Search

The prevalence of dyslexia identification has increased significantly over the last two decades. Yet there is debate over whether there are distinct biological and cognitive differences between those with literacy difficulties and the subgroup of people identified as dyslexic. This is the first paper that provides evidence for this ongoing debate by investigating the socio-demographic factors, outside biology and cognition, that predict whether a child is identified as dyslexic in the UK. Using secondary data from the UK's Millennium Cohort Study, this paper examines the socio-demographic factors that predict whether a child's teacher identifies them as dyslexic at age 11. Gender, season of birth, socio-economic class and parental income are found to be significant predictors of the dyslexia label. Therefore, factors seemingly unrelated to the clinical aspects of dyslexia influence whether a child is identified as dyslexic in England and Wales. This suggests that label may not be evenly distributed across a population; furthermore, it may also indicate that resources for support may not be fairly allocated. The findings further support the argument that a 'dyslexic sub-group' within poor readers is created due to the impact of environmental factors. The results from this national-scale study thus questions the reliability, validity and moral integrity of the allocation of the dyslexia label across current education systems in the UK. [ABSTRACT FROM AUTHOR]

British supermarket-panel data suggest no increases in overall sales and purchases of alcohol following COVID-19 lockdowns, yet survey and mortality data suggest otherwise. This paper attempts to unravel the paradox. Based on purchase data of 79,417 British households from Kantar Worldpanel, we undertake controlled interrupted time series analysis of the impact of COVID-19 confinement introduced on 23rd March 2020, and variably applied during 2020, compared to purchases during 2015 to 2019 as controls. We also undertook Poisson regression analyses to estimate if changes in purchases differed by household socio-demographic and economic factors. Excess off-trade household alcohol purchases (expressed as grams of ethanol) following the introduction of confinement, were 29.2% higher (95% CI = 25.8% to 32.5%) for the post-confinement months of 2020, being larger until mid-July 2020 (37.5%, 95%CI = 33.9 to 41.26%) when pubs re-opened with restrictions, and smaller (24.6%, 95%CI = 21.6 to 27.7) thereafter. During the time of complete pub closures, and fully adjusting for no on-trade purchases, household purchases of alcohol did not change when compared with the same time period during 2015–2019 (coefficient = -0.9%, 95%CI = -5.6 to 3.8). Excess purchases from 23rd March to 31st December 2020 varied by region of Great Britain, being higher in the north of England, and lower in Scotland and Wales. Excess purchases were greater in the most deprived households, compared with the least deprived households. Excess purchases increased substantially as the amount of alcohol normally purchased by a household increased, with the top one fifth of households that normally bought the most alcohol increasing their purchases more than 17 times than the bottom one fifth of households that bought the least alcohol. That the heaviest buyers of alcohol increased their purchases the most, with some independent impact of socio-economic disadvantage, might explain why reported alcohol problems and recent alcohol-related death rates might have increased. A conclusion of this is that alcohol policy to reduce high consumption of alcohol, and the availability of help and treatment to reduce alcohol consumption become more important during extraordinary times, such as COVID lockdowns. [ABSTRACT FROM AUTHOR]

Screening for vulnerability factors associated with historic suicidality and self-harm on entry to prison is critical to help prisons understand how to allocate extremely limited mental health resources. It has been established that having previous suicide attempts increases odds of future suicidality and self-harm in prison. We utilised administrative screening data from 665 adult male prisoners on entry to a category B prison in Wales, UK, collected using the Do-IT Profiler. This sample represents 16% of all prisoners who entered that prison during a 26-month period. 12% of prisoners reported a history of attempted suicide, 11% reported historic self-harm, and 8% reported a history of both. Historic traumatic brain injury and substance use problems were associated with a 3.3- and 1.9- times increased odds of a historic suicide attempt, respectively, but no significant increased risk of historic self-harm (95% CI: 1.51–6.60 and 1.02–3.50). However, those who were bullied at school had 2.7 times increased odds of reporting a history of self-harm (95% CI: 1.63–6.09). The most salient risk factors associated with both historic suicide and self-harm were higher levels of functional neurodisability (odds ratio 0.6 for a 1 standard deviation change in score, 95% CI: 0.35–0.75), and mood disturbance (odds ratio 2.1 for a 1 standard deviation change in score, 95% CI: 1.26–3.56). Therefore, it could be beneficial for prisons to screen for broader profiles of needs, to better understand how to provide appropriate services to prisoners vulnerable to suicide and self-harm. Multidisciplinary care pathways for prisoner mental health interventions are important, to account for complex multimorbidity. Adaptations may be needed for mental health interventions to be appropriate for, for example, a prisoner with a brain injury. Understanding this broad profile of vulnerability could also contribute to more compassionate responses to suicide and self-harm from prison staff. [ABSTRACT FROM AUTHOR]

Rates of Multimorbidity (also called Multiple Long Term Conditions, MLTC) are increasing in many developed nations. People with multimorbidity experience poorer outcomes and require more healthcare intervention. Grouping of conditions by health service utilisation is poorly researched. The study population consisted of a cohort of people living in Wales, UK aged 20 years or older in 2000 who were followed up until the end of 2017. Multimorbidity clusters by prevalence and healthcare resource use (HRU) were modelled using hypergraphs, mathematical objects relating diseases via links which can connect any number of diseases, thus capturing information about sets of diseases of any size. The cohort included 2,178,938 people. The most prevalent diseases were hypertension (13.3%), diabetes (6.9%), depression (6.7%) and chronic obstructive pulmonary disease (5.9%). The most important sets of diseases when considering prevalence generally contained a small number of diseases, while the most important sets of diseases when considering HRU were sets containing many diseases. The most important set of diseases taking prevalence and HRU into account was diabetes & hypertension and this combined measure of importance featured hypertension most often in the most important sets of diseases. We have used a single approach to find the most important sets of diseases based on co-occurrence and HRU measures, demonstrating the flexibility of the hypergraph approach. Hypertension, the most important single disease, is silent, underdiagnosed and increases the risk of life threatening co-morbidities. Co-occurrence of endocrine and cardiovascular diseases was common in the most important sets. Combining measures of prevalence with HRU provides insights which would be helpful for those planning and delivering services. [ABSTRACT FROM AUTHOR]

Do regional boundaries defined by governments respect the more natural ways that people interact across space? This paper proposes a novel, fine-grained approach to regional delineation, based on analyzing networks of billions of individual human transactions. Given a geographical area and some measure of the strength of links between its inhabitants, we show how to partition the area into smaller, non-overlapping regions while minimizing the disruption to each person's links. We tested our method on the largest non-Internet human network, inferred from a large telecommunications database in Great Britain. Our partitioning algorithm yields geographically cohesive regions that correspond remarkably well with administrative regions, while unveiling unexpected spatial structures that had previously only been hypothesized in the literature. We also quantify the effects of partitioning, showing for instance that the effects of a possible secession of Wales from Great Britain would be twice as disruptive for the human network than that of Scotland. [ABSTRACT FROM AUTHOR]

Background: Addressing violence related harm is a global public health priority. While violence is primarily managed in the criminal justice system, healthcare supports and manages those injured by violence. Emergency Departments (EDs), the primary destination for those seriously injured, have emerged as a candidate location for violence prevention initiatives. There is limited evaluation of ED-based violence prevention, and a lack of guidance for the implementation and delivery of them. Nurse-led Violence Prevention Teams (VPTs) have been developed and implemented in two EDs in Wales, UK. This protocol describes methods used in the process evaluation of these VPTs. Aim: To understand how VPTs function, how they were implemented, and mechanisms of impact, as well as the exploration of wider contextual factors influencing their function. Methods: Adopting a critical realist approach and informed by the Medical Research Council (MRC) guidance for process evaluations, the process evaluation will employ qualitative methods to collect and analyse data: a scoping review of evidence of effectiveness that considers the causal mechanisms underpinning violence; a documentary analysis to determine operational considerations concerning the development, implementation and delivery of the VPTs; a descriptive analysis of routine ED data to characterise the prevalence of violence-related attendances in each ED; interviews with professional stakeholders (N = 60) from the violence prevention ecologies in which the VPTs are embedded. Discussion: This protocol outlines a process evaluation of a novel, nurse led violence prevention intervention. Findings will be used to inform policy makers' decision making on whether and how VPTs should be used in practice in other EDs across the UK, and the extent that a single operational model should be adjusted to address the local characteristic of violence. To the authors knowledge, this is the first process evaluation of a UK-based, nurse led Emergency Department Violence Prevention Team. Trial registration: Protocol registration ISRCTN: 15286575. Registered 13th March, 2023. [ABSTRACT FROM AUTHOR]

In August 2020, the UK government and regulation body Ofqual replaced school examinations with automatically computed A Level grades in England and Wales. This algorithm factored in school attainment in each subject over the previous three years. Government officials initially stated that the algorithm was used to combat grade inflation. After public outcry, teacher assessment grades used instead. Views concerning who was to blame for this scandal were expressed on the social media website Twitter. While previous work used NLP-based opinion mining computational linguistic tools to analyse this discourse, shortcomings included accuracy issues, difficulties in interpretation and limited conclusions on who authors blamed. Thus, we chose to complement this research by analysing 18,239 tweets relating to the A Level algorithm using Corpus Linguistics (CL) and Critical Discourse Analysis (CDA), underpinned by social actor representation. We examined how blame was attributed to different entities who were presented as social actors or having social agency. Through analysing transitivity in this discourse, we found the algorithm itself, the UK government and Ofqual were all implicated as potentially responsible as social actors through active agency, agency metaphor possession and instances of passive constructions. According to our results, students were found to have limited blame through the same analysis. We discuss how this builds upon existing research where the algorithm is implicated and how such a wide range of constructions obscure blame. Methodologically, we demonstrated that CL and CDA complement existing NLP-based computational linguistic tools in researching the 2020 A Level algorithm; however, there is further scope for how these approaches can be used in an iterative manner. [ABSTRACT FROM AUTHOR]

The economic landscape of the United Kingdom has been significantly shaped by the intertwined issues of Brexit, COVID-19, and their interconnected impacts. Despite the country's robust and diverse economy, the disruptions caused by Brexit and the COVID-19 pandemic have created uncertainty and upheaval for both businesses and individuals. Recognizing the magnitude of these challenges, academic literature has directed its attention toward conducting immediate research in this crucial area. This study sets out to investigate key economic factors that have influenced various sectors of the UK economy and have broader economic implications within the context of Brexit and COVID-19. The factors under scrutiny include the unemployment rate, GDP index, earnings, and trade. To accomplish this, a range of data analysis tools and techniques were employed, including the Box-Jenkins method, neural network modeling, Google Trend analysis, and Twitter-sentiment analysis. The analysis encompassed different periods: pre-Brexit (2011-2016), Brexit (2016-2020), the COVID-19 period, and post-Brexit (2020-2021). The findings of the analysis offer intriguing insights spanning the past decade. For instance, the unemployment rate displayed a downward trend until 2020 but experienced a spike in 2021, persisting for a six-month period. Meanwhile, total earnings per week exhibited a gradual increase over time, and the GDP index demonstrated an upward trajectory until 2020 but declined during the COVID-19 period. Notably, trade experienced the most significant decline following both Brexit and the COVID-19 pandemic. Furthermore, the impact of these events exhibited variations across the UK's four regions and twelve industries. Wales and Northern Ireland emerged as the regions most affected by Brexit and COVID-19, with industries such as accommodation, construction, and wholesale trade particularly impacted in terms of earnings and employment levels. Conversely, industries such as finance, science, and health demonstrated an increased contribution to the UK's total GDP in the post-Brexit period, indicating some positive outcomes. It is worth highlighting that the impact of these economic factors was more pronounced on men than on women. Among all the variables analyzed, trade suffered the most severe consequences in the UK. By early 2021, the macroeconomic situation in the country was characterized by a simple dynamic: economic demand rebounded at a faster pace than supply, leading to shortages, bottlenecks, and inflation. The findings of this research carry significant value for the UK government and businesses, empowering them to adapt and innovate based on forecasts to navigate the challenges posed by Brexit and COVID-19. By doing so, they can promote long-term economic growth and effectively address the disruptions caused by these interrelated issues. [ABSTRACT FROM AUTHOR]

Introduction: At the start of the COVID-19 pandemic there was an urgent need to identify individuals at highest risk of severe outcomes, such as hospitalisation and death following infection. The QCOVID risk prediction algorithms emerged as key tools in facilitating this which were further developed during the second wave of the COVID-19 pandemic to identify groups of people at highest risk of severe COVID-19 related outcomes following one or two doses of vaccine. Objectives: To externally validate the QCOVID3 algorithm based on primary and secondary care records for Wales, UK. Methods: We conducted an observational, prospective cohort based on electronic health care records for 1.66m vaccinated adults living in Wales on 8th December 2020, with follow-up until 15th June 2021. Follow-up started from day 14 post vaccination to allow the full effect of the vaccine. Results: The scores produced by the QCOVID3 risk algorithm showed high levels of discrimination for both COVID-19 related deaths and hospital admissions and good calibration (Harrell C statistic: ≥ 0.828). Conclusion: This validation of the updated QCOVID3 risk algorithms in the adult vaccinated Welsh population has shown that the algorithms are valid for use in the Welsh population, and applicable on a population independent of the original study, which has not been previously reported. This study provides further evidence that the QCOVID algorithms can help inform public health risk management on the ongoing surveillance and intervention to manage COVID-19 related risks. [ABSTRACT FROM AUTHOR]

Background: Drones are increasingly used in healthcare, and feasibility studies of deployment of Automated External Defibrillators (AED) in Out-of-hospital cardiac arrest (OHCA) have been conducted. Despite the potential contribution of drones to healthcare, regulatory barriers exist, including limits on flights beyond visual line-of-sight (BVLOS). The aim of this project was to deliver an AED BVLOS in Wales. Methods: We developed of a Concept of Operations (CONOPS) to identify requirements, constraints, organisation and roles and responsibilities associated with deploying a drone to deliver an AED BVLOS. We equipped a Penguin B drone with satellite-enabled technology to enhance situational awareness and safety for the remote pilot. A BVLOS Operating Safety Case and three-week flight test programme was conducted with an AED attached directly to parachute for deployment to simulated OHCA. Results: We completed six flights totalling 92km, 1:02.5 hours of flight time and four successful parachute payload drops. We conducted a successful end-to-end flight demonstration of an AED delivered via BVLOS by drone to a simulated OHCA and resuscitation by lay responder's in a remote location; the final delivery of 4.5km was completed in 2:50 minutes. Conclusion: We have delivered an AED by parachute, from fixed wing drone BVLOS in the UK in simulated OHCA. This project adds to the body of knowledge required for regulatory assurance on drone use BVLOS. Further research is needed before routine use of this technology. [ABSTRACT FROM AUTHOR]

Public perceptions of pandemic viral threats and government policies can influence adherence to containment, delay, and mitigation policies such as physical distancing, hygienic practices, use of physical barriers, uptake of testing, contact tracing, and vaccination programs. The UK COVID-19 Public Experiences (COPE) study aims to identify determinants of health behaviour using the Capability, Opportunity, Motivation (COM-B) model using a longitudinal mixed-methods approach. Here, we provide a detailed description of the demographic and self-reported health characteristics of the COPE cohort at baseline assessment, an overview of data collected, and plans for follow-up of the cohort. The COPE baseline survey was completed by 11,113 UK adult residents (18+ years of age). Baseline data collection started on the 13th of March 2020 (10-days before the introduction of the first national COVID-19 lockdown in the UK) and finished on the 13th of April 2020. Participants were recruited via the HealthWise Wales (HWW) research registry and through social media snowballing and advertising (Facebook®, Twitter®, Instagram®). Participants were predominantly female (69%), over 50 years of age (68%), identified as white (98%), and were living with their partner (68%). A large proportion (67%) had a college/university level education, and half reported a pre-existing health condition (50%). Initial follow-up plans for the cohort included in-depth surveys at 3-months and 12-months after the first UK national lockdown to assess short and medium-term effects of the pandemic on health behaviour and subjective health and well-being. Additional consent will be sought from participants at follow-up for data linkage and surveys at 18 and 24-months after the initial UK national lockdown. A large non-random sample was recruited to the COPE cohort during the early stages of the COVID-19 pandemic, which will enable longitudinal analysis of the determinants of health behaviour and changes in subjective health and well-being over the course of the pandemic. [ABSTRACT FROM AUTHOR]

Built environments have been cited as important facilitators of activity and research using geographic information systems (GIS) has emerged as a novel approach in exploring environmental determinants. The Active Children Through Individual Vouchers Evaluation Project used GIS to conduct a cross-sectional analysis of how teenager's (aged 13–14) environments impacted on their amount of activity and influences fitness. The ACTIVE Project recruited 270 participants aged 13–14 (year 9) from 7 secondary schools in south Wales, UK. Demographic data and objective measures of accelerometery and fitness were collected from each participant between September and December 2016. Objective data was mapped in a GIS alongside datasets relating to activity provision, active travel routes, public transport stops, main roads and natural resources. This study shows that fitness and physical activity are not correlated. Teenagers who had higher levels of activity also had higher levels of sedentary time/inactivity. Teenagers showed higher amounts of moderate-to-vigorous physical activity if their homes were closer to public transport. However, they were also more active if their schools were further away from public transport and natural resources. Teenagers were fitter if schools were closer to natural resources. Sedentary behaviour, fitness and activity do not cluster in the same teenagers. Policymakers/planning committees need to consider this when designing teenage friendly environments. Access to public transport, active travel, green space and activities that teenagers want, and need could make a significant difference to teenage health. [ABSTRACT FROM AUTHOR]

Regular physical activity (PA) during childhood is associated with a range of positive health outcomes and higher educational attainment. However, only 2.0% to 14.7% of girls and 9.5% to 34.1% of boys are meeting the current PA guidelines of 60 minutes of moderate to vigorous PA daily. Schools are targeted as a key setting to improve children's PA levels. The Daily Mile (TDM), a teacher-led 15 minute PA intervention was established in 2012 and has been widely adopted globally. However, the dynamic school environment generates challenges for school-based interventions to follow a uniform implementation method resulting in sustainability issues and limited evaluation. The aims of this mixed-methods study were to (1) explore whether whole-school experiences of TDM were related to implementation and (2) examine the association between TDM and CRF in children from high and low socio-economic groups. Focus groups with pupils (n = 6) and interviews with teachers (n = 9) and headteachers (n = 2) were conducted to explore factors associated with successful implementation. Pupils (n = 258 imputed) aged 9–11 from six primary schools in south Wales, United Kingdom participated in CRF assessments (20m shuttle run test) at two time-points (baseline, 6 month follow-up). Thematic analyses of qualitative measures and linear regression analyses of quantitative measures were used to assess the research questions. Qualitative findings identified implementation factors associated with a positive experience of TDM; flexible and adaptable, not replacing current play provision but delivered as an additional playtime, incorporate personal goal setting, teacher participation, whole-school delivery with community support. Both groups demonstrated equal increases in shuttles between baseline and follow-up (deprived: 4.7 ± 13.4, non-deprived: 4.8 ± 16.0). There was no significant difference in this increase for deprived compared to non-deprived children adjusted for age and gender. Findings from this study provide a set of recommendations for the future implementation and sustainability of TDM. [ABSTRACT FROM AUTHOR]

Access to reliable and timely information ensures that decision-makers can operate effectively. The motivations and challenges of parliamentarians and policy-makers in accessing evidence have been well documented in the policy literature. However, there has been little focus on research-providers. Understanding both the demand- and the supply-side of research engagement is imperative to enhancing impactful interactions. Here, we examine the broader experiences, motivations and challenges of UK-based research professionals engaging with research-users relevant to policy-making and scrutiny in the UK using a nationwide online questionnaire. The context of the survey partly involved contributing to the UK Evidence Information Service (EIS), a proposed rapid match-making service to facilitate interaction between parliamentary arenas that use evidence and research-providers. Our findings reveal, at least for this sub-sample who responded, that there are gender-related differences in policy-related experience, motivations, incentives and challenges for research professionals to contribute to evidence-informed decision-making through initiatives such as the EIS. Male and female participants were equally likely to have policy experience; however, males reported both significantly broader engagement with the research-users included in the survey and significantly higher levels of engagement with each research-user. Reported incentives for engagement included understanding what the evidence will be used for, guidance on style and content of contribution, and acknowledgement of contributions by the policymaker or elected official. Female participants were significantly more likely to select the guidance-related options. The main reported barrier was workload. We discuss how academia-policy engagement initiatives can best address these issues in ways that enhance the integration of research evidence with policy and practice across the UK. [ABSTRACT FROM AUTHOR]