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The rise in technology-rich learning environments is reflective of a global trend in higher education (HE), recently accelerated because of necessary digital teaching and assessment practices embraced during the COVID-19 pandemic. This qualitative study facilitated through focus groups and an interview explores the teaching and learning experiences of tertiary level students in the COVID-19 era. Data from 24 students based within a UK Higher Education Institution highlights how an expanded digital environment can optimise conditions for some students to independently practise and apply what they are learning at their own pace. Digitally enhanced opportunities to interact with teaching staff and learning resources also increased the options for these students to experience themselves as competent members of the HE community. This was particularly relevant for first-year students new to the processes and practices of tertiary education. In contrast, third year students with more experience of HE appeared less reliant on the provision of online learning resources. Participants also identified some potential problems associated with the enhanced flexibility of online teaching and learning resources in relation to students' ability to be self-regulated. This paper rationalises the need for educators and educational and learning developers who teach and undertake scholarship in teaching and learning to consider the sociocultural context of the student and their learning environment when designing teaching activities and curricula. The data presented here highlight the need for a clearly defined framework to underpin the integration of digital technologies with on-campus activities.

Background: It is widely accepted that family caregivers are central to the future of cancer care and the impetus is to understand how best to support and empower them. Aims: This study explored the role of the relationship between the caregiver and the child, the level of perceived support, and the self-compassion of the caregiver, on distress and wellbeing in mothers who were the primary caregiver for a child with cancer. Methods: A self-report questionnaire survey of 255 mothers assessed perceived support, attachment to the child, self-compassion and a range of demographic variables including age, education, employment and time since diagnosis. Results: A model was proposed and explored using Hierarchical Multiple Regression Analysis (HMRA) and tested more fully using Structural Equation Modelling. The results of both analyses support the model and show it to be an excellent fit for the data. Conclusions: The findings suggest that the quality of the attachment bond with the child along with mother's ability to be self-compassionate, combined with perceived social support may moderate the impact of care burden on perceived distress for mothers caring for a child with cancer.

Although the support provided by social relationships may be essential to a successful student transition, the transition to postgraduate study has had little consideration from a social support perspective. The study described in this article investigated the role played by social support in postgraduate taught students' adjustment to university, and how social media contributes to this support. Thematic analysis indicated that participants benefitted most from specialised support from peers dealing with similar academic challenges. Facebook groups showed potential as a platform for building supportive peer networks. However, the heightened visibility of communications on this platform led some participants towards Facebook Messenger as a medium for peer contact. The study suggested that, in order to meet postgraduates' needs, institutions could ensure postgraduate students have sufficient opportunity for collaboration within their cohorts. In addition, while social media may aid this process, students' individual communication preferences may inevitably influence their engagement with particular platforms.

This paper investigates the role of interpreters in addressing cultural differences in the context of a cross-cultural collaborative teacher professional development project. Based on positioning theory, this study employed interpreter-mediated interactions and interviews to reveal the complex roles that interpreters played when interpreting culture-related terms. Findings revealed that interpreters' roles were shifting between those of transmitters of information, cultural insiders and constructors of shared understandings between interlocutors. Notably, the lack of training in this specialised field obliged interpreters to rely mainly on their personal experiences to judge which role they should play in the face of cultural differences.

The period between 1980 and 2022 has seen the most radical reforms of education in England since the 1944 Education Act. This article explores those changes and their impact upon the conception and execution of pastoral care in schools. The argument is that these reforms have narrowed the thinking and practice and that what is needed now is a radical reform if we are to be able to engage with all students, enable them to learn and live in the world of today. Specific topics discussed are engagement and inclusion in school, school exclusions, behaviour policies, and mental health.

Drawing on elements of self-determined learning or heutagogy, the graduate employability impact of the UK's leading Universities Business Challenge (UBC) competition is investigated over a five year period of from 2012-17. A central research question was addressed, namely: "what do inter-university business simulations, such as the UBC, contribute to developing self-determined learner skills and graduate employability?" A mixed-methods research approach combined structured equation modelling (SEM) results of 2 student surveys from over 50 (UK) universities, with qualitative analysis of 7 student focus-groups and 15 semi-structured interviews. The article contributes to new knowledge about the role of UBC as an example of an inter-university business simulation. It models the direct and indirect effects of personal/managerial skills development and reflective learning capacity (as mediator) on perceived employability impact. There is fresh evidence to support the claim that "reflective learning" is important in the study of self-determined learning and graduate employability.

In 2018, the UK Conservative government issued a 'non-negotiable' instruction for universities to make 'positive mental health' a strategic priority. This was responding to growing pressure from a variety of stakeholders including mental health organisations, student groups and higher education (HE) management who claimed a worsening crisis of student mental health in the UK. We conducted a qualitative media analysis (QMA) of public discussions of student mental health as a social problem in a sample of (a) newspapers and (b) policy documents produced in the UK between 2010 and 2019 using a contextual constructionist approach and Kingdon's policy streams framework. It identifies expansive definitions of mental illness, assumptions that precede evidence-gathering, 'professional exes' as policy entrepreneurs, and solutions that spread risk across institutions. We conclude by discussing the shift away from autonomous subjectivity towards more heteronomous constructions. In so doing it provides an important contribution to sociological understandings of contemporary subjectivity and social policy regarding mental health in HE. [ABSTRACT FROM AUTHOR]

This study investigates the role of personal values as motivational antecedents for understanding higher education (HE) student career decidedness among university business school (UBS) students. We propose a new "protean"-informed HE student career decidedness model for theorizing how both personal values and social capital mediators ("student social capital"; "personal, social and enterprise skills"; "access to resources") help in the student-centric and self-directed processes of career decision-making. A mixed-methods study combines a (stage 1) survey of 308 UBS students from 5 (UK) UBS, with results from (stage 2) 4 student focus groups, and (stage 3) 2 staff-student interactive seminars. From an employability perspective, arguably, the ultimate responsibility for becoming a "protean graduate" rests with each UBS student, while the obligation of HE staff is to effectively facilitate and nurture all possible personal growth and skills development opportunities.

This article is the second in a 2-part synthesis of an international comparative seminar on the classification of children with disabilities. In this article, the authors discuss classification frameworks used in identifying children for the purpose of providing special education and related services. The authors summarize 7 papers that addressed aspects of disability classification in educational systems in the United States and the United Kingdom. They discuss current policies for determining which children receive special education services, the origins and evolution of these policies, and current dilemmas and challenges associated with classification schemes and the provision of special education. The authors also describe emerging data and possible models and practices that might be used in educational systems. They conclude with the recognition that both formal and informal educational classification systems will continue to be required within a system that must address the competing priorities of individual needs and the broader social and community goals of education. However, as was argued in the previous article, by understanding the mix of intentions that underpin these policies, as well as periodically reviewing the norms that underlie them, it may be possible to move classification to descriptors that can be used to efficiently and effectively define educational needs and distribute resources. [For Part I see, EJ758165.]

Aim: For people with haemophilia A (PwHA), bleeding in the joints leads to joint damage and haemophilia‐related arthropathy, impacting range of motion and life expectancy. Existing guidelines for managing haemophilia A support healthcare professionals (HCPs) and PwHA in their efforts to preserve joint health. However, such guidance should be reviewed, considering emerging evidence and consensus as presented in this manuscript. Methods: Fifteen HCPs experienced in the management of PwHA in the UK participated in a three‐round Delphi panel. Consensus was defined at ≥70% of panellists agreeing or disagreeing for Likert‐scale questions, and ≥70% selecting the same option for multiple‐ or single‐choice questions. Questions not reaching consensus were revised for the next round. Results: 26.8% (11/41), 44.8% (13/29) and 93.3% (14/15) of statements reached consensus in Rounds 1, 2 and 3, respectively. HCPs agreed that prophylaxis should be offered to patients with a baseline factor VIII (FVIII) level of ≤5 IU/dL and that, where there is no treatment burden, the aim of prophylaxis should be to achieve a trough FVIII level ≥15 IU/dL and maintain a longer period with FVIII levels of ≥20–30 IU/dL to provide better bleed protection. The aspirational goal for PwHA is to prevent all joint bleeds, which may be achieved by maintaining normalised (50–150 IU/dL) FVIII levels. Conclusion: The panel of experts were largely aligned on approaches to preserving joint health in PwHA, and this consensus may help guide HCPs. [ABSTRACT FROM AUTHOR]

This paper analyses teachers' engagement with collaborative and open educational practices to develop their pedagogical expertise in the field of modern language (ML) learning and specific learning difficulties (SpLD). The study analyses the findings of a staff development initiative at the Department of Languages, Open University, UK, in 2013, that aimed to support language teachers in distance learning to develop a better understanding of key issues in relation to MLs and adult learners with SpLD and dyslexia in particular. It discusses the motivational benefits of online collaboration for teachers' professional development and explains the implications of using a range of network-based tools to facilitate the construction of active shared learning and the joint production of open-access learning resources aimed at supporting adult language learners with SpLD in distance learning settings.

In this paper we explore the importance of relationality and care for understanding women's alcohol use, using a theoretical framework comprising concepts from feminist ethics of care, the sociology of personal life, and feminist approaches to governmentality. A key focus is how care giving responsibilities and expectations in families appear to be particularly significant for creating or constraining possibilities for drinking practices. We draw on findings from a qualitative study about alcohol use and stress with 26 women, aged 24-67 years, in the North East of England, UK. We consider how care practices in families feature in the accounts of alcohol use by women with and without children, and how the symbolic and material aspects of social class interact with care to alter the drinking practices women engage in. The interpretation extends scholarship on women's drinking, by adopting a relational approach to identity and linking private care practices and alcohol use to social and political structures. Public health approaches for preventing or reducing heavy drinking practices are predominantly situated within biomedical or psychological paradigms. Intervention approaches to reduce women's drinking that draw on our theoretical framework could offer potential for reducing harmful alcohol use in a more meaningful way. [ABSTRACT FROM AUTHOR]

Background: Cerebral palsy (CP) is one of the most common neurological disorders in children and results in lifelong physical impairments. Adults with CP have approximately the same life expectancy as their non-disabled peers, so helping them to stay healthy throughout the life course will have long-term cost benefits via reductions in hospital admissions, long-term care, and unemployment rates. Aim: To explore how adults with CP experience ageing. Design & setting: National online survey given to adults with CP in the UK. Method: The participants were adults with CP. Items for the online survey were taken from existing self-report measures, with additional items developed for the survey. Several domains of functioning were assessed including mobility, dexterity, fatigue, pain, speech, mental health, swallowing and health maintenance/self-care as well as healthcare usage. Data were analysed using χ2 to examine the relationships between the demographic variables and the survey responses. Results: The survey was completed by 395 participants, of whom 74.2% were female and approximately 59.3% aged <45 years. Responders reported having problems with mobility, pain, and fatigue with older participants reporting higher levels of pain and more mobility problems, although the correlations were fairly small. Healthcare usage was surprisingly low. Conclusion: The study found that age was associated with a decline in mobility and a higher level of pain, although the relationships were weak. It is possible that the low healthcare usage among the responders is owing to services not being available to respond to their needs. [ABSTRACT FROM AUTHOR]

Introduction: Joint bleeds in haemophilia cause destruction of articular structures, impaired function and pain. Up to 70% of people with haemophilia (PWH) report chronic pain. Little is known about the pain experiences in PWH in the UK. Aim: To identify prevalence and perceptions of pain among PWH living in the UK. Methods: A cross‐sectional, non‐interventional survey study conducted among PWH (all severities). The survey incorporated elements from validated tools (EQ‐5D; EQ‐VAS) and was distributed via participating treatment centres. Results: Five hundred and ninety‐nine PWH responded, 91% aged > 18. 81% used factor prophylactically or on demand. More pain was reported by those treated on demand versus prophylaxis particularly in those who reported daily pain. 65% reported 'problem joints' based on individual impact rather than medically defined 'target joints', 2/3 reported multiple joint issues. The ankle was most commonly affected. 59% reported frequent pain, with 56% aware of pain constantly or most of the time and were more likely to report less favourable EQ‐5D or EQ‐VAS scores (p <.001). Pain frequency/awareness was consistent across all severities. Most discussed pain with care teams, 31% only when asked; 25% did not discuss it. Pain discussions resulted in physiotherapy referral (63%) analgesia prescription (48%), and a minority specialist pain referral (9%). Most felt well supported with regard to their pain, but 70% reported learning to live with it. Conclusion: Pain affects PWH of all ages and severities even in a well‐resourced country significantly impacting quality of life. Clinicians must be more aware of chronic pain in PWH. Biopsychosocial approaches to pain assessment and management are recommended. [ABSTRACT FROM AUTHOR]

In modern language (ML) distance learning programmes, teachers and students use online tools to facilitate, reinforce and support independent learning. This makes it essential for teachers to develop pedagogical expertise in using online communication tools to perform their role. Teachers frequently raise questions of how best to support the needs of their diverse groups of adult language learners. This is particularly relevant in the case of modern language students with learning difficulties, including dyslexia, whose previous experiences of language learning can sometimes be negative and frustrating. This case study relates to a staff development project which took place between December 2012 and June 2013 at the Department of Languages in the Open University, UK, and involved 12 ML teachers across a range of languages and levels. In the "Dyslexia and Modern Language Learning project," teachers worked and learnt together to: (1) develop understanding of key issues in relation to ML learning and dyslexia, (2) share good practice and experiences through reflection and collaboration, (3) find effective methods and strategies to support adult ML learners with dyslexia and (4) facilitate the joint design of learning resources for the online environment. The study presents the findings and the outcomes of the project, including the set of teaching and learning resources produced by the teachers as well as their recommendations on good practice. It also discusses the impact of the project on developing ML teachers' attitudes and practices when supporting adult students with dyslexia.

The circadian clock regulates multiple aspects of human physiology including immunity. People have a circadian preference termed chronotype. Those with an evening preference may be better suited to shift work, but also carry higher risk of adverse health. Shift work leads to misalignment of circadian rhythms and is associated with increased risk of inflammatory disease such as asthma and cancer. Here, we investigate the association between chronotype, shift work, and rheumatoid arthritis (RA). The associations between exposures of shift work and chronotype on risk of RA were studied in up to 444,210 U.K. Biobank participants. Multivariable logistic regression models were adjusted for covariates: age, sex, ethnicity, alcohol intake, smoking history, Townsend Deprivation Index (TDI), sleep duration, length of working week, and body mass index (BMI). After adjusting for covariates, individuals with a morning chronotype had lower odds of having rheumatoid arthritis (RA; odds ratio [OR]: 0.93, 95% confidence interval [CI]: 0.88-0.99) when compared to intermediate chronotypes. The association between morning chronotype and RA persisted with a more stringent RA case definition (covariate-adjusted OR: 0.89, 95% CI: 0.81-0.97). When adjusted for age, sex, ethnicity, and TDI, shift workers had higher odds of RA (OR: 1.22, 95% CI: 1.1-1.36) compared to day workers that attenuated to the null after further covariate adjustment (OR: 1.1, 95% CI: 0.98-1.22). Morning chronotypes working permanent night shifts had significantly higher odds of RA compared to day workers (OR: 1.89, 95% CI: 1.19-2.99). These data point to a role for circadian rhythms in RA pathogenesis. Further studies are required to determine the mechanisms underlying this association and understand the potential impact of shift work on chronic inflammatory disease and its mediating factors. [ABSTRACT FROM AUTHOR]

Introduction: The current study explored whether camouflaging autistic traits is associated with defeat and entrapment and lifetime suicidal thoughts, as predicted by the Integrated Volitional Model of Suicide (IMV model). Methods: 180 UK undergraduate students (76.7% female 18–67 years) completed a cross‐sectional online survey from February 5 to March 23, 2020, including self‐report measures of defeat and entrapment (SDES), autistic traits (AQ‐10), depression (PHQ‐9), anxiety (GAD‐7), camouflaging autistic traits (CAT‐Q), and lifetime suicidal thoughts and behaviors (SBQ‐R item 1). Results: After controlling for age, gender, current depression, and anxiety symptoms, autistic traits accounted for significantly more of the variance in defeat and entrapment (1.1%), and camouflaging accounted for a further 3.2% of the variance. The association between autistic traits and lifetime suicidality was significantly mediated by camouflaging, defeat, and entrapment. After controlling for age, gender, current depression, and anxiety symptoms, defeat and entrapment (but not camouflaging) accounted for significantly more variance in lifetime suicidal thoughts. The interaction between camouflaging, defeat and entrapment predicted significantly less variance in lifetime suicidal thoughts than either variable alone. Conclusion: Results suggest that camouflaging autistic traits is a transdiagnostic risk factor for lifetime suicidality, relevant to the defeat and entrapment constructs of the IMV model. [ABSTRACT FROM AUTHOR]

Aim: To investigate the acceptability and feasibility of adapted group therapy for anxiety in children with autism spectrum disorder in a pilot randomised controlled trial. Method: A total of 32 children aged 9-13 years were randomised to immediate or delayed therapy using the "Exploring Feelings" manual (Attwood, 2004). Child and parent groups were run in parallel, for seven weekly sessions, under the supervision of experienced psychologists. The primary blinded outcome measures addressed change in overall functioning and in severity of the primary anxiety diagnosis after 3 months. esults: Children met diagnostic criteria for 1-6 anxiety disorders (median 3). At end point, both parents and children in the immediate therapy group were more likely to report a reduction in anxiety symptoms. Fidelity of delivery of the group therapy was high, and attendance was 91%. Conclusions: This pilot trial established that children and families were willing to be recruited and randomised, the outcome measures were acceptable, the format and content of the groups were feasible within UK child and adolescent mental health services, the intervention was appreciated by families and attrition was very small.

Amanda McLaughlin discusses the need for support for care home staff when it comes to oral health. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to discuss the value of social learning from group work that emulates a professional community of practice. Design/methodology/approach: A thought piece that first, examines the role of group-work projects as part of social learning, then outlines key arguments for social learning based upon applying a "communities of practice" approach and finally, discusses the experience of a leading UK university in light of Hoadley and Kilner's "C4P" communities of practice framework. Some reflections are offered to help practitioners and academics who wish to adopt a similar approach. Findings: Developing a communities of practice approach using group work can promote social learning and workplace transferrable skills. The authors discussed five main elements of the C4P communities of practice framework in light of a group project at a leading UK university: "purpose"--to emulate an IT consultancy environment and create energy and results as part of the final year group-work project; "conversation and connections"--to promote information exchange between group members through meetings, e-mail, or wikis; "content and context"--drawing upon organisational knowledge and directing groups to improve the quality of project deliverables. Some key reflections include: emulating real world practice helps develop transferrable skills; building membership of a community through simulated teamwork roles encourages motivation; and group leadership helps achieve common purpose. Originality/value: The paper offers a unique insight and applies a communities of practice framework for analysing and developing group work as part of social learning. (Contains 1 figure.)

This article explores the research underpinning views of emotional well-being and its development in schools and classrooms. Research concerning the concepts of emotional intelligence, resilience and protective factors, mental health and young people and emotional regulation is examined and its implications interpreted. The author critically reviews the focus of interventions, the nature of the interventions and the strategies being adopted by policy-makers. She argues that there are dangers in solely adopting an individualistic programmatic approach and suggests that a wider emphasis on relationships, pedagogy and community building is central to the development of emotional well-being in young people.

This article reports on part of a study of dissertation work in taught Masters courses. It focuses on presenting findings from interviews with 13 supervisors in a faculty of education concerning the normative order that they believed should prevail within the supervisory relationship, and their complex representation of student agency and of student and supervisor responsibilities. The final discussion frames central findings within a sociocultural account of learning and teaching. It highlights the quality of shaping and supporting students efforts that framed supervisors commitments and actions: i.e. it details how supervisors saw themselves as having a gatekeeping role and a commitment to align students work with academic standards, and at the same time a personal commitment which involved a responsibility to assist students to pursue a topic that excited their interest and to support their sense of agency. (Contains 2 figures.)

Background: Bereavement is a common traumatic event associated with adverse health outcomes across the life course. Despite these risks, not all bereaved individuals experience these negative effects. Limited scientific consensus exists on how to define resilience in individuals who have experienced the death of a loved one. Methods: Using a sample of N = 3766 youth from the Avon Longitudinal Study of Parents and Children birth cohort, we identified bereavement of a family member between ages 7 and 8.5. We derived and compared three different approaches to assess resilience among bereaved youth. Trajectory-based psychological resilience identified sub-groups with similar psychological symptom profiles between ages 6 and 16 using latent growth mixture models. Relative psychological resilience at age 16 leveraged standardized residuals from a model regressing psychological symptoms on bereavement to determine better-than-expected psychological functioning relative to bereavement status. Relative cross-domain resilience around age 16 was a sum score of the residuals approach applied to eight unique domains of health. Predictive validity of each approach was assessed using depressive symptoms at age 17.5 Results: Overall, N = 877 (23%) youth were bereaved of a family member between ages 7 and 8.5. Using latent growth mixture models, a three-class solution described 84% of bereaved youth with low and stable psychological symptoms over time, 8% with worsening symptoms, and 8% with improving yet elevated symptoms. Each relative resilience score was largely concordant with the trajectory-based approach in identifying individuals as resilient or not, though relative psychological resilience demonstrated a stronger degree of concordance than the cross-domain score. Relative psychological and cross-domain resilience exhibited moderate to low correlation, depending on the domains included (r = 0.14–0.43). For each approach, resilience significantly predicted lower depressive symptoms at age 17.5, highlighting predictive validity of these measures. Conclusions: Psychological symptom trajectories among bereaved youth aligned with those previously identified among bereaved adults. The residual-based approach to defining resilience exhibited limited utility in the context of bereavement. When identifying risk and resilience after bereavement, researchers and clinicians must address the interplay across psychosocial and physical health domains, as bereaved youth considered resilient from a mental health perspective may benefit from intervention in other domains. [ABSTRACT FROM AUTHOR]

This article explores school-university partnerships in educational research and is written from the perspective of the university partner. It explores three main questions: Why engage in teacher research? Why do it in a partnership? What are the benefits, limits and difficulties? The author draws on her experience of two collaborations, where the university and teachers were co-researchers, to inform the exploration of these three questions. She also explores and reflects on current research and policy initiatives in the United Kingdom. (Contains 2 figures.)

Reports on two classroom studies in which teachers deliberately evaluated their own teaching strategies in relation to their students' writing and homework tasks. Students were asked about their preferences for the various strategies. Finds that effective learning requires pupils to be mentally active in and take some responsibility for their own writing and homework. (Author/WRM)

The article discusses the different types of restrictive interventions and describes some strategies that can support reduction of their use in mental health settings. Topics discussed include different types of restrictive interventions such as enhanced observations, seclusion and restraint; ethical issues and legal framework around restrictive interventions; and strategies to prevent behaviour that challenges and reduce the need for restrictive interventions.

Background: People with dementia and their caregivers often lack equitable access to hospice care which is a concern internationally. Domains of best practice in palliative care for this population exist and hospices are urged to become dementia friendly. Aim: This study aimed to evaluate the model of 'Hospice Enabled Dementia Partnership' mapped to international domains of best practice. Design: Three-phased monitoring, group interview and individual interview study using a formative evaluation framework. Setting / Participants: The partnership model was a collaboration between a large specialist palliative care hospice, a dementia charity and a Health Care Trust in the United Kingdom. Service documents were subjected to documentary review of monitoring activity and key indicators of service success. Group interviews and individual interviews took place with family carers (n = 12), health care professionals involved in delivering the service (n = 32) and senior professionals (n = 5) responsible for service commissioning in palliative or dementia care. Results: One hundred people with dementia were referred to the service between May 2016 and December 2017. Thirty-eight of the 42 people who died, achieved their preferred place of care and died at home. Four themes were derived from the data 'Impact of Dementia', 'Value of the Service', 'Information and Learning Needs' and 'Working in Partnership'. Conclusions: Positive outcomes resulted from this best practice model; achievement of preferred place of care and death at home, dual benefits of therapies for patients and families and partnership in cross working and learning between services. Replication of this model should be considered internationally. [ABSTRACT FROM AUTHOR]

This study has two aims: to explore the experiences and impact of adoption among five adults (three males and two females, all over the age of 55) adopted from mother and baby homes in the UK and Ireland, and to establish each participant's state of mind (SOM) with regards to attachment using the Adult Attachment Interview (AAI) (George, Kaplan and Main, 1985–1996). It makes use of all information gained from the AAI by analysing the interview transcripts in two ways: (1) using the AAI scoring system (Main, Goldwyn and Hesse, 2003) to assess SOM; and (2) thematic analysis of the transcripts to produce an inductive set of themes. It was found that all participants had an insecure SOM with regards to attachment. For four out of the five participants, this was unresolved/disorganised, and the category 'preoccupied' was the most prevalent underlying three-way classification. Qualitative analysis of transcripts identified four overarching themes: (1) identity and belonging; (2) trauma; (3) 'silenced' coping; and (4) adverse parenting which reflected their experiences of adoption. The findings indicate that the participants were highly susceptible to trauma associated with loss. They also highlight the importance of suitable adoption placements and vetting of potential adopters. The clinical and research implications of the results and their contribution to the broader discussion of trauma related to adoption are discussed. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to empirically analyse specific characteristics of an audit committee that could be associated with the likelihood of corporate fraud/scandal/sanctions. Design/methodology/approach: The sample includes all firms that were investigated by the Financial Reporting Council through the audit enforcement procedure from 2014 to 2019, and two matched no-scandal firms. It uses logistic binary regression analysis to examine the hypotheses. Findings: Results based on the logit regression suggest that audit member tenure and audit committee meeting frequency both have positive associations to the likelihood of corporate scandal. Complementing this result, the authors find negative but insignificant relationships amongst audit committee female chair, audit committee female members percentage, audit committee qualified accountants members, audit committee attendance, number of shares held by audit committee members, audit committee remuneration, board tenure and the likelihood of corporate scandal across the sample. Research limitations/implications: The results should help regulatory policymakers make decisions, which could be crucial to future corporate governance. Additionally, these results should be useful to investors who use corporate governance as criteria for investment decisions. Originality/value: The authors extend, as well as contribute to the growing literature on the audit committee, and therefore, wider corporate governance literature and provide originality in that it is the first, to the knowledge, to consider two characteristics (i.e. remuneration and gender) in a UK context of corporate scandal. Also, the results imply that the structure and diversity of the audit committee affect corporate fraud/scandal/sanctions. [ABSTRACT FROM AUTHOR]

Introduction: Prior to the COVID-19 pandemic, research in virtual care for young people with eating disorders was preliminary and implementation rare. This study explored the experience of young people, parents and clinicians when therapy was transitioned to virtual provision as a result of the UK lockdown in March 2020. Methods: A mixed-method approach was used in this study. Online questionnaires that included a mixture of rating (Likert scale) and free-text response questions were completed by 53 young people with any eating disorder, 75 parents and 23 clinicians. Questions focused on the experience of online treatment as well as the impact on engagement, perceived treatment efficacy and preferences around treatment mode in the future. Likert scale questions were analysed using a summary approach. Free-text responses were analysed qualitatively using reflexive thematic analysis. Results: Responses to rating scale questions indicate satisfaction with treatment, good engagement and ability to manage technology. Young people who had transitioned care, rather than started care virtually in lockdown, rated therapy as less effective. However, individual accounts of experience were more varied. Reflexive thematic analysis of free-text responses identified key themes of 1) Making it work, 2) Home as a therapeutic space, and 3) Disrupted connection and 4) Into the future. Conclusions: These results have implications for ongoing care during the pandemic and for future implementation of virtual care in the treatment of young people with eating disorders. Particular issues arising are the trade-off between accessibility and therapeutic engagement and depth and need for consideration of equal access to treatment in socially unequal societies. Plain English summary: Due to the COVID-19 pandemic specialist eating disorder treatment needed to quickly adapt to new technologies. All but urgent and crisis appointments needed to be delivered online. This study looked at what that was like for the young people, their parents and clinicians engaged in treatment in a large specialist eating disorder service in London, UK. Fifty-three young people with an eating disorder, 75 parents and 23 clinicians completed anonymous online surveys about their experience. Results showed that generally people were satisfied with treatment, the therapeutic relationship was maintained and most managed technological issues well. Four main themes were identified from responses to open ended free-text response questions. All three groups wrote about 1) making it work, 2) home as a therapeutic space, and 3) disrupted connection. The fourth theme, 4) into the future, came from parent and clinician responses only. These results have implications for ongoing care during the pandemic and for future implementation of virtual care in the treatment of young people with eating disorders. Particular issues arising are the trade-off between accessibility and the potential impact on the therapeutic relationship. There is also a need to make sure there is equal access to treatment in socially unequal societies. [ABSTRACT FROM AUTHOR]

Food systems are significant sources of global greenhouse gas emissions (GHGE). Since emission intensity varies greatly between different foods, changing food choices towards those with lower GHGE could make an important contribution to mitigating climate change. Public engagement events offer an opportunity to communicate these multifaceted issues and raise awareness about the climate change impact of food choices. An interdisciplinary team of researchers was preparing food and climate change educational activities for summer 2020. However, the COVID‐19 pandemic and lockdown disrupted these plans. In this paper, we report on shifting these events online over the month of June 2020. We discuss what we did and the reception to our online programme. We then reflect on and highlight issues that arose. These relate to: (1) the power dynamics of children, diet and climate change; (2) mental health, diet and COVID‐19; (3) engaging the wider science, agriculture and food communities; (4) the benefits of being unfunded and the homemade nature of this programme; (5) the food system, STEAM (science, technology, engineering, arts and mathematics) and diversity; and (6) how our work fits into our ongoing journey of food and climate change education. [ABSTRACT FROM AUTHOR]

The coronavirus (COVID-19) outbreak started in December 2019 and rapidly spread around the world affecting millions of people. With the growth of infection rate, many countries adopted different policies to control the spread of the disease. The UK implemented strict rules instructing individuals to stay at home except in some special circumstances starting from 23 March 2020. Accordingly, this study focuses on sensitivity analysis of transmissibility of the infection as the effects of removing restrictions, for example by returning different occupational groups to their normal working environment and its effect on the reproduction number in the UK. For this reason, available social contact matrices are adopted for the population of UK to account for the average number of contacts. Different scenarios are then considered to analyse the variability of total contacts on the reproduction number in the UK as a whole and each of its four nations. Our data-driven retrospective analysis shows that if more than 38.5% of UK working-age population return to their normal working environment, the reproduction number in the UK is expected to be higher than 1. However, analysis of each nation, separately, shows that local reproduction number in each nation may be different and requires more adequate analysis. Accordingly, we believe that using statistical methods and historical data can provide good estimation of local transmissibility and reproduction number in any region. As a consequence of this analysis, efforts to reduce the restrictions should be implemented locally via different control policies. It is important that these policies consider the social contacts, population density, and the occupational groups that are specific to each region. [ABSTRACT FROM AUTHOR]

The regulation of professional activity in the Health and Social Care sector in the UK is carried out by a number of statutory bodies that hold legal mandates to manage the risks of professional malpractice. The prime method used to perform this duty, and thereby protect the public, is the construction of a register of the suitability qualified—and creation of appropriate professional standards to establish a benchmark for practice. When registrant's performance or conduct is felt not to meet these standards, they are placed within a fitness to practice process administered by the regulatory body. This article examines the publicly available data on fitness to practice cases from UK regulatory bodies relating to the professions of social workers, nurses, midwives and doctors. Examining nearly 1,000 cases, the authors run a statistical analysis of the data to establish whether any differences are found amongst and between these professional groupings. We find there are several areas where significant differences arise, namely gender, attendance and representation. Most of these regulatory bodies are, in turn, regulated in the UK by the Professional Standards Authority (PSA), and the article concludes by suggesting ways forward for the PSA in addressing or further examining apparent inequalities. The analysis is placed within a wide range of literature, with an emphasis on the international transferability of the approach to professional regulation. [ABSTRACT FROM AUTHOR]

Older adults in the community are at risk of malnutrition and dehydration. The present article aims to outline an intervention and a population-health approach to raise awareness of the importance of good nutrition and hydration in later life. This was addressed by developing strong partnership working, governance frameworks and local steering committees. Through the Greater Manchester Nutrition and Hydration Programme, 39 500 older people have been asked about appetite and weight loss and/or used the PaperWeight Armband to date. A total of 5586 people from this population were found to be at risk of malnutrition. All were provided resources, advice and signposting to address this issue. The gross fiscal return on investment over a 5-year period was 3.2-fold and the net present budget impact was £800 000. The long-term cashable fiscal return on investment was estimated at 2.69. This very promising approach has potential to enable older adults to extend their healthy life span and deliver cost savings to the health and care system. [ABSTRACT FROM AUTHOR]

Drawing on elements of self-determined learning or heutagogy, the graduate employability impact of the UK's leading Universities Business Challenge (UBC) competition is investigated over a five year period of from 2012–17. A central research question was addressed, namely: what do inter-university business simulations, such as the UBC, contribute to developing self-determined learner skills and graduate employability? A mixed-methods research approach combined structured equation modelling (SEM) results of 2 student surveys from over 50 (UK) universities, with qualitative analysis of 7 student focus-groups and 15 semi-structured interviews. The article contributes to new knowledge about the role of UBC as an example of an inter-university business simulation. It models the direct and indirect effects of personal/managerial skills development and reflective learning capacity (as mediator) on perceived employability impact. There is fresh evidence to support the claim that reflective learning is important in the study of self-determined learning and graduate employability. [ABSTRACT FROM AUTHOR]

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RituxiCAN-C4 combined an open-labeled randomized controlled trial (RCT) in 7 UK centers to assess whether rituximab could stabilize kidney function in patients with chronic rejection, with an exploratory analysis of how B cell-depletion influenced T cell anti-donor responses relative to outcome. Between January 2007 and March 2015, 59 recruits were enrolled after screening, 23 of whom consented to the embedded RCT. Recruitment was halted when in a pre-specified per protocol interim analysis, the RCT was discovered to be significantly underpowered. This report therefore focuses on the exploratory analysis, in which we confirmed that when B cells promoted CD4+ anti-donor IFNγ production assessed by ELISPOT, this associated with inferior clinical outcome; these patterns were inhibited by optimized immunosuppression but not rituximab. B cell suppression of IFNγ production, which associated with number of transitional B cells and correlated with slower declines in kidney function was abolished by rituximab, which depleted transitional B cells for prolonged periods. We conclude that in this patient population, optimized immunosuppression but not rituximab promotes anti-donor alloresponses associated with favorable outcomes. Clinical Trial Registration: Registered with EudraCT (2006-002330-38) and www.ClinicalTrials.gov, identifier: NCT00476164. [ABSTRACT FROM AUTHOR]

This article presents the first academic analysis of 'national treasure' as a status designation for an elite category of British celebrities who hold a unique position in the Great British hall of fame. The emergence of this status designation is situated in the context of two intersecting processes of cultural change in the post-War period – the rise of celebrity culture and the popularisation of the state honours system. It is proposed that national treasure status results from the accumulation of three interlocking forms of validation: peer, state and media. After reviewing these underpinning forms of validation, we consider one of Britain's most celebrated national treasures – Dame Judi Dench. The aim is to illustrate empirically the status elevation and sedimentation processes through which particular elite celebrities become national treasures, and the various ways in which they might respond to this status designation. Although the term 'national treasure' for many – including those so-designated – may seem a trite term of endearment, we argue that it is in fact an ideological assemblage invested with significance. On one hand, national treasures help revalidate the notion of the authentic celebrity within an apparently meritocratic system that recognises and rewards talent, hard work and dedication. In the context of a relentlessly bleak news cycle, they are a wholly virtuous expression of national identity, signifying all that is great about Britain. On the other hand, although national treasures are constructed as being 'of the people', by authenticating the underpinning institutional forms of validation, their status transformation contributes to the legitimation and reproduction of status hierarchies, cultural authority and inequality in the UK. [ABSTRACT FROM AUTHOR]

Background: Irritable bowel syndrome (IBS) with diarrhoea (IBS-D) is a common and chronic condition that can significantly impair quality of life. The emergence of new drugs for IBS-D has been slow and there is a need for new treatments, including drug-free treatments, which are easy to use and suitable for different patient groups. Currently available drug-free treatments include Enterosgel®, an intestinal adsorbent approved for use in IBS-D and acute diarrhoea and available over-the-counter in the UK and 30 countries worldwide. The aim of this randomised, double-blind, placebo-controlled, multi-centre study is to test the efficacy and safety of Enterosgel® compared to placebo in symptomatic treatment in IBS-D.Methods/design: We will recruit 430 participants with IBS-D from approximately 30 primary and secondary care sites in England. Participants meeting the required abdominal pain and stool consistency criteria over a 2-week screening period will be randomly allocated to receive blinded treatment (Enterosgel® or placebo) for 8 weeks. This will be followed by an 8-week open-label treatment phase with Enterosgel®. Participants will be allowed to adjust their daily dosage during both phases based on their symptoms. Participants will then return to standard care and those who responded to treatment will receive a follow-up call 8 weeks later. Co-medication with loperamide will be permitted and use recorded. The primary outcome measure is the percentage of participants defined as responders for abdominal pain and stool consistency during at least 4 weeks in the 8-week blinded phase. Secondary outcome measures include stool frequency, stool consistency, abdominal pain, bloating, urgency, adequate relief, questionnaire scores and rescue medication use. Exploratory outcomes will be assessed in subsets of participants including qualitative and quantitative data on faecal microorganisms and biomarkers and gut-related measurements from magnetic resonance imaging data.Discussion: This is the first large scale randomised controlled trial investigating Enterosgel® in IBS-D. A study design with blinded phase followed by an open-label phase was chosen to encourage participation and study completion. Demonstrating that Enterosgel® is effective and safe in IBS-D could encourage adoption by patients and healthcare professionals and foster future clinical trials assessing its use in related conditions.Trial Registration: ISRCTN17149988. Prospectively registered on 14 November 2017. [ABSTRACT FROM AUTHOR]

Background: Palliative care is acknowledged as an appropriate approach to support older people in nursing homes. Ethical issues arise from many aspects of palliative care provision in nursing homes; however, they have not been investigated in this context. Aim: To explore the ethical issues associated with palliative care in nursing homes in the United Kingdom. Design: Exploratory, sequential, mixed-methods design. Methods: Semi-structured interviews with 13 registered nurses and 10 healthcare assistants (HCAs) working in 13 nursing homes in the United Kingdom were used to explore ethical issues in palliative care. The 'Ethical Issues in Palliative Care for Nursing Homes' instrument was used to measure the frequency and level of distress arising from ethical issues through a cross-sectional survey with 69 registered nurses and 129 healthcare assistants. Data collection occurred between December 2014 and November 2015. Ethical considerations: Ethical approval was granted by Queen's University's School of Nursing and Midwifery Research Ethics Committee and governance sought from each nursing home's manager. Findings: The interviews revealed three themes: ethical issues in practice; relational issues; and organisational issues. No significant differences between registered nurses and healthcare assistants were evident, confirming the patterns emerging from the interviews. Relational issues, primarily issues with residents and families, occurred most frequently and caused greater distress. Conclusion: The shared environment is key in the experience of ethical issues; therefore, multidisciplinary education is needed for ethical decision making in palliative care. Addressing staff knowledge and service organisation may reduce ethical issues locally and provide a benchmark for global change. [ABSTRACT FROM AUTHOR]

Introduction Background and rationale Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis is considered the procedure of choice in patients with ulcerative colitis (UC) refractory to medical therapy and in those who develop colonic dysplasia or cancer. 1 The procedure is performed with the aim of improving quality of life with generally good outcomes; 2 , 3 however, complications including pouchitis can arise. The incidence of acute pouchitis is 20% at 1 year and up to 40% at 5 years following surgery. 4 Chronic idiopathic pouchitis develops in ~10%–15% of patients with acute pouchitis. 5 , 6 Another less well-reported complication is prepouch ileitis (PPI). PPI has no standard definition but is inflammation of the ileum proximal to the pouch. The estimated frequency of PPI is 6%. 7 , 8 This pattern of inflammation can extend for a significant distance into the afferent limb (up to 50 cm), 9 but this is unusual. 8 It is usually seen with coexisting pouchitis. It is mostly a condition that is associated with a pouch for UC and is rarely seen in patients who have undergone a pouch for familial adenomatous polyposis. 9 This therefore suggests that both the immune system and the environment interact within a genetically susceptible patient to cause inflammation. As the immune system is likely to play a role in PPI, the use of biologic medications may potentially help achieve remission through the immunomodulatory actions. Furthermore, biologic drugs have been shown to result in remission in about 50% of patients with inflammation of their pouch. 10 As it has been shown that PPI is often associated with pouchitis, it may therefore be beneficial in treating this problem. 8 , 11 Symptoms of PPI are generally nonspecific but can include increased stool frequency, outlet obstruction, and bleeding. 12 The treatment of PPI as a specific entity has been poorly studied, but it is generally treated concurrently with pouchitis. One small study looked at the effects of antibiotics on PPI in a cohort with a diagnosis of UC and showed that 86% of patients showed symptomatic improvement with significant reduction in both stool frequency and length of PPI. However, this was based on only 14 patients. Furthermore, there has been only one small case series of five patients where infliximab was found to be effective in the short term for the specific treatment of PPI in a cohort with a diagnosis of Crohn's disease. 13 Historically, the limited literature reporting outcomes of biologic therapy for PPI has assumed that PPI is a Crohn's-like complication. 13 – 15 Recent studies, however, have highlighted that PPI is not a strong predictor for the development of unequivocal features of Crohn's disease, 11 , 12 and therefore, it is important to report treatment outcomes dependent on whether Crohn's disease is thought to be the underlying cause or not. Objectives This aim of this study was to document the efficacy of biologics for the treatment of PPI. To our knowledge, this is the largest study to explore the efficacy of all biologics for the specific treatment of PPI with the longest follow-up data. Methods Study design and setting This was a retrospective observational study across three centers. Data were collected from two centers in the UK and one center in Bologna, Italy. This included two tertiary referral centers and one district general hospital. Patients were censored at the last clinical encounter following their most recent biologic therapy or until they had pouch failure defined by the need to form an ileostomy to relieve symptoms. Participants Patients were included if they met all of the following inclusion criteria: Undergone restorative proctocolectomy for UC Evidence of PPI on endoscopic assessment with inflammation confirmed histologically Treated with infliximab, adalimumab, or vedolizumab (other biologics were not available at our centers during the study period) Variables Patients were followed up until last clinical encounter. Outcomes included the presence of PPI following biologic therapy, pouch failure defined by the need for an ileostomy, remission of PPI defined by the absence of any prepouch inflammation on endoscopic assessment within a year of biologic therapy and the need to switch to an alternative biologic. Primary nonresponse was defined as failure of clinical improvement at 12 weeks of biologic therapy. Secondary loss of response was defined as lack of clinical response to biologic therapy after 12 weeks of treatment. Lack of clinical benefit was judged by the senior clinician looking after the patient and was guided by symptoms, endoscopic, histological, and biochemical markers. A template data collection sheet was given to each sub-investigator to collect the variables of interest. Potential patients were identified using each hospital's biologics and pouch databases. Those patients identified from the database were then screened against the inclusion and exclusion criteria by interrogation of the patient's electronic and case notes. Completed templates were then collated and analyzed. Measurement of variables The use of the term Crohn's disease (CD) is controversial in pouch-related inflammatory problems. 16 In our study, we defined this by the presence of conclusive histology (granulomas supporting CD) and/or presence of skip lesions in the small bowel. Pouchitis was defined using the pouch disease activity index (PDAI). 17 Patients were classified as having pouchitis if their PDAI within 1 year before starting infliximab was ≥7. PPI was defined as any inflammation immediately proximal to the pouch; inflammation was defined if the endoscopist reported the presence of edema, ulceration, erythema, or contact bleeding in the immediate prepouch ileum with histological confirmation of inflammation in that section. Statistical methods All variables were analyzed using STATA (StataCorp LP, College Station, TX, USA). Ethical approval Ethical approval was granted by the Health Research Authority (IRAS ID: 233311). The study was considered a service evaluation study, and hence as anonymized data were used, written consent was not required by our ethics committee. Local ethics was not considered a requirement by Malpighi Hospital as the study was considered an audit of practice. The study was carried out in accordance with the principles of the declaration of Helsinki. Results There were 29 patients in our cohort. The median age of diagnosis of UC was 27 years (range 6–48 years). The median age of the patients at censorship was 53 years (range 19–68 years). The median time from pouch formation to diagnosis of PPI was 79 months (range 1–147 months). The median length of time a patient was on biologics at censorship was 12 months (range 2–62 months). The median length of follow-up on the whole cohort was 21 months (range 1–99 months) (Table 1). Table 1 Baseline characteristics Abbreviations: CD, Crohn's disease; IBD, inflammatory bowel disease; PPI, prepouch ileitis; UC, ulcerative colitis. Ten patients were reclassified as having confirmed CD after a median time from formation of pouch of 202 months (range 1–372 months; Figure 1). Six had granulomas on further histological assessment and skip lesions on small bowel imaging and four had granulomas on histology alone. Figure 1 Kaplan–Meier graph for pouch failure. Notes: Log rank test comparing "survival" times in the two groups P=0.72, no evidence of a difference between groups. Abbreviations: CD, Crohn's disease; UC, ulcerative colitis. Change of medications One patient had primary nonresponse to infliximab and was changed to vedolizumab. Nine other patients had secondary loss of response to infliximab; of these, six were changed to adalimumab and three were changed to vedolizumab. Of all those in whom the first biologic failed, the median time to failure was 12.0 months (range 2–39 months). Remission and pouch failure At last endoscopic follow-up within 1 year of starting a biologic, 20 of 29 patients still had endoscopic evidence of PPI, seven had achieved remission, and two had no endoscopic follow-up. Of the six patients who achieved endoscopic remission, four had a biopsy from the prepouch ileum which demonstrated histological remission. The other two were not biopsied at endoscopic follow-up. Of the seven who had achieved remission, five have stopped all medications and remained clinically well, one was taking colifoam enemas and one used cyclical metronidazole to maintain symptomatic response. All patients who had achieved remission were patients who had their biologic for PPI with coexisting pouchitis. In our cohort, 11 patients went on to pouch failure after a median time from starting a biologic of 25 months (range 14–91 months). Of those who had their UC reclassified to CD, three of ten patients (30%) had pouch failure compared with eight of 19 (42%) who had UC (P=0.72) (Figure 1). The cumulative 1-, 2-, 5-, and 8-year failure rates were 0%, 17%, 30%, and 38%, respectively (Figure 1). Discussion PPI remains a difficult condition to treat. Our study has highlighted that the use of biologics for PPI is associated with relatively low remission rates of 31% at a median follow-up of 20.5 months (range 1–99 months). When using biologics for PPI, there was pouch failure in just over one third of the cohort after a median follow-up of 25 months (range 14–91 months). In our small cohort, we found that PPI associated with CD had lower rates of failure than PPI with UC but this was not statistically significant. Although it is hard to draw conclusions in a small study, it is possible that PPI associated with CD has different response rates to PPI associated with UC but this will require further exploration in larger prospective studies. There are a paucity of data highlighting the outcomes of biologic treatments in inflammatory pouch problems. A systematic review that included all chronic inflammatory pouch problems highlighted that remission could be achieved in 53%. 18 Only under a quarter of patients achieved remission from their PPI when using a biologic, suggesting that the presence of PPI is associated with a less favorable treatment response. It has been shown that PPI is often associated with pouchitis. 8 , 11 As such it is difficult to know what additional contribution to symptoms is made by PPI, or if PPI in isolation requires any different treatment from pouchitis, or indeed should be classified as CD, as it effectively represents a skip lesion. It has however been demonstrated that PPI is likely to be a poor prognostic sign and associated with higher rates of pouch failure 19 and therefore treatment with the aim of achieving remission may be associated with better outcomes. This study has highlighted that PPI has practical and clinical implications. It is therefore essential that this complication is recorded during endoscopic pouch assessment. This study is limited by small numbers and retrospective analysis. It is also limited by relative heterogeneity in patient cohort. Ideally future studies should explore comparing treatments for PPI in direct head to head trials. It is also surprising that no patients had prior exposure to a biologic. It has been reported that in patients with UC who require a biologic, those previously exposed to a biologic had poorer outcomes than those who had never previously been exposed to a biologic medication 20 and so future work may help understand if this trend also occurs in those with PPI. A standard definition of PPI would also aid our understanding and outcomes of this complication, which has been shown to have a poorer prognosis than pouchitis in isolation. Conclusion To our knowledge, this is the largest study to explore the efficacy of all biologics for the specific treatment of PPI with the longest follow-up data. Biologics fail to achieve endoscopic remission of PPI in the majority of patients. In a small proportion of patients, they may help to prevent deterioration in pouch dysfunctional symptoms. In a large proportion of patients with PPI, surgery with indefinite diversion may be required despite biologic use. Acknowledgments This paper was presented in abstract form at the British Society of Gastroenterology Conference in Liverpool, UK, 2018 with interim findings. The poster's abstract was entitled "Biological therapy for the treatment of pre-pouch ileitis: a retrospective experience from three centres" and was published in "Poster Abstracts" GUT which can be found at: http://dx.doi.org/10.1136/gutjnl-2018-BSGAbstracts.183 (category: inflammatory bowel disease). Author contributions JPS, MR, CV, and RKF collected the data. JPS analyzed the data and prepared the manuscript. JPS and PB performed statistical analysis. JPS, MR, CV, RKF, GHTW, SDM, ALH, SKC, and ODF have revised the manuscript critically and prepared the final version of the manuscript. All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work. Disclosure The authors report no conflicts of interest in this work. References 1. Sandborn WJ. Pouchitis: definition, risk factors, frequency, natural history, classification, and public health perspective. Trends Inflamm Bowel Dis Ther 1996. 1997. 2. de Buck van Overstraeten A, Wolthuis AM, Vermeire S, et al. Long-term functional outcome after ileal pouch anal anastomosis in 191 patients with ulcerative colitis. J Crohns Colitis. 2014;8(10):1261–1266. 3. Tulchinsky H, Dotan I, Halpern Z, Klausner JM, Rabau M. A longitudinal study of quality of life and functional outcome of patients with ulcerative colitis after proctocolectomy with ileal pouch-anal anastomosis. Dis Colon Rectum. 2010;53(6):866–873. 4. Lepistö A, Luukkonen P, Järvinen HJ. Cumulative failure rate of ileal pouch-anal anastomosis and quality of life after failure. Dis Colon Rectum. 2002;45(10):1289–1294. 5. Pardi DS, Shen B. Endoscopy in the management of patients after ileal pouch surgery for ulcerative colitis. Endoscopy. 2008;40(6):529–533. 6. Shen B. Pouchitis: what every gastroenterologist needs to know. Clin Gastroenterol Hepatol. 2013;11(12):1538–1549. 7. Samaan MA, de Jong D, Sahami S, et al. Incidence and Severity of Prepouch Ileitis. Inflamm Bowel Dis. 2016;22(3):662–668. 8. Mclaughlin SD, Clark SK, Bell AJ, Tekkis PP, Ciclitira PJ, Nicholls RJ. Incidence and short-term implications of prepouch ileitis following restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis. Dis Colon Rectum. 2009;52(5):879–883. 9. Bell AJ, Price AB, Forbes A, Ciclitira PJ, Groves C, Nicholls RJ. Pre-pouch ileitis: a disease of the ileum in ulcerative colitis after restorative proctocolectomy. Colorectal Dis. 2006;8(5):402–410. 10. Segal JP, Ding NS, Worley G, et al. Systematic review with meta-analysis: the management of chronic refractory pouchitis with an evidence-based treatment algorithm. Aliment Pharmacol Ther. 2017;45(5):581–592. 11. Segal JP, Mclaughlin SD, Faiz OD, Hart AL, Clark SK. Incidence and long-term implications of prepouch ileitis: an observational study. Dis Colon Rectum. 2018;61(4):472–475. 12. Rottoli M, Vallicelli C, Bigonzi E, et al. Prepouch ileitis after ileal pouch-anal anastomosis: patterns of presentation and risk factors for failure of treatment. J Crohns Colitis. 2018;12(3):273–279. 13. Colombel JF, Ricart E, Loftus EV, et al. Management of Crohn's disease of the ileoanal pouch with infliximab. Am J Gastroenterol. 2003;98(10):2239–2244. 14. Shen B, Remzi FH, Lavery IC, et al. Administration of adalimumab in the treatment of Crohn's disease of the ileal pouch. Aliment Pharmacol Ther. 2009;29(5):519–526. 15. Ferrante M, D'Haens G, Dewit O, et al. Efficacy of infliximab in refractory pouchitis and Crohn's disease-related complications of the pouch: a Belgian case series. Inflamm Bowel Dis. 2010;16(2):243–249. 16. Lightner AL, Pemberton JH, Loftus EJ. Crohn's Disease of the Ileoanal Pouch. Inflamm Bowel Dis. 2016;22(6):1502–1508. 17. Sandborn WJ, Tremaine WJ, Batts KP, Pemberton JH, Phillips SF. Pouchitis after ileal pouch-anal anastomosis: a Pouchitis Disease Activity Index. Mayo Clin Proc. 1994;69(5):409–415. 18. Segal JP, Ding NS, Worley G, et al. Systematic review with meta-analysis: the management of chronic refractory pouchitis with an evidence-based treatment algorithm. Aliment Pharmacol Ther. 2017;45(5):581–592. 19. Segal JP, Mclaughlin SD, Faiz OD, Hart AL, Clark SK. Incidence and long-term implications of prepouch ileitis: an observational study. Dis Colon Rectum. 2018;61(4):472–475. 20. Reinisch W, Sandborn WJ, Hommes DW, et al. Adalimumab for induction of clinical remission in moderately to severely active ulcerative colitis: results of a randomised controlled trial. Gut. 2011;60(6):780–787. [ABSTRACT FROM AUTHOR]

Approximately 70% of the elderly population in the United Kingdom are edentulous, and their prosthetic status has been recognised as poor. Treatment standards need to be improved, but this is often difficult with the elderly person, who may present with a combination of unfavourable features. It is essential to develop an understanding of the limitations of such patients. Particular attention must be given to specific treatment planning, including modifications to standard design principles, together with the establishment of effective communication. [ABSTRACT FROM AUTHOR]

Amanda McLaughlin considers the importance of oral health care in nursing and residential care homes Aim: The reader should be able to understand the importance of introducing and maintaining effective oral health care in nursing and residential care home and nursing home settings. Objectives: To have an overview of UK statistics. To understand the implications of poor oral health on overall wellbeing To understand ways in which teams can improve the oral health of the elderly. [ABSTRACT FROM AUTHOR]

Aim: To explore the experience and the preparedness of family carers in their caregiving role as best interest decision-makers of a relative living with advanced dementia. Background: The prevalence of dementia is a global issue. The role of being a carer of a relative living with dementia does not necessarily lessen once they are admitted to a nursing home. Best interest decision-making including end-of-life care decisions need to be made and reaching these choices can be challenging. The preparedness of family carers in this role needs greater understanding. Design: Descriptive qualitative study. Methods: During 2015 twenty semi-structured interviews were conducted of family carers of nursing home residents living with advanced dementia, then analysed using Braun and Clarke's thematic analysis. Results: Three themes were identified: (1) Caring for someone living with dementia. The impact on the carer's holistic well-being and their experience of being a best interest decision-maker; (2) Accessing support. The influential nature of formal and informal networks; (3) Perceived knowledge and understanding of the dementia trajectory of carers and nursing staff. Conclusion: The experiences and preparedness of informal carers is a reflection of their personal response, but the distress experienced highlights the significant need of adequate support availability and of enhancing nursing staffs' dementia expertise to maximize their role in facilitating best interest decision-making. This has significant implications for nursing practice and for service user and nursing staff education. Considering the global impact of dementia, our findings have international relevance to similar nursing homes across the world. [ABSTRACT FROM AUTHOR]

Background: In dementia care, a large number of treatment decisions are made by family carers on behalf of their family member who lacks decisional capacity; advance care planning can support such carers in the decision-making of care goals. However, given the relative importance of advance care planning in dementia care, the prevalence of advance care planning in dementia care is poor. Aim: To evaluate the effectiveness of advance care planning with family carers in dementia care homes. Design: Paired cluster randomized controlled trial. The intervention comprised a trained facilitator, family education, family meetings, documentation of advance care planning decisions and intervention orientation for general practitioners and nursing home staff. Setting/participants: A total of 24 nursing homes with a dementia nursing category located in Northern Ireland, United Kingdom. Family carers of nursing home residents classified as having dementia and judged as not having decisional capacity to participate in advance care planning discussions. Results: The primary outcome was family carer uncertainty in decision-making about the care of the resident (Decisional Conflict Scale). There was evidence of a reduction in total Decisional Conflict Scale score in the intervention group compared with the usual care group (-10.5, 95% confidence interval: -16.4 to -4.7; p < 0.001). Conclusion: Advance care planning was effective in reducing family carer uncertainty in decision-making concerning the care of their family member and improving perceptions of quality of care in nursing homes. Given the global significance of dementia, the implications for clinicians and policy makers include them recognizing the importance of family carer education and improving communication between family carers and formal care providers. [ABSTRACT FROM AUTHOR]

Summary The research activity of social work academics in the UK has been of interest and concern amongst academics and research funders. Multiple initiatives have been implemented to develop social work research activity, yet research by social work academics remains limited, hindered by lack of time, support infrastructures, funding and training. Through the use of a mixed-methods cross-sectional survey (N = 200) and follow-up individual interviews (N = 11), this study reports on the factors that were found to contribute to or impede the amount of time that social work academics reported spending on research. Findings The results from the survey indicated that 73% of respondents were research active. Bivariate analysis revealed that academics spent less time on research and teaching, and more time on administration than expected by their employing universities. Multivariate analysis found that less time spent on administration and teaching, more university supports, and being from a pre-1992 university predicted more time spent on research. Applications The findings indicate that the administrative burdens associated with teaching and assessment in social work education result in academics struggling to fit research into their busy lives, despite initiatives to raise the profile and productivity of social work research. Research support infrastructures and strategies should be reviewed in light of such findings. [ABSTRACT FROM AUTHOR]