is a Centre for Industry Education Collaboration (CIEC) project, aimed at key stage 2 children (ages 7-11). This activity highlights how science can be used to develop solutions to real-world problems by using a waste product to make a valuable (and biodegradable) material.

In this paper, we examine the paradoxes of hailing health care workers as "Covid-19 heroes" in Canada and the United Kingdom. We ask how public discourses—primarily by governments, politicians, mainstream media, but also by racially minoritized groups and migrant-led associations—frame the ambiguous social and legal status of mostly women of color "essential" health care workers during the pandemic. We argue that hailing is a form of conditional inclusion. Hailing involves both the camouflaging of individuals' low-class status, precarious position in the workplace, gendered and racially minoritized positionality and insecure/non-permanent immigration status on the one hand, as well as the potential for resistance, emancipation, wider organizing, and claims-making on the other. Through a focus on Filipino/a workers because of their high levels of representation as health care staff in both contexts, our empirical analysis underlines that hailing as conditional inclusion is asymmetrical and unequal. It enables co-optation and deflection from structural inequalities as the price of conditional inclusion of selected individuals and groups. However, at the same time, hailing generates resistance. Through "tiny openings" these contradictions are named, and the binary language of inclusion/exclusion is challenged. [ABSTRACT FROM AUTHOR]

Objective: We aimed to explore the experiences and perspectives of pregnant women, antenatal healthcare professionals, and system leaders to understand the impact of the implementation of remote provision of antenatal care during the COVID-19 pandemic and beyond. Methods: We conducted a qualitative study involving semi-structured interviews with 93 participants, including 45 individuals who had been pregnant during the study period, 34 health care professionals, and 14 managers and system-level stakeholders. Analysis was based on the constant comparative method and used the theoretical framework of candidacy. Results: We found that remote antenatal care had far-reaching effects on access when understood through the lens of candidacy. It altered women's own identification of themselves and their babies as eligible for antenatal care. Navigating services became more challenging, often requiring considerable digital literacy and sociocultural capital. Services became less permeable, meaning that they were more difficult to use and demanding of the personal and social resources of users. Remote consultations were seen as more transactional in character and were limited by lack of face-to-face contact and safe spaces, making it more difficult for women to make their needs – both clinical and social – known, and for professionals to assess them. Operational and institutional challenges, including problems in sharing of antenatal records, were consequential. There were suggestions that a shift to remote provision of antenatal care might increase risks of inequities in access to care in relation to every feature of candidacy we characterised. Conclusion: It is important to recognise the implications for access to antenatal care of a shift to remote delivery. It is not a simple swap: it restructures many aspects of candidacy for care in ways that pose risks of amplifying existing intersectional inequalities that lead to poorer outcomes. Addressing these challenges through policy and practice action is needed to tackle these risks. [ABSTRACT FROM AUTHOR]

Approximately one-third of patients with low-risk Gestational Trophoblastic Neoplasia (WHO 0–6) develop methotrexate-resistance (MTX-R). In the UK, subsequent treatment with either actinomycin-D (Act D) or multi-agent combination chemotherapy has depended on whether the hCG was above or below an hCG threshold. To reduce exposure to combination chemotherapy (CC), over the years the UK service has raised this threshold as well as using single-agent carboplatin AUC6 3-weekly at MTX-R instead of CC. Updated results for carboplatin demonstrate an 86% complete hCG response (hCG CR) but associated with haematological dose-limiting toxicity. In 2017, single-agent carboplatin became the national standard second-line treatment following MTX-R at hCG of >3000 IU/L. Carboplatin was changed to two-weekly AUC4 scheduling and continued until normal hCG plus 3 consolidation cycles. For patients failing to respond, CC (Etoposide-Actinomycin-D or EMA-CO) was introduced. 22 evaluable patients with a median hCG at MTX-R of 10,147 IU/L (IQR 5527–19,639) received carboplatin AUC4 2-weekly (median no. of cycles = 6, IQR 2–8). Of these, 36% achieved a hCG CR. All 14 non-CR patients were cured with subsequent CC; 11 and 2 patients with 3rd line and 4th line CC respectively and 1 patient following 5th line CC and hysterectomy. Overall survival remains 100%. Carboplatin is not sufficiently active in the second-line treatment of low-risk MTX-resistant GTN. New strategies are required to increase hCG CR and spare more toxic CC regimens. • Methotrexate-resistance (MTX-R) develops in approx. 30% of low-risk GTN patients. • hCG CR to single-agent carboplatin is considerably less in MTX-R at higher hCG levels. • At MTX-R with hCG ≥3000 IU/L, 2nd line carboplatin is associated with a 36% hCG CR. • New strategies are required to increase hCG CR and spare more toxic CC regimens. • Overall survival of low-risk GTN should approximate 100%. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to investigate students' energy literacy at a UK university, and recommends ways in which it can be enhanced using a behaviour change model. Developing students' energy literacy is a key part of the "greening" agenda, yet little is known about how students develop their ideas about energy use and energy saving at a university. Design/methodology/approach: The research utilised a mixed-methods approach including an online survey (with 1,136 responses) and focus groups. Findings: The research identified strengths and weaknesses in students' energy literacy, and noted the relative influence of formal and informal curricula. The potential for aligning these curricula is highlighted through the 4Es model of enable, engage, exemplify and encourage. Research limitations/implications: The research involved a single instrumental case-study site. The wider applicability of the findings should therefore be tested further in other institutions. Practical implications: The research suggests ways in which universities might better support their students in making more sustainable energy-related behaviour choices, and it indicates the importance of knowledge as well as attitudes. Social implications: The research may have implications for the energy-saving behaviours of individuals in the wider society. Originality/value: Attempts to reduce energy use in higher education are widely seen in campus operations. This research provides an indication of the potential for enhancing energy-saving through different forms of curricula.

The last decade has seen intensification in moves to professionalise the practice of university teaching, including graduate teaching assistants (GTAs). It has also seen significant growth in terms of the internationalisation of the postgraduate student body and changing expectations around doctoral training. These transformations have implications for the construction, delivery, and management of educational training for this group, yet little contemporary research exists investigating the adaptability of academic development and institutions to such change. This paper reports empirical research exploring these issues using a UK-based case study. The research investigated the international doctoral students' experience of a teaching course and subsequent academic development. GTAs reported institutional and cultural factors governing access to teaching opportunities, particularly in relation to the international cohort. We explore the possible reasons for this, and the implications for the case institution and the wider HE sector.

Social isolation within agricultural communities is prevalent within the United Kingdom (UK). Along with other social and economic determinants, social isolation is considered to be a contributing factor towards the high rates of mental health issues experienced among people working in agriculture. The livestock auction mart is one of the remaining spaces upon which many livestock farmers rely for consistent social interaction and to experience community, both determinants proven to improve physical and mental health. However, the importance of the social contribution of livestock auction marts to farmer wellbeing appears rarely in associated literature. The aims of this study, therefore, were i) to determine levels of isolation experienced by livestock farmers who attend auction marts and ii) to identify the role of the mart as a system of social support, with an emphasis on the informal support system attendees provide for one another. Findings from 90 qualitative interviews demonstrate that the auction mart is an important social site where occupational community and identity can be produced and reproduced for all attending stakeholders, positively impacting upon mental health and wellbeing. The strength of the occupational community among livestock farmers should be considered as a key element among a basket of options approach in the development of support interventions, and as a pathway to negotiating barriers to both help-seeking behaviors and reaching the hard-to-reach. [ABSTRACT FROM AUTHOR]

The article discusses the significant impact of ultra-processed foods (UPFs) on public health, particularly in healthcare settings. It defines UPFs as industrial formulations with many ingredients processed through industrial methods, which dominate energy intake and contribute heavily to free sugars in the UK diet. It highlights concerns from healthcare professionals about their contribution to obesity, diabetes, and other health issues among patients.

George F Winter explores existing issues in the provision of midwifery care for women in prison, in relation to the United Nations' declaration regarding standards of care for prisoners [ABSTRACT FROM AUTHOR]

Current changes to policy around higher education in the United Kingdom are leading to an increasingly marketised system. As funding is transferred from the United Kingdom government to the individual student, universities will be required to pay more attention to marketing. This paper draws on the literature relating to marketing of services to assess the extent to which higher education marketing addresses issues of covenant, quiddity and representation. Using a mixed sample of universities and associated further education colleges who provide higher education opportunities, this research investigates the marketing strategies of different types of higher education institution. Differences identified include the extent to which reputation, educational experience, research and student life are used in marketing. We conclude that newer universities and further education colleges appear to be more greatly influenced by contemporary government policy agenda than are the older more traditional institutions, which continue to trade largely on their established strong reputations. (Contains 1 figure and 2 tables.)

There is a chronic international shortage of mathematics and science teachers, particularly physicists. The study reported here examines why physicists become teachers and why they stay in teaching. Physicists from seven preservice teacher training cohorts from three English universities were invited to answer an online survey with follow-up telephone interviews exploring their decisions to become teachers and the factors influencing their retention in the profession. Key to becoming teachers were pivotal experiences revealing teaching as a career "they" could enjoy. Analysis also showed a frequent lack of support and feelings of isolation for beginning physics teachers in schools.

Objective: To determine the feasibility of a randomised controlled trial to estimate the effectiveness and cost-effectiveness of a rehabilitation intervention following neck dissection (ND) after head and neck cancer (HNC). Design: Two-arm, open, pragmatic, parallel, multicentre, randomised controlled feasibility trial. Setting: Two UK NHS hospitals. Participants: People who had HNC in whom a ND was part of their care. We excluded those with a life expectancy of six months or less, pre-existing, longterm neurological disease affecting the shoulder and cognitive impairment. Intervention: Usual care (standard care supplemented with a booklet on postoperative self-management) was received by all participants. The GRRAND intervention programme consisted of usual care plus up to six individual physiotherapy sessions including neck and shoulder range of motion and progressive resistance exercises, advice and education. Between sessions, participants were advised to complete a home exercise programme. Randomisation: 1:1 randomisation. Allocation was based on minimisation, stratified by hospital site and spinal accessory nerve sacrifice. It was not possible to mask treatment received. Main outcome measures: Primary: Participant recruitment, retention and fidelity to the study protocol and interventions from study participants and staff at six months post-randomisation (and 12 months for those reaching that time-point). Secondary: clinical measures of pain, function, physical performance, healthrelated quality of life, health utilisation and adverse events. Results: 36 participants were recruited and enrolled. The study achieved five of its six feasibility targets. These included consent - 70% of eligible participants were consented; intervention fidelity - 78% participants discharged completed the intervention sessions; contamination - none - no participants in the control arm received the GRRAND-F intervention and retention - 8% of participants were lost to follow-up. The only feasibility target that was not achieved was the recruitment target where only 36 of the planned 60 participantswere recruited over 18months. This was principally due to the COVID-19 pandemic which caused all research activity to be paused or reduced, with a subsequent reduction in. Conclusions: Based on the findings a full-trial can now be designed to better understand whether this proposed intervention is effective. [ABSTRACT FROM AUTHOR]

Background medical education must adapt to meet the challenges and demands of an ageing population, ensuring that graduates are equipped to look after older patients with complex health and social care needs. Recommended curricula in geriatric medicine in the United Kingdom and Europe offer guidance for optimal undergraduate education in ageing. The UK version, written by the British Geriatrics Society (BGS), requires updating to take account of innovations in the specialty, changing guidance from the General Medical Council (GMC), and the need to support medical schools preparing for the introduction of the national Medical Licensing Assessment (MLA). Methods the BGS recommended curriculum was mapped to the most recent European curriculum (2014) and the MLA content map, to compare and contrast between current recommendations and nationally mandated guidance. These maps were used to guide discussion through a virtual Nominal Group Technique (NGT), including 21 expert stakeholders, to agree consensus on the updated BGS curriculum. Results the curriculum has been re-structured into seven sections, each with 1–2 overarching learning outcomes (LOs) that are expanded in multiple sub-LOs. Crucially, the curriculum now reflects the updated GMC/MLA requirements, having incorporated items flagged as missing in the mapping stages. Conclusion the combined mapping exercise and NGT have enabled appropriate alignment and benchmarking of the UK national curriculum. These recommendations will help to standardise and enhance teaching and learning around the care of older persons with complexity. [ABSTRACT FROM AUTHOR]

Objective: To quantify the incidence of intrapartum risk factors in labours with an adverse outcome, and compare them with the incidence of the same indicators in a series of consecutive labours without adverse outcome. Design: Case–control study. Setting: Twenty‐six maternity units in the UK. Population or sample: Sixty‐nine labours with an adverse outcome and 198 labours without adverse outcome. Methods: Observational study. Main outcome measures: Incidence of risk factors in hourly assessments for 7 hours before birth in the two groups. Results: A risk score combining suspected fetal growth restriction, tachysystole, meconium in the amniotic fluid and fetal heart rate abnormalities (baseline rate and variability, presence of decelerations) gave the best indication of likely outcome group. Conclusions: Accurate risk assessment in labour requires fetal heart rate abnormalities to be considered in context with additional intrapartum risk factors. [ABSTRACT FROM AUTHOR]

The word "geo-graphy" means "writing the earth". The subject of geography bears responsibility for engaging, constituting and configuring world knowledge, in other words, what the world is. This paper describes an enquiry into the nature of school geographical knowledge at a time of curriculum policy reform. In 2010, the newly appointed Coalition government in Britain introduced the concept of core knowledge for the school curriculum. Some of the problems associated with core knowledge are illustrated by showing two alternative ways of knowing the world that core knowledge overlooks. To understand the nature of the constitution of knowledge, I turn to Heidegger. His idea of Enframing explains the emergence of meaning about the world within the constraints of a technical scheme that conceals as much as it reveals. A second idea of Heidegger's, the event of appropriation, suggests how meaning comes into being through the "belonging together" of humans and the world. This belonging together takes us away from representational thinking into the realm of a more original and authentic sense of what is. Although this appears to provide a very credible argument about world meaning-making, it is superseded by Derrida's critique of Heidegger as someone who claims to deconstruct the history of ontology at the same time as retaining a commitment to it. Derrida's "differance" advances Heidegger's work into a consideration of meaning and justice. The associated deconstructive attitude takes responsibility seriously by disrupting taken-for-granted meanings and conceptual schemes and opening them up to see what other groups of people or ways of knowing might be overlooked. (Contains 4 figures and 4 notes.)

Despite strong political support for the development of sustainability literacy amongst the UK graduates, embedding sustainability in the higher education curriculum has met with widespread indifference, and in some cases, active resistance. However, opportunities exist beyond the formal curriculum for engaging students in learning about sustainability. Previous research has highlighted the potential of the university campus for experiential, place-based learning about and for sustainability. This has been conceptualised as the "informal" curriculum, consisting of extra-curricular activities and student projects linking estates and operations to formal study. However, the impact of the so-called "hidden curriculum" (the implicit messages a university sends about sustainability through the institutional environment and values) has been overlooked as a potential influence on student learning and behaviour. This article reports on a small-scale research project which utilised a phenomenographic approach to explore students" perceptions of the "hidden sustainability curriculum" at a leading sustainability university. The findings suggest that helping students deconstruct the hidden campus curriculum may enhance aspects of sustainability literacy; developing students' understanding about sustainability and creating solutions to sustainability issues, enabling evaluative dialogue around campus sustainability and also self-reflection, which could be transformative and translate into pro-environmental behaviour change. This research is transferable to other contexts.

Ever decreasing numbers of applicants arrive in language departments at UK universities. In the face of this decline, and against the backdrop of higher education languages departments being reduced across the UK, it is important to investigate the supply chain of languages undergraduates in the pre-entry sector. This article reports on a collaborative action research project between Language Networks for Excellence, University of Wolverhampton, and King Edward VI College, Stourbridge. The objective was to investigate how the HE sector can effectively influence and support linguists and post-16 establishments in enhancing progression to studying languages at university and how the post-16 sector can ensure they meet language students' needs in progression to HE. The research presents a number of conclusions and recommendations, not least that, whilst support from HE for 17-18-year-old school students and their institutions is welcome and contributes to students' confidence and skills, there may be merit in targeting students much further down the supply chain, encouraging progression to HE through tailored linguistic and motivational support strategies. (Contains 1 note.)

This paper reports the findings of a small-scale study that documented the use of information technology for learning by a small group of postgraduate students. Our findings support current knowledge about characteristics displayed by effective e-learners, but also highlight a less researched but potentially important issue in developing e-learning expertise: the ability of students to manage the combination of learning and non-learning activities online. Although multi-tasking has been routinely observed amongst students and is often cited as a beneficial attribute of the e-learner, there is evidence that many students found switching between competing activities highly distracting. There is little empirical work that explores the ways in which students mitigate the impact of non-learning activities on learning, but the evidence from our study suggests that students employ a range of "boundary management" techniques, including separating activities by application and by technology. The paper suggests that this may have implications for students' and tutors' appropriation of Web 2.0 technologies for educational purposes and that further research into online boundary management may enhance understanding of the e-learning experience. (Contains 3 tables and 1 note.)

If education is a solution in working toward a sustainable future then initial teacher training (ITT) provides a strategic opportunity for ensuring that all teachers are able to teach for sustainability when they begin their teaching careers. This paper reports on a study of how four Postgraduate Certificate of Education (PGCE) student teachers planned and taught education for sustainable development (ESD) through geography during a school placement. It was carried out to provide exemplification of the nature of student teachers' planning and teaching about ESD in secondary schools in England and to identify ways of improving their PGCE course. The findings are based on interviews with student teachers after the school placement, as well documentary evidence. Policy-driven changes in the provision of both ITT and school curricula and pedagogy in England are an important context for the study. The paper concludes by arguing that ITT faces considerable challenges if it is to be reoriented towards sustainability. A sample of the Class information and scheme of work theme as defined by the student teachers is appended. (Contains 6 notes.)

Can education for sustainable development (ESD) policies help to create a more sustainable society? In the article I argue that contemporary secondary school curriculum policies relating to ESD are rhetorical devices that will achieve little towards resolving global problems. I suggest that the conceptualization of SD is itself fundamentally flawed and inevitably restricts the scope of possible policy solutions. I analyse three ESD curriculum policy texts to reveal their concealments, silences and blocks to enquiry, demonstrating how their rhetorical forms make them readily assimilable into dominant economic discourse. I then introduce a recent UK Government Report explaining the failure in implementing ESD policies in the school curriculum and I expose how this analysis is a further demonstration of the problems in the prevailing policy perspective. In conclusion, I propose a new direction for progress in curriculum policy regarding sustainability. (Contains 1 note.)

In this paper we report some of the literacy and numeracy actions developed on the Home School Knowledge Exchange (HKSE) project and examine these in relation to the engagement of participants. The exchanges of knowledge included two-way processes where aspects of children's out-of-school worlds informed teaching and learning in the classroom as well as the more usual sharing of knowledge about school with children's families. We comment on patterns of parental engagement and on the development of actions that built not only on parental knowledge but also on the agency of the child. A key implication of this work is that "one size does not fit all"--more successful actions include different family members at different times and in different ways. Although the positive potential of home-school knowledge exchange for engagement is discussed, the difficulties and complexities of this field are recognized and explored. ["Getting Engaged: Possibilities and Problems for Home-School Knowledge Exchange" was written with Leida Salway and Mary Scanlan.] (Contains 17 notes.)

This paper describes the development of an innovative interprofessional doctorate in health and social care, within an academic framework designed explicitly to ensure that candidates must demonstrate qualities of cognitive application commensurate with doctoral study, yet must also meet the practice-focused outcomes of a professional doctorate. The degree requires students to attend highly interactive workshops in Stage 1 that encourage academic debate and "doctoral" development, in contrast to the "taught" modular elements of many other professional doctorates. Papers submitted during Stage 1 assume increasing levels of complex doctoral skills in developing a research proposal that undergoes the same rigorous evaluation required of PhD students in securing University Approval. The degree is awarded at the end of Stage 2 only after defence of a thesis in a viva voce examination that involves procedures and processes defined by the University for the award of PhD. (Contains 1 table and 2 figures.)

The subject of geography is declining in popularity at secondary school level and recent developments following the "cultural turn" in Higher Education have had little impact in revitalising it. In this paper I explore the question: is there a problem with the school geography curriculum policy? After briefly sketching the history of the Geography National Curriculum policy (GNC), I focus on Caputo's (1997) commentary on Derrida and the idea of deconstruction and invention to explore the contemporary GNC policy text (1999) programme of study at Key Stage 3.

A balanced or modified school year is a rearrangement of the traditional school calendar to provide more continuous learning throughout the school year. Students receive the same amount of instructional time as those on the traditional calendar but in-school time is more evenly balanced with out-of-school time throughout the year. It has been the subject of discussion in a number of educational jurisdictions in the United Kingdom, and the available research shows that it has both advantages and disadvantages. The main social argument for this change is rooted in the notion that the traditional calendar is outdated in today's society. The main academic argument is that it is better suited to the way children learn, and that balancing the year alleviates the problems associated with learning loss, particularly over the long summer break. This article focuses on the balanced calendar from the perspective of the early years. It examines the current literature, and presents the views of early educators working in two Canadian schools where a balanced calendar is offered alongside a traditional one. These early childhood educators believe that a more balanced year is eminently suited to young learners. In this context, the balanced school year calendar is known as a Modified School Year.

Background: The benefits of enhancing practitioner empathy include better patient outcomes and improved job satisfaction for practitioners. Evidence suggests empathy can be taught and empathy is listed as an outcome for graduates in the General Medical Council requirements. Despite this, empathy training is not mandatory on medical school curricula and the extent to which medical students are given empathy-specific training is unknown. Aim: To conduct a survey of empathy training currently offered to medical students in UK medical schools. Methods: An invitation to participate in an online survey was sent to all UK medical schools (n = 40). The survey was developed through a consultancy and pilot process to ensure validity and reliability. Questions explored what empathy-focused training is offered, and asked educators whether or not they believed that current provision of empathy training is sufficient. In parallel, medical school websites were searched to identify what information regarding empathy-focused training is described as being part of the degree course. Descriptive statistics were used to describe empathy training delivery from the results of the online materials survey and closed survey questions. Thematic analysis was used to explore free text comments. Results: Response rate was 70% (28/40), with 28 medical schools included in the analysis. Twenty-six schools reported that their undergraduate curriculum included some form of empathy-focused training with variation in what, when and how this is delivered. Thematic analysis revealed two overarching themes with associated sub-themes: (i) empathy-focused training and development (considering where, when and how empathy training should be integrated); (ii) challenges presented by including empathy on the curriculum (considering the system, students and faculty). All schools agreed empathy training should be on the undergraduate curriculum. Conclusion: This is the first nationwide survey of empathy-focused training at UK medical schools. While some form of empathy-focused training appears to be provided on the undergraduate curriculum at most UK medical schools, empathy is rarely specifically assessed. Most medical educators do not feel their school does enough to promote empathy and the majority would like to offer more. [ABSTRACT FROM AUTHOR]

Introduction: Impacted fetal head (IFH) is a challenging complication of cesarean section (CS) associated with significant morbidity. Training opportunities for IFH have been reported as inconsistent and inadequate. This study assessed the validity of a novel birth simulator for IFH at cesarean section. Material and methods: Obstetricians and midwives collaborated with model‐making company, Limbs & Things (UK), to modify the original PROMPT Flex® simulator and develop a new "Enhanced CS Module" for IFH at cesarean section. Changes included addition of a retractable uterus and restricted pelvic inlet, and the fetal mannequin was modified to allow accurate limb articulation and flexion at the waist. Obstetricians and midwives from three maternity units in Southwest England were individually recorded, each undertaking three simulated scenarios of IFH at cesarean section. Obstetricians were asked to deliver the fetal head and midwives, to perform a vaginal push‐up. Participants completed a questionnaire on realism (face validity) and usefulness for training (content validity) with five‐point Likert scale responses. Construct validity was assessed by testing an a priori hypothesis that "experts" (consultant obstetricians with >7 years' experience) would be more likely to achieve delivery than "novices" (registrars with <7 years' experience). Performance variables were compared between groups using Chi‐square and Mann–Whitney U‐tests. Results: In all, 105 simulated scenarios were undertaken by 35 obstetricians and midwives. A range of techniques were employed to deliver the IFH including change of hand, vaginal disimpaction and reverse breech extraction. Overall, 86% (30/35) described the model as fairly (4)/very realistic (5) (median = 4, interquartile range [IQR] = 4–5). The model was considered fairly (4)/very useful (5) for training by 97% (34/35; median = 5; IQR = 5–5). Experts delivered the fetal head in all simulations (36/36) and novices delivered the head in 76.9% (30/39) (p = 0.002). Experts delivered the fetal head 58% quicker than novices (median = 66.8 s, IQR = 53–86 vs median = 104 s, IQR = 67.7–137). Conclusions: This novel birth trainer realistically simulates IFH at cesarean section and allows rehearsal of all disimpaction techniques. It was reported to be very useful for training and distinguishes between novice and expert obstetricians. Techniques for IFH are difficult to learn experientially. Simulation is likely to provide an effective and safe form of training. [ABSTRACT FROM AUTHOR]

Background Brief advice is recommended to increase physical activity (PA) within primary care. This study assessed change in PA levels and mental well-being after a motivational interviewing (MI) community-based PA intervention and the impact of signposting (SP) and social action (SA) (i.e. weekly group support) pathways. Methods Participants (n  = 2084) took part in a community-based, primary care PA programme using MI techniques. Self-reported PA and mental well-being data were collected at baseline (following an initial 30-min MI appointment), 12 weeks, 6 months and 12 months. Participants were assigned based upon the surgery they attended to the SP or SA pathway. Multilevel models derived point estimates and 95% confidence intervals for outcomes at each time point and change scores. Results Participants increased PA and mental well-being at each follow-up time point through both participant pathways and with little difference between pathways. Retention was similar between pathways at 12 weeks, but the SP pathway retained more participants at 6 and 12 months. Conclusions Both pathways produced similar improvements in PA and mental well-being; however, the addition of a control would have provided further insight as to the effectiveness. Due to lower resources yet similar effects, the SP pathway could be incorporated to support PA in primary care settings. [ABSTRACT FROM AUTHOR]

In this month's article, George Winter looks at how ethical concerns about rare diseases may only be addressed by using the language of the humanities [ABSTRACT FROM AUTHOR]