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Statistics is a core subject in the psychology undergraduate curriculum and is often associated with increased anxiety among learners. The aim of this study was to identify factors relating to statistics anxiety, and specifically, how prior experiences in mathematics and A-Level science qualifications may influence students' perceptions as they begin their undergraduate course. Four hundred and eighty-seven first year psychology students filled in an online survey with a range of quantitative and qualitative measures. Number of science A-Level subjects studied at school was a significant negative predictor of interpretation anxiety, and a positive predictor of perceived worth of statistics and perceived self-concept. Students without a mathematics qualification felt at a disadvantage in studying statistics in their degree overall and compared to their peers. Findings provide key insights into students' specific concerns and highlight the benefits of studying science subjects in secondary education prior to a psychology undergraduate degree.

During the last eight years, over 8000 academic faculty and professional services women working in the United Kingdom and the Republic of Ireland have participated in a women-only leadership in higher education programme called Aurora. The organization that designed and delivers the programme (Advance HE) sees it as an important force for change in the sector. However, the potential for meaningful change in traditionally male domains through greater representation of women may be undermined by organizations that remain gendered. To address these issues this article outlines findings from a longitudinal, mixed-methods study on women working in higher education (HE), drawing on data from 1094 research participants. Women completed online surveys at different time points before and after participation in Aurora, with a smaller sample of participants taking part in in-depth interviews and diaries. Analysis of these data shows that the leadership programme is perceived to have a significant impact on some behaviours and attitudes of women and this impact does not on the whole diminish over time. This research is important as it is the first longitudinal study of its kind that includes both professional services and academic women. The findings will be of interest to higher education institutions (HEIs) globally that wish to develop organizational contexts in which women go on to lead.

Recent recommendations have been made to ensure that assessments are aligned with prescribed learning objectives. However, little is known about their usefulness to student and academic groups. Focus groups were conducted with students and academics who studied or taught on a UK undergraduate psychology degree; participants were asked about their perspectives on the purposes of assessments, whether they test the skills they think students should be gaining, and how they use learning objectives in relation to this. Participants were also asked to complete a task matching assessment types to common learning objectives. Results suggested that despite best intentions, both groups still perceive traditional examinations as a test of memory, and students use surface and strategic learning approaches in response. Furthermore, whilst academics use learning objectives to structure teaching, students incorporate learning objectives into strategic and surface level assessment preparations. Results from the matching task suggested that a high proportion of learning objective verbs could cover both surface and deep learning approaches. Consequently, it is argued that students may use learning objectives to develop strategic approaches to learning and assessment preparation, leading to a mismatch between the academic's intended learning approach and the student's used learning approach.

Purpose: At a time when many education systems are grappling with the issue of school reform, there is a concern that traditional UK secondary schools are organised in a way that makes them unable to respond to increasingly complex environmental demands. This research-based paper uses complexity theory to gauge the organisational differences between (1) the traditional model of schooling based on same-age organisation and (2) a form of organisation based on multi-age tutor groups, one that schools call a vertical tutoring (VT) system. The intention is to highlight the organisational changes made by schools that choose to transition from their same-age iteration to the VT system, and expose organisational assumptions in the dominant same-age structure that may account for the failure of reform. Design/methodology/approach: The author's consultancy and research work spans two decades, and includes around 200 UK secondary schools, and others in China, Japan, South Africa, Australia, Qatar, Germany and Colombia. This conceptual paper draws on the recorded discourse and critical reflections of leadership teams during programmes of transformative learning, the process involved in the transition from one system to another. Using descriptions of school organisation abstracted from the complexity literature, differences in the two models not otherwise apparent, come into sharp focus. These not only reveal a substantive connection between organisation, complexity, and individual and organisational learning, but offer insights into the challenge of school reform. Findings: Same-age organisations act in ways that regulate and restrict the agency of participating actors (staff, students and parents). The effect is to reduce a school's learning capacity and ability to absorb the value demand on its system. Such a system is closed and non-complex. VT schools construct an open and fluid learning system from the base, deregulating agency. By unfreezing their structure, they intervene in processes of power, necessitating the distribution of leadership to the organisational edge, a process of complexification. The form of organisation chosen by a school explains the failure of reform. Originality/value: Insights from VT schools cast considerable doubt on the viability of traditional same-age structures to serve complex societies and communities, while highlighting the critical role played by complexity theory in organisational praxis. If correct, the current emphasis on teacher "will and skill", curricular editing, pedagogy and the "what works agenda" will be insufficient to bring about reformational change and more likely to contribute to systemic stasis.

The transition of early career researchers into academic posts is understood to be a crucial career step and marks a point at which representation of women declines significantly. The research adopts a participatory qualitative research methodology through career narrative interviews and group discussions with women engineers recently appointed into academic posts. It was found that academic careers are 'hoped for', but not described as a straightforward option in terms of either securing tenure or future career development. The collective career paths outlined were rarely linear and featured key moments of crisis and self-doubt, culminating in 'tentative' career identity formation in the face of gendered career structures. There is evidence of a pre-emptive and continuing uncertainty about the feasibility of an academic career that begins years before embarking on a PhD. The distinctive contribution of the study is the consideration of gendered early processes of forming an academic identity and ongoing collective experiences of "becoming" an academic.

In this article, we introduce a threefold peer learning model developed during the design and implementation of an innovative researcher-led digital skills training programme for early career researchers. The programme brought together researchers from three UK universities and facilitated the personal and professional development of: (1) the researchers who organised the programme; (2) the researchers who designed and delivered content; (3) the researchers who attended and participated in the digital skills workshops. This article outlines and reflects on its participatory approach to collaborative learning, which responded to the changing needs of UK higher education researchers who increasingly find themselves in interdisciplinary and digitally mediated research contexts. Finally, we propose the transferability of the approach to other fields of knowledge, student/staff learning and professional development.

Background: Stroke survivors with aphasia want to improve their everyday talking (discourse). In current UK practice, 90% of speech and language therapists believe discourse assessment and treatment is part of their role but are hampered by barriers in resources, time and expertise. There is a clinical need for well-articulated discourse assessment and treatments. LUNA is a multi-level treatment targeting words, sentences and discourse macrostructure in personal stories that addresses this clinical need. Objectives: This study aimed to assess the feasibility and acceptability of LUNA trial procedures in a randomised waitlist-controlled trial; and to evaluate preliminary efficacy. Methods: This paper reports a phase II, waitlist-controlled, proof-of-concept feasibility trial. Participants with chronic aphasia (n = 28) were recruited from the community and randomised to an Immediate (n = 14) or Delayed (n = 14) group. LUNA treatment was delivered twice weekly for 10 weeks via the videoconferencing technology, Zoom. Feasibility was assessed in terms of participant recruitment and retention, adherence, missing data, and treatment fidelity. Preliminary treatment efficacy was assessed in terms of between group differences in outcome measures relating to discourse, language, and psychosocial state. Results: The remote LUNA trial was feasible: 85% of those eligible consented to the trial; trial retention was 86%; 87% of treatment sessions were delivered as scheduled, and 79% of participants completed 80%+ of the treatment programme; data was missing only for participants who withdrew; treatment fidelity was high at 92% adherence; and only one clinical outcome measure demonstrated ceiling effects. ANCOVA analysis of the clinical outcome measures revealed group differences with medium and large effect sizes, indicating, improvements in the production of words, sentences, discourse macrostructure, overall language functioning (WAB-R), and psychosocial state (VAMS) following LUNA treatment. For most outcomes measured, similar treatment benefits were suggested in a secondary, non-parametric analysis. Conclusions: Large-scale evaluation of the clinical efficacy and cost-effectiveness of LUNA is warranted and supported by these findings. Trial registration: Clinical trials registration: NCT05847023 (clinical trials.gov). [ABSTRACT FROM AUTHOR]

Background: Early blood transfusion improves survival in patients with life-threatening bleeding, but the optimal transfusion strategy in the pre-hospital setting has yet to be established. Although there is some evidence of benefit with the use of whole blood, there have been no randomised controlled trials exploring the clinical and cost effectiveness of pre-hospital administration of whole blood versus component therapy for trauma patients with life-threatening bleeding. The aim of this trial is to determine whether pre-hospital leukocyte-depleted whole blood transfusion is better than standard care (blood component transfusion) in reducing the proportion of participants who experience death or massive transfusion at 24 h. Methods: This is a multi-centre, superiority, open-label, randomised controlled trial with internal pilot and within-trial cost-effectiveness analysis. Patients of any age will be eligible if they have suffered major traumatic haemorrhage and are attended by a participating air ambulance service. The primary outcome is the proportion of participants with traumatic haemorrhage who have died (all-cause mortality) or received massive transfusion in the first 24 h from randomisation. A number of secondary clinical, process, and safety endpoints will be collected and analysed. Cost (provision of whole blood, hospital, health, and wider care resource use) and outcome data will be synthesised to present incremental cost-effectiveness ratios for the trial primary outcome and cost per quality-adjusted life year at 90 days after injury. We plan to recruit 848 participants (a two-sided test with 85% power, 5% type I error, 1-1 allocation, and one interim analysis would require 602 participants—after allowing for 25% of participants in traumatic cardiac arrest and an additional 5% drop out, the sample size is 848). Discussion: The SWiFT trial will recruit 848 participants across at least ten air ambulances services in the UK. It will investigate the clinical and cost-effectiveness of whole blood transfusion versus component therapy in the management of patients with life-threatening bleeding in the pre-hospital setting. Trial registration: ISRCTN: 23657907; EudraCT: 2021-006876-18; IRAS Number: 300414; REC: 22/SC/0072, 21 Dec 2021. [ABSTRACT FROM AUTHOR]

With the introduction of key information sets (KIS) for all university programmes in the UK from 2012, the character, content and delivery of university degrees may be increasingly used by potential students to differentiate between degree programmes. Therefore, developments in curricula and the relationship to the profession are of growing importance. In this paper, we explore the role of programme content in prospective students' decision-making and describe the prevalence of interdisciplinary content in civil engineering curricula. Following this, we detail student perceptions of interdisciplinary content. It is found that universities currently operate a varied approach to transparency regarding curriculum; students pay little attention to programme content before embarking on their chosen degree; and engineering students view interdisciplinary content in the curriculum with ambivalence, usually ascribing its necessity in the preparation for post-university employment.

Despite sustained efforts to promote engineering careers to young women, it remains the most male-dominated academic discipline in Europe. This paper will provide an overview of UK data and research on women in engineering higher education, within the context of Europe. Comparisons between data from European countries representing various regions of Europe will highlight key differences and similarities between these nations in terms of women in engineering. Also, drawing on qualitative research the paper will explore UK students' experiences of gender, with a particular focus on the decision to study engineering and their experiences in higher education. (Contains 7 notes, 2 tables, and 2 figures.)

Patients with cancer are at increased risk of hospitalisation and mortality following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, the SARS-CoV-2 phenotype evolution in patients with cancer since 2020 has not previously been described. We therefore evaluated SARS-CoV-2 on a UK populationscale from 01/11/2020-31/08/2022, assessing case-outcome rates of hospital assessment(s), intensive care admission and mortality. We observed that the SARS-CoV-2 disease phenotype has become less severe in patients with cancer and the non-cancer population. Case-hospitalisation rates for patients with cancer dropped from 30.58% in early 2021 to 7.45% in 2022 while case-mortality rates decreased from 20.53% to 3.25%. However, the risk of hospitalisation and mortality remains 2.10x and 2.54x higher in patients with cancer, respectively. Overall, the SARS-CoV-2 disease phenotype is less severe in 2022 compared to 2020 but patients with cancer remain at higher risk than the non-cancer population. Patients with cancer must therefore be empowered to live more normal lives, to see loved ones and families, while also being safeguarded with expanded measures to reduce the risk of transmission. [ABSTRACT FROM AUTHOR]

Describes an electronic survey indicating that there is a wide variety of methods that are currently used in United Kingdom higher education institutions to support undergraduate learning. Raises awareness of what colleagues are doing and promotes an exchange of ideas. (Author/ASK)

Outlines the importance of chemical patents as an information source, highlighting the area of structural information and some of the special characteristics of the generic (Markush) type of description. Summarizes important research at Sheffield University (United Kingdom) performed from 1979 to 1995 by a team led by Mike Lynch. (PEN)

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The National Institute for Clinical Excellence updated guidance for continuous glucose monitoring (CGM) in 2022, recommending that CGM be available to all people living with type 1 diabetes. Manufacturers can trade in the UK with Conformité Européenne (CE) marking without an initial national assessment. The regulatory process for CGM CE marking, in contrast to the Food and Drug Administration (FDA) and Australian Therapeutic Goods Administration (TGA) process, is described. Manufacturers operating in the UK provided clinical accuracy studies submitted for CE marking. Critical appraisal of the studies shows several CGM devices have CE marking for wide‐ranging indications beyond available data, unlike FDA and TGA approval. The FDA and TGA use tighter controls, requiring comprehensive product‐specific clinical data evaluation. In 2018, the FDA published the integrated CGM (iCGM) criteria permitting interoperability. Applying the iCGM criteria to clinical data provided by manufacturers trading in the UK identified several study protocols that minimized glucose variability, thereby improving CGM accuracy on all metrics. These results do not translate into real‐life performance. Furthermore, for many CGM devices available in the UK, accuracy reported in the hypoglycaemic range is below iCGM standards, or measurement is absent. We offer a framework to evaluate CGM accuracy studies critically. The review concludes that FDA‐ and TGA‐approved indications match the available clinical data, whereas CE marking indications can have discrepancies. The UK can bolster regulation with UK Conformity Assessed marking from January 2025. However, balanced regulation is needed to ensure innovation and timely technological access are not hindered. [ABSTRACT FROM AUTHOR]

This article presents emergent findings from an empirical research study conducted during Covid lockdown with 52 undergraduate students at a UK university November 2020–April 2021. The research study, which adopts a teacher-practitioner stance, builds on a 2012–2019 programme of research (represented by publications including Barnard 2019) which explores the potentials and dangers that digital technologies hold for pedagogy and education. It is located in the field of Creative Writing and uses the discipline's pedagogical practice of 'workshopping' as a case study. The Creative Writing workshop centres on the exchange of information and critically informed comment by participating students (generally in small groups), and, as such, has similarities with seminars in other disciplines. Hence it is hoped that this article will be of benefit both in the home discipline and more widely. The contention of this article is that, to maintain quality in the delivery of participatory online teaching, it is necessary to ensure an ongoing feedback loop between individuals' bodily existence 'IRL' ('In Real Life') and the section of cyberspace that they carve out and inhabit collaboratively during virtual seminar groups. It considers how the cliché of the 'digital native' can inhibit learning and the role of affect in enabling productive online and engagement. In taking initial steps towards development of a pedagogy of affect in which a 'neutral terrain' is established that enables students to apply and develop close reading skills in an online environment, it presents a new theoretical position on what constitutes effective pedagogy in the context of participatory virtual classrooms. [ABSTRACT FROM AUTHOR]

EU citizenship, now so central to the European Union's project, remains a highly contested concept in respect of its meaning, its scope, and its purpose. By considering the large body of legal texts and their travaux préparatoires from the 1972 Paris European Council until the adoption of the Maastricht Treaty in 1992, we have explored what the original drafters had in mind in developing the concept of EU citizenship and, crucially, what they did not. The article argues that the notion of European citizenship was seen as a tool to define European identity, and thus to continue the building of the European Union as a whole. European citizenship was thus viewed through a constitutional prism from the outset. The constitutional approach to the concept of European citizenship fed into the wider constitutionalisation project under the Maastricht Treaty and, later, permeated the case law of the Court of Justice of the European Union. We wish to argue that this focus on the constitutional nature of EU citizenship overlooked the more practical implications of citizenship, such as how to manage immigration flows or the infrastructure changes needed in the host state to accommodate a significant number of arrivals of EU citizens (in particular in respect of housing and social welfare benefits). It took more than 20 years after the introduction of EU citizenship for the Court of Justice to become aware of the practical, as opposed to constitutional, implications of the direction of travel it had pursued. By that time, it was too late for the United Kingdom, one of the countries which had received the largest number of EU citizens; the UK voted by a narrow margin to leave the European Union. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, digital contact-tracing has been employed in many countries to monitor and manage the spread of the disease. However, to be effective such a system must be adopted by a substantial proportion of the population; therefore, public trust plays a key role. This paper examines the NHS COVID-19 smartphone app, the digital contact-tracing solution in the UK. A series of interviews were carried out prior to the app's release (n = 12) and a large scale survey examining attitudes towards the app (n = 1,001) was carried out after release. Extending previous work reporting high level attitudes towards the app, this paper shows that prevailing negative attitudes prior to release persisted, and affected the subsequent use of the app. They also show significant relationships between trust, app features, and the wider social and societal context. There is lower trust amongst non-users of the app and trust correlates to many other aspects of the app, a lack of trust could hinder adoption and effectiveness of digital contact-tracing. The design of technology requiring wide uptake, e.g., for public health, should embed considerations of the complexities of trust and the context in which the technology will be used. [ABSTRACT FROM AUTHOR]

There has been increasing attention within environmental science, policy and management on the application of natural capital approaches. Despite this, there is an evidence gap in terms of our current understanding of how natural capital and societal benefits are identified at the local scale. This paper presents a novel stakeholder-driven approach to participatory mapping which enables engagement of communities in natural capital discussions across a series of face-to-face workshops. A real-world application is presented for the Deben Estuary, Suffolk (UK); however, the methodological framework could be applied to any global ecosystem (terrestrial, freshwater, estuarine, marine, urban) and community setting. All outputs developed and produced by the Deben Estuary stakeholders, who represent 26 different organisations, were used in subsequent workshops to support scenarios assessments and logic chain developments. The development of logic chains allow for the relationships between natural capital, benefits and beneficiaries to be viewed through multiple lenses, recognising the importance of natural capital in delivering societal benefits and the reliance of beneficiaries on those benefits and the natural capital which underpins them. From a management perspective, the results of this study help to identify which benefits, and therefore which beneficiaries, may be impacted by an intervention, and what direction that impact may take. [Display omitted] • There is increasing attention in science and policy on natural capital approaches. • Evidence gap of how natural capital and benefits are identified at the local scale. • Participatory mapping is advocated to support local natural capital discussions. • Logic chains enable relationships to be viewed through multiple lenses. • The 10-step stakeholder-driven framework has global relevance across all ecosystems. [ABSTRACT FROM AUTHOR]

To explore how the information-sharing context influences how speech and language therapy (SLT) and nursing staff interact on stroke units and what they discuss. Ethnographic methodology was used, with data collected during 40 weeks of fieldwork across three inner city stroke units in the UK. Data comprised field notes collected during 357 h of participant observation and 43 interviews. Interviews were conducted with 14 SLTs, 1 SLT assistant, 24 registered nurses and 4 nursing assistants. This paper is focused on informal information-sharing. SLTs and nurses had different experiences of time and space (the temporal-spatial context) with respect to ward presence and proximity to patients, influencing how they interacted, the content of their talk and their relationships. Most interactions had the quality of interruptions, in which SLTs seized moments in between nursing tasks. Conditions were less suited to sharing information about communication than swallowing and SLTs felt more allied to other therapists than nurses. The temporal-spatial context impeded information-sharing, particularly about patients' communication needs. Consideration should be given to developing relationships between SLTs and nurses as key partners for patient care and raising the profile of communication information in ways that are relevant and useful to nursing work. Strategic waiting for opportunities to interrupt nurses and gain their attention is central to how speech and language therapists manage their need to share information informally with nurses. The small "windows in time" available for interaction influence information-sharing, with a limiting effect on information about patients' communication. There is potential to improve information-sharing between speech and language therapists and nurses by considering how the relevance of information for patient care could be made clearer. [ABSTRACT FROM AUTHOR]

Some social settings such as households and workplaces, have been identified as high risk for SARS-CoV-2 transmission. Identifying and quantifying the importance of these settings is critical for designing interventions. A tightly-knit religious community in the UK experienced a very large COVID-19 epidemic in 2020, reaching 64.3% seroprevalence within 10 months, and we surveyed this community both for serological status and individual-level attendance at particular settings. Using these data, and a network model of people and places represented as a stochastic graph rewriting system, we estimated the relative contribution of transmission in households, schools and religious institutions to the epidemic, and the relative risk of infection in each of these settings. All congregate settings were important for transmission, with some such as primary schools and places of worship having a higher share of transmission than others. We found that the model needed a higher general-community transmission rate for women (3.3-fold), and lower susceptibility to infection in children to recreate the observed serological data. The precise share of transmission in each place was related to assumptions about the internal structure of those places. Identification of key settings of transmission can allow public health interventions to be targeted at these locations. [ABSTRACT FROM AUTHOR]

Diabetes 101 was created by a virtual multidisciplinary diabetes team and initially operated via Twitter in March 2020 as a response to the first national UK lockdown of the COVID-19 pandemic. Anxieties for parents and carers of children living with diabetes were extremely high. Misinformation and a lack of specific guidance for children with type 1 diabetes was a significant problem. This was coupled with intense pressure on clinical services, which were working with reduced staff due to redeployment or self-isolation. The account quickly became a mainstay of the diabetes online community and is now routinely tagged when Twitter users have questions about diabetes. Novel formats of education delivery have been successfully trialled and a resource-sharing website has been developed. The project has demonstrated the power of creative and agile team working combined with accessible technology during one of the most challenging years in NHS diabetes care history. [ABSTRACT FROM AUTHOR]

This paper combines two case studies from the UK and Israel to question/'que(e)ry' LGBTQ people's travel and mobility behaviours, to explore the issue of 'queer mobilities' and related exclusions from heteronormative public transport spaces. Our research demonstrates how the fear of anti-LGBTQ discrimination and violence have profound impacts on LGBTQ people's travel options and activity spaces. Using a mix of qualitative and quantitative methods, we examine how LGBTQ identity/'queerness', visibility, and safety perceptions affect mobility opportunities and choices. We pursue feminist and queer approaches to expose how LGBTQ people embody a complex, intersectional set of mobility considerations. The study reveals grounded experiences of different LGBTQ travellers and their coping strategies to feel able to travel safely. It identifies how LGBTQ participants are not necessarily physically excluded from mobility opportunities. Rather, they pay hidden costs to travel safely, which take the shape of identity and visibility compromises and heightened levels of fear while travelling. They also use more expensive travel alternatives, such as taxis, or take less direct routes to overcome their experiences of unsafe and inaccessible public transport alternatives. Thereby, we advocate a view of mobility as another important dimension of the discrimination and exclusion of sexual and gender minorities. [ABSTRACT FROM AUTHOR]

Aphasia, a language disability, can profoundly affect a person's mood and identity. The experiences of participants who received Solution-Focused Brief Therapy, a psychological intervention, were explored in the Solution-Focused brief therapy In poststroke Aphasia (SOFIA) Trial. Thirty participants with chronic aphasia, 14 with severe aphasia, participated in in-depth interviews that were analyzed using framework analysis. Two overarching themes emerged: valued therapy components (exploring hopes, noticing achievements, companionship, sharing feelings, and relationship with therapist) and perceptions of progress (mood, identity, communication, relationships, and independence). Participants were categorized into four groups: (a) "changed," where therapy had a meaningful impact on a person's life; (b) "connected," where therapy was valued primarily for companionship; (c) "complemental," where therapy complemented a participant's upward trajectory; and (d) "discordant," where therapy misaligned with participants' preference for impairment-based language work. This study suggests that it is feasible to adapt a psychological therapy for people with aphasia, who perceive it as valuable. [ABSTRACT FROM AUTHOR]

Background: Cardiothoracic surgical outcomes are poorer in people with diabetes compared with those without diabetes. There are two important uncertainties in the management of people with diabetes undergoing major surgery: (1) how to improve diabetes management in the weeks leading up to an elective procedure and (2) whether that improved management leads to improved postoperative outcomes. The aim of this study was to develop and pilot a specialist diabetes team-led intervention to improve surgical outcomes in people with diabetes. Design: Open pilot feasibility study Setting: Diabetes and cardiothoracic surgery departments, University Hospital Southampton NHS Foundation Trust Participants: Seventeen people with diabetes undergoing cardiothoracic surgery Intervention: Following two rapid literature reviews, a prototype intervention was developed based on a previously used nurse-led outpatient intervention and tested. Primary outcome: Feasibility and acceptability of delivering the intervention Secondary outcomes: Biomedical data were collected at baseline and prior to surgery. We assessed how the intervention was used. In depth qualitative interviews with participants and healthcare professionals were used to explore perceptions and experiences of the intervention and how it might be improved. Results: Thirteen of the 17 people recruited completed the study and underwent cardiothoracic surgery. All components of the OCTOPuS intervention were used, but not all parts were used for all participants. Minor changes were made to the intervention as a result of feedback from the participants and healthcare professionals. Median (IQR) HbA1c was 10 mmol/mol (3, 13) lower prior to surgery than at baseline. Conclusion: This study has shown that it is possible to develop a clinical pathway to improve diabetes management prior to admission. The clinical and cost-effectiveness of this intervention will now be tested in a multicentre randomised controlled trial in cardiothoracic centres across the UK. Trial registration: ISRCTN; ISRCTN10170306. Registered 10 May 2018. [ABSTRACT FROM AUTHOR]

There has been a longstanding concern among construction scholars and practitioners in classifying construction innovations, whether as "incremental" or "radical," "technological" or "organizational," "product" or "process". In this paper we extend this interest in classification to examine what classification work accomplishes within construction innovation practices. Instead of addressing the validity of innovation categories as objective representations we explore how innovations are classified within everyday interactions that shape how they proliferate. Our approach is informed by socio-material theories of classification, communication and innovation, particularly those from Actor-Network Theory (ANT) and Ventriloquial Analysis (VA). Empirically, our approach is developed through an analysis of how a single innovation – a large format concrete block – was classified within a single warranty approval meeting as it entered the UK housing market. Our analysis explains how such classification work is dynamically constituted by formal and informal classificatory acts that involve displacements of human agency that shape how construction innovations proliferate. Classification work is thus shown to make a vital difference to how construction innovation is accomplished and can be understood. [ABSTRACT FROM AUTHOR]

Learie Constantine was born in Trinidad in 1901 and grew up in Trinidad playing cricket at a time when cricket in Trinidad and the West Indies was divided along racial lines. During the time he was in Nelson, Constantine began to write articles and published his first book I Cricket and I i in 1933, encouraged by C.L.R. James who came to stay with the Constantine family in 1932. James and Constantine knew one another having played cricket in Trinidad. [Extracted from the article]

There is little information about the types of social support and content of assistance for informal carers. This article aims to fill this knowledge gap by studying 37 informal carers in a region of the UK. It was found that adult children were the main source of support for older carers regardless of ethnic backgrounds, minority ethnic carers supported their husband to fulfill traditional caring duties by taking care of mother-in-law in the same household. Young carers received support mainly from uncles and aunts to look after sick parents while adult carers obtained information and peer support from the internet. Surprisingly, support from neighbors was limited. Additionally, social support for carers was undermined by the stigmatization of drug and alcohol misuse and mental illness. It is proposed that different types of online support services and appropriate educational programs need to be offered to carers to set up self-help groups and tackle stigmatization associated with health problems. It is suggested that future studies can use a large representative sample to give a comprehensive picture on the contents of informal support for different types of caregivers and the impact of social support on helping informal carers to fulfill their duties. [ABSTRACT FROM AUTHOR]

Background: Clozapine is the only licensed treatment for treatment refractory schizophrenia. Despite this, it remains grossly underused relative to the prevalence of refractory schizophrenia. The extent of underuse and the degree of regional variation in prescribing in the United Kingdom is unknown. It is also unclear, how the UK compares with other European countries in rates of clozapine prescribing. Methods: We obtained data relating to all clozapine prescribing in the UK from the relevant clozapine registries. We examined regional variation in clozapine use across England, corrected for the known prevalence of severe mental illness (SMI). We also compared the UK rate of clozapine use per 100,000 population to that described in other European countries. Findings: There is substantial variation in clozapine prescribing across different regions of England and only about a third of potentially eligible patients were prescribed the drug in the UK. Clozapine prescribing rate in the UK was lower than in several European countries. Interpretation: There is clear regional inequity in access to the most effective treatment in refractory schizophrenia in England. Strategies to increase clozapine use, by overcoming both real and perceived barriers, are urgently necessary to reduce treatment inequity for patients with refractory schizophrenia. [ABSTRACT FROM AUTHOR]

In this short article I want to consider the economic, legal and political aspects of Brexit. I will do this through the structure of 'red' Brexit (the red lines); white Brexit (the effect of Brexit on the integrity of the United Kingdom); and blue Brexit (the antagonism between the UK and the EU. I want to show the tensions created by Brexit, the implications for the Union of Great Britain and Northern Ireland and the future for the UK. [ABSTRACT FROM AUTHOR]

Purpose: Non‐urgent face‐to‐face outpatient ophthalmology appointments were suspended in the United Kingdom in March 2020, due to the COVID‐19 outbreak. In common with other centres, Moorfields Eye Hospital NHS Foundation Trust (London) offered modified telephone consultations to new and follow‐up patients in the low vision clinic. Here we assess the success of this telephone service. Methods: Data were collected for 500 consecutive telephone low vision appointments. Successful completion of the assessment and clinical outcomes (low vision aids prescribed, onward referral) were recorded. Results: Telephone assessments were completed for 364 people (72.8%). The most common reasons for non‐completion were either no answer to the telephone call (75 people, 15%), or the patient declining assessment (20 people, 4%). There was no association between age and the likelihood of an assessment being completed. 131 new low vision aids were dispensed, 77 internal referrals were made and 15 people were referred to outside services. More than 80% of the low vision aids prescribed were useful. Conclusions: Telephone low vision assessments were completed in about three‐quarters of cases. About one‐quarter of consultations resulted in new low vision aids being dispensed, which were generally found useful. Telephone low vision assessments can be used successfully in a large low vision clinic, but have many limitations when compared to face‐to‐face assessments. [ABSTRACT FROM AUTHOR]

The ability of workers generally to enforce their labour rights in the UK has been a matter of ongoing discussion over a number of years. However, the dominance of the topic of immigration in the Brexit debates, along with questions surrounding the need for, and position of, EU migrant workers in the British labour market, has brought into sharp focus the issues facing the most vulnerable workers in their ability to enforce their employment rights. This, we argue, poses a serious challenge to the rule of law as defined by Bingham. For him, one of the principles of the rule of law is that access to courts is the 'obvious corollary of the principle that everyone is bound by and entitled to the benefit of the law'. This leads to our consideration of, first, the perspective of formal enforcement (a 'thin' conception of the right of access to the courts) and second, effective substantive enforcement (a 'thicker' conception of the right). We argue that some of the reforms proposed in the Taylor review will be a thickened right of access for all workers, but a relatively thinner right for EU migrant workers, in which their particular vulnerabilities and obstacles are not recognized or ameliorated. The chasm between EU migrant and non‐migrant workers in the application of the rule of law would at the very least, remain, if not widen further. [ABSTRACT FROM AUTHOR]

This article addresses the termination of the CJEU's jurisdiction post-Brexit and its replacement with a much more restricted dispute resolution provision, more reminiscent of that found in free trade agreements, focusing in particular on the enforcement of mobility rights. It begins by addressing the root causes for Britain's antagonism towards the Court. It argues that the Court's expansive interpretation of the Treaties, masked by a legalist approach to European integration, has allowed the Court largely to avoid scrutiny by most Member States. Nevertheless, the Court's judicial activism was ultimately rejected by the UK leading to the Court's curia non grata status post-Brexit. It then analyses the key features of the post-Brexit dispute settlement system proposed by the UK and the EU. We argue that while the Court has been criticized for its judicial activism, EU law did provide significant avenues for an individual's access to courts. This fundamental feature is missing from the dispute resolution mechanism under the proposed UK-EU free trade agreement (FTA), leaving an important gap in the system of justice in the future UK-EU relationship. We argue that under the new dispute settlement regime mobility rights will be adjudicated as trade disputes. This has serious implications for the protection of rights of individuals wishing to exercise any future mobility rights. [ABSTRACT FROM AUTHOR]

Only a small number of English hospitals provide postcardiotomy venoarterial extracorporeal membrane oxygenation (VA‐ECMO) and there are doubts about its efficacy and safety. The aim of this service evaluation was to determine local survival rates and report on patient demographics. This was a retrospective service evaluation of prospectively recorded routine clinical data from a tertiary cardiothoracic center in the United Kingdom offering services including cardiac and thoracic surgery, heart and lung transplantation, venovenous extracorporeal membrane oxygenation (VV‐ECMO) for respiratory failure, and all types of mechanical circulatory support. In six years, 39 patients were supported with VA‐ECMO for refractory postcardiotomy cardiogenic shock (PCCS). We analyzed survival data and looked for associations between survival rates and patient characteristics. The intervention was venoarterial‐ECMO in patients with PCCS either following weaning from cardiopulmonary bypass or following a trial of inotropes and intra‐aortic balloon counterpulsation on the intensive care unit. 30‐day, hospital discharge, 1‐year and 2‐year survivals were 51.3%, 41%, 37.5%, and 38.5%, respectively. The median (IQR [range]) duration of support was 6 (4‐9 [1‐35]) days. Nonsurvival was associated with advanced age, shorter intensive care length of stay, and the requirement for postoperative hemofiltration. Reasonable survival rates can be achieved in selected patients who may have been expected to have a worse mortality without VA‐ECMO. We suggest postoperative VA‐ECMO should be available to all patients undergoing cardiac surgery be it in their own center or through an established pathway to a specialist center. [ABSTRACT FROM AUTHOR]

This article reports the findings of a qualitative investigation of the way people find meaning through caregiving. It draws on the results of in-depth interviews with 37 informal carers and 11 stakeholders in Nottinghamshire, the United Kingdom. For most respondents caregiving involved looking after family members—for example, husband or wife, father or mother, young or adult children and mother-in-law. The meaning that respondents found through caregiving motivated them to cope with the difficulties associated with looking after a person in need. This research found that most informal carers operate with long-standing, gender-based understandings of their role, creating a potential risk that using gender-neutral terminology when referring to family members may obscure the subjective values that carers attach to informal caregiving and lead to role confusion. Moreover, although informal carers typically feel obliged to take care of family members in need and may value this role, they often require additional support from the state to reduce the pressures associated with caregiving and to enable them to continue to lead a meaningful life both within and beyond their caring role. [ABSTRACT FROM AUTHOR]

Discussed are trends in British mathematics education with special attention to practice. The importance and proper use of practical work, student-led activities, and matching instruction to student ability are emphasized. Lists 9 references. (YP)

Objective: To identify outcomes relevant to women with lived experience of pre-eclampsia.Design: Qualitative interview study.Setting: A national study conducted in the United Kingdom.Sample: Purposive sample of women with lived experience of pre-eclampsia.Methods: Thematic analysis of qualitative interview transcripts.Results: Thirty women with lived experience of pre-eclampsia were interviewed. Thematic analysis identified 71 different treatment outcomes. Fifty-nine of these had been previously reported by pre-eclampsia trials. Outcomes related to maternal and neonatal morbidity, commonly reported by pre-eclampsia trials, were frequently discussed by women with lived experience of pre-eclampsia. Twelve outcomes had not been previously reported by pre-eclampsia trials. When compared with published research, it was evident that the outlook of women with lived experience of pre-eclampsia was broader. They considered pre-eclampsia in relation to the 'whole' person and attached special significance to outcomes relating to emotional wellbeing and the future health, development and wellbeing of their offspring.Conclusions: Selecting, collecting and reporting outcomes relevant to women with pre-eclampsia should ensure that future pre-eclampsia research has the necessary reach and relevance to inform clinical practice. Future core outcome set development studies should use qualitative research methods to ensure that the long list of potential core outcomes holds relevance to patients.Tweetable Abstract: What do women want? A national study identifies key treatment outcomes for women with pre-eclampsia. Next step: @coreoutcomes for #preeclampsia @NIHR_DC. [ABSTRACT FROM AUTHOR]

A consensus is emerging on the need to use person‐centred planning (PCP) as an approach to the identification of educational learning needs and goals for pupils with special needs, including those on the autism spectrum. The aim of this study was to analyse the interactions of participants in one PCP meeting, specifically the nature of participation of the focus pupil with autism and the way in which this was supported by staff members and parents. Conversation analysis was used to investigate interactional turns and the way in which social actions in the meeting unfolded. Findings are that, despite encouragement and prompting by adult participants, the contribution of the pupil with autism was minimal throughout, except for the mention of one potentially painful issue. The suitability of PCP meetings as a forum for the exploration of difficult issues is discussed and the issue of prior preparation for meetings by child and adult participants is raised with reference to the management of autism as a transactional disability. [ABSTRACT FROM AUTHOR]

Many EU-8 migrant workers work in low-skilled, low-paid jobs, particularly in sectors such as food processing and agriculture. Our interest lies in the experience of those migrant workers in the UK and specifically what happens when they are denied their employment rights. In earlier work, we have already shown that there was a significant underuse by EU-8 migrant workers of Employment Tribunals (ETs). So the questions for this article are three-fold. First, why do so few EU-8 migrant workers enforce their employment rights before ETs and to what extent do legal, economic, political and cultural landscapes, as they are experienced by migrant workers, constrain or enable enforcement action? Second, if migrant workers do not resort to ETs, what do they do? Do they simply move on, or do they use alternative enforcement mechanisms (such as the Gangmasters' Licensing Authority)? How effective are these other enforcement processes and institutions in protecting the rights of migrant and similarly vulnerable domestic workers? And third, what might be done to improve the enforcement of employment rights for EU-8 migrant workers and for other vulnerable workers on the UK labour market, including non-EU migrants, especially in the light of the new labour market enforcement agency (LMEA)? We argue that the establishment of a Pay and Work Rights Ombudsman might help address some of the problems experienced by EU-8 migrant workers and other vulnerable national workers. [ABSTRACT FROM AUTHOR]

Background: The relationship between physical fitness and risk markers for type 2 diabetes (T2D) in children and the contribution to ethnic differences in these risk markers have been little studied. We examined associations between physical fitness and early risk markers for T2D and cardiovascular disease in 9‐ to 10‐year‐old UK children. Methods: Cross‐sectional study of 1445 9‐ to 10‐year‐old UK children of South Asian, black African‐Caribbean and white European origin. A fasting blood sample was used for measurement of insulin, glucose (from which homeostasis model assessment [HOMA]‐insulin resistance [IR] was derived), glycated hemoglobin (HbA1c), urate, C‐reactive protein (CRP), and lipids. Measurements of blood pressure (BP) and fat mass index (FMI) were made; physical activity was measured by accelerometry. Estimated VO2 max was derived from a submaximal fitness step test. Associations were estimated using multilevel linear regression. Results: Higher VO2 max was associated with lower FMI, insulin, HOMA‐IR, HbA1c, glucose, urate, CRP, triglycerides, LDL‐cholesterol, BP and higher HDL‐cholesterol. Associations were reduced by adjustment for FMI, but those for insulin, HOMA‐IR, glucose, urate, CRP, triglycerides and BP remained statistically significant. Higher levels of insulin and HOMA‐IR in South Asian children were partially explained by lower levels of VO2max compared to white Europeans, accounting for 11% of the difference. Conclusions: Physical fitness is associated with risk markers for T2D and CVD in children, which persist after adjustment for adiposity. Higher levels of IR in South Asians are partially explained by lower physical fitness levels compared to white Europeans. Improving physical fitness may provide scope for reducing risks of T2D. [ABSTRACT FROM AUTHOR]

Introduction: Novel psychoactive substances (NPS) are rapidly proliferating in the United Kingdom and elsewhere. We lack detailed information on rationales for their use.Methods: Qualitative data from 431 NPS users were collected as part of a 2014 online survey on NPS (n = 468 NPS users, 704 non-NPS users). These 431 users answered some or all of five open-ended questions on favourite NPS and NPS they would not use and rationales for these assessments.Findings: Respondents were asked to identify and describe favourite NPS. The favourite NPS identified (n = 258 respondents) mostly had brand names (148). Favourite NPS was associated with a good buzz/feeling, euphoria, enhancing sociability and relaxation. Ease of availability, cheapness and legality of NPS were cited. Achieving a predictable, safe high was important. Adverse NPS experience, including dependency issues both personally or amongst friends was reported by a majority of the 148 who described NPS that they would definitely not take and why, most of these reported having now ceased NPS use. Negative experiences ran from the mildly unpleasant to the persistent, serious and life threatening.Conclusions: Developing new methods of reaching and working with NPS users need timely knowledge of global and local trends in NPS use and effects. These data are of some assistance in expanding such knowledge. [ABSTRACT FROM PUBLISHER]

Context Longitudinal integrated clerkships ( LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. Objectives This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. Methods Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. Results Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. Conclusions Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context. [ABSTRACT FROM AUTHOR]

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Aims To assess the impact of continual major National Health Service reorganization on commissioning, organizational and delivery arrangements for secondary care diabetes services. To explore how consultant diabetologists and diabetes specialist nurses perceive the issues facing diabetes specialist services in 2011 and how these have changed in the preceding decade. Methods We used a longitudinal case study approach that combined quantitative and qualitative methods. Five locations in England were purposively selected to represent the wider diabetes specialist community, and seven semistructured interviews were conducted. Interviews were recorded, transcribed verbatim and analysed using Framework analysis. Findings were compared with and contrasted to results from national quantitative surveys of diabetes specialist services undertaken in 2000 and 2006. Results Clinicians viewed positively the expertise and commitment of multidisciplinary teams and their ability to adapt to new situations. Negative perceptions persisted throughout the decade, relating to the continual change that threatens to dismantle relationships and services which had taken many years to establish. Lack of resources, inadequate manpower planning and poor access to psychological support for people with diabetes remained constant themes from 2000 to 2011. Conclusions A willingness to innovate and work differently to improve services was identified; however, clinicians must be supported through organizational changes to ensure people with diabetes receive high-quality care. The disruptive nature of organizational change was a recurrent theme throughout the decade. Periods of stability must exist within commissioning to allow relationships, which are key to integration, to be maintained and permit service improvements to develop. [ABSTRACT FROM AUTHOR]

The article discusses several social work approaches for children and families within Children's Services and Children's Social Care in Great Britain. The issues considered related to the context, application, and evaluation of these methods are explored. The benefits of adopting specific models or one formal approach are also examined.

The article talks about the literary works of poet John Dryden and the translation of the Dryden's poetry book "The Works of Virgil". It discusses the political associations of Dryden and Great Britain's publisher Jacob Tonson. It is noted that Dryden wrote three single dedications for each of Virgil's poems, which shows his political and religious beliefs.

The article discusses the experiences of Irish people in London, England during the 17th and 18th centuries. The author notes that existing historical evidence mostly concerns wealthy travelers rather than poor Irish immigrants living in London. Details on Anglo-Irish identity are presented. Other topics include Irish participation in commerce, social networks, religious life, and recreational activities.

Low bone mass, a major cause of morbidity in patients with β-thalassemia major (β-TM), is multifactorial. There is lack of data about the current prevalence of low bone mass in patients with β-TM. The aims of this study are to examine the current prevalence of low bone mass in β-TM patients and the association between demographic characteristics, markers of iron overload, endocrinopathies, glycemic status and bone mineral density (BMD) as well as to study the 25-OH-vitamin D status of the patients and its relationship with BMD. Our institution serves the largest cohort of β-TM patients in the UK. From 99 patients (49 males, 50 females) with a mean ± standard deviation (SD) age of 36 ± 9 years, 55.5% had low BMD for their age as defined by Z-score BMD <−2.0 either at the lumbar spine (43.9%) or at the hip (25.5%). The only statistically significant association on the multivariate analysis was between hypogonadism and low BMD at the lumbar spine. In our study, 29.9% of patients had vitamin D deficiency, 65.7% had vitamin D insufficiency and 12.4% had optimal levels. No association between vitamin D status and low bone mass was found. Our study demonstrated a much lower prevalence of low bone mass in adults with β-TM compared to previous studies. Further studies are needed to examine whether this suggests a widespread improvement across patients with β-TM possibly due to advances in therapeutics. Most patients had suboptimal 25-OH-vitamin D levels, but no association between vitamin D status and bone mass was demonstrated. [ABSTRACT FROM AUTHOR]

National Audit Data highlight persistent sub-optimum control among increasing numbers of people living with diabetes, with severe consequences for the individual and the NHS. The aim of the present review was to introduce a new cohesive, holistic model of care, tailored to individual needs to support optimum diabetes outcomes. This model of diabetes is necessary in order to understand the driving forces behind behaviour and their impact on diabetes management. Feelings (an emotional state or reaction) and beliefs (an acceptance that something is true or real) are fundamental behavioural drivers and influence diabetes self-management choices. Individually, these explain some of the complexities of behaviour and, collectively, they impact on personal motivation (rationale/desire to act) to achieve a specific outcome. Inevitably, they independently affect diabetes self-management and the environment in which individuals live. A model of care that proposes the encompassing of environment, intrinsic thought and therapy regimens to provide tailored, personalized healthcare should support enhanced diabetes self-management and outcomes from diagnosis. The Kaleidoscope model of care could be deliverable in routine care, incorporating each of the influences on diabetes self-management, and should benefit both individuals with diabetes and healthcare professionals. [ABSTRACT FROM AUTHOR]