Laryngeal reinnervation vs type I thyroplasty in unilateral vocal fold paralysis (VOCALIST) : a randomized feasibility study

Objectives. We wished to determine the feasibility of performing a multi-centre phase III randomized controlled trial that compares laryngeal reinnervation to type I thyroplasty for adults with unilateral vocal fold paralysis (UVFP) in the UK. Methods. A feasibility study was designed; 27 participants were recruited at three UK sites. Trial procedures mirrored those intended for a full-scale trial. We assessed recruitment rates, acceptability of randomization, and dropout rates and conducted a qualitative study to understand the recruitment processes. Participants were followed up for up to 12 months to assess optimal outcome measures for the definitive trial covering voice, swallowing, and overall quality of life. A qualitative study was run in parallel with the quantitative clinical trial. Results. Recruitment was successful with 23 patients with UVFP randomized to reinnervation (n = 12) and thyroplasty (n = 11). 96% (n = 22) of participants accepted the treatment to which they were allocated, of which 17 received their intervention before the study end date. The qualitative study identified minor recruitment challenges that could be addressed through in-trial training. The set of subjective and objective voice, swallowing, and quality of life outcome measures used demonstrated a responsiveness to change following interventions. Conclusion. The results from this study have provided us with the assurance that conducting an adequately powered randomized controlled clinical trial of laryngeal reinnervation versus type I thyroplasty for adults with UVFP in the UK is feasible in terms of conduct, recruitment, outcome measurement, and completion. Level of Evidence: 2. Trial Registration: ISRCTN9020173

Prospective Memory: The Effect of Cognitive Load and Task Focality on Prospective Memory Performance

‘Prospective memory’ (PM) is the ability to remember to perform intended actions in the future. The number of targets to be monitored (i.e. task load) and the closeness of the PM target to the ongoing task (ONG) (i.e. task focality) have been found to impact PM performance. The purpose of the current study is to address limitations of previous research into the effect of task load and task focality on participants’ prospective memory performance in event-based prospective memory (EBPM) tasks, and to investigate whether these conditions affect participants’ strategy of retrieval (as set out in the multiprocess framework). A modified version of the test used in Cantarella et al., (2023) was administered online to four groups: low-load focal targets (LF; N = 14), low-load non-focal targets (LN; N = 14), high-load focal targets (HF; N = 17), and high-load non-focal targets (HN; N = 13) to determine whether prospective memory related changes were evident. A Stroop test preceded the EBPM test to account for the potentially confounding variable of processing speed. In keeping with previous findings, the effect of task load and focality had a significant effect on PM performance in respect to both reaction time (RT) and accuracy. Furthermore, results identified that participants’ possessing speed had a significant effect on RT in ONG tasks, but not for PM retrieval. Contrary to previous literature the effect of the interaction between factors was only significant for PM performance accuracy, not RT. It was concluded that PM retrieval relies on different, more costly mechanisms when exposed to increased task complexity. The results emphasise the importance of focality in successful PM retrieval. Future research should look to implement standardised methods of task response and consider individual differences in processing speed to ensure that RT in EBPM tasks is not affected by these when investigating PM performance

'Nothing but trouble', or reasoned inconsistency? The development of religion and belief protection since 2000

The article considers the development of the law on religion and belief discrimination in the EU since the introduction of the Employment Equality Directive 2000/78 (the Equality Directive) in 2000. At the time of its introduction, it was anticipated that a number of problems would face the courts given that the new equality ground would cover similar interests to those protected by existing human rights protection for freedom of religion and belief. The article explores the extent to which those fears were realised in subsequent legal developments. It explores the development of the CJEU case law on religion and belief law and shows that in large part the predictions of inconsistent treatment of religion and belief have been borne out. It concludes with an assessment of the extent to which the inconsistencies that are identified are a serious problem for the future development of the law on religion and belief within Europe

Empowering nursing students : a cross-sectional study

In nursing, empowerment can enable nurses to raise concerns about patient safety and to do so within a safe and supportive environment. Furthermore, empowering patients to gain more ownership of their health can positively influence both nurses and patients. This narrative review focused on the importance of empowering nursing students. The literature determined that nursing students must feel valued and be treated equally, and to work in an environment that is open and transparent, in order to feel empowered. Fear of retaliation may prevent nursing students from speaking out about poor care and poor practice. Moreover, co-developing care and support regimens with service users benefited both nursing students and patients, as well as local communities, reduced stress and burnout, and allowed the patient to self-care, and act in their own best interests

PROMOTING STEM EDUCATION IN ENGLAND’S KEY STAGE 3 (KS3): A LITERATURE REVIEW OF SCHOOL LEADERSHIP STRATEGIES

The effective promotion of STEM education at Key Stage 3 (KS3) in England requires robust school leadership approaches, yet evidence indicates that school leadership at this level remains marginalised. This study examined the effective school leadership strategies that promote STEM education at KS3, an often overlooked but critical phase in learners’ academic development. It investigated the role of school leadership in advancing STEM education, the effective strategies employed by school leaders at KS3, and the challenges they encounter. A systematic literature review was conducted, analysing findings from 15 studies selected from an initial pool of 55, drawn from England, Australia, and the United States. The study was guided by instructional leadership theory, which positions leaders as visionaries who support teachers and recommend professional development to enhance staff and student learning outcomes. Findings revealed that school leadership is fundamental in setting a vision, building STEM ecosystems, and advocating for STEM-related policies. However, challenges persist, including limited resources, the marginalisation of KS3 leadership, and misalignment between curriculum and policy frameworks. Instructional leadership emerged as the most suitable approach in fostering effective STEM education by shaping school culture, enhancing pedagogical practices, and strengthening institutional capacity to integrate STEM disciplines at KS3. The study highlights implications for policy and practice, such as prioritising school leadership at KS3 within leadership development frameworks and ensuring equitable resource allocation. Ultimately, instructional leadership’s emphasis on vision setting, teacher support, and curriculum coherence is essential for fostering STEM interest and improving learning outcomes in line with the complex demands of the twenty-first-century workforce

Social learning under ambiguity : an experimental study

Many behaviours spread through contact with others. The extent to which people adopt observed behaviour can critically affect whether policymakers are successful when introducing new initiatives. In many situations, people can either make decisions based on their own intuitive signals or follow a social signal. Depending on the quality of the signals, one might be more informative than the other. This study aims to better understand how people use social information to learn in ambiguous situations, when both the private and the social signal are not perfectly informative. We conduct an experimental study that observes whether people are prone to imitate others in risky and ambiguous environments. We find that individuals do learn from social information and that this learning is robust and not significantly affected by ambiguity

Co-development of the CoMUni intervention : a social-media based resource to increase mental health help-seeking behaviours in UK undergraduates

Introduction Each academic year, numerous students experience mental health problems. Despite this, many avoid seeking any form of help which can lead to problems worsening. This paper reflects upon the co-development process of an intervention which aimed to increase help-seeking behaviours in undergraduate students. Methods Online workshops were conducted with a student co-production team, including the completion of tasks designed to incorporate the eight steps of the Behaviour Change Wheel framework. During the co-production process, the team made key decisions in relation to the developed intervention’s main function, the behaviour change techniques used, and the content presented. Results As a result of the process the team developed CoMUni, a social media-based intervention sharing other students’ experiences of seeking help. After the final workshop, each team member provided feedback through an online form relating to their experiences during the development process. Results of this work illustrate how the values of co-production were upheld during the development process, with team members feeling actively involved and respected. Conclusion This work provides reflective insight into the qualitative approach of co-production and illustrates its benefits when utilised to develop interventions around university student mental health. Participant or public contribution A stakeholder advisory group made up of university staff (with experience or interest in student mental health) was consulted during the design of the co-production workshops. A student team attended co-production meetings, making key decisions around the functionality and content used in the intervention. Some members of the team also reviewed and commented on the final manuscript

Neural correlates of lexical, sublexical and motor processes in word handwriting

Writing recruits a vast neural network underpinning both linguistic and motor processes. Previous studies have tried to identify which brain areas underpin both the linguistic and motor aspects of writing. However, little is known about the neural substrate of the lexical and sublexical “routes” for spelling. In this fMRI study, participants (n = 25) copied or saw/read symbols or words. Words varied in lexical frequency and phonology-to-orthography (P-O) consistency. Anterior parts of the inferior frontal gyrus were selectively recruited when copying P-O inconsistent words, while the right Heschl's gyrus was recruited only when copying consistent words. Non-specific motor and linguistic areas were also identified. Our results contribute to our knowledge of the neural substrate of the lexical and sublexical spelling routes and suggest that different brain areas might be involved in the lexical processing of input (reading) and output (writing) orthography

Professional identity in nursing : a narrative review of the ISPIN definition and domains usage

Introduction. Established in 2020, the International Society for Professional Identity in Nursing (ISPIN) developed a definition of professional identity in nursing (PIN). This definition encompasses four domains: values and ethics, knowledge, nurse as leader, and professional comportment. Objective. This narrative review aimed to summarize and synthesize identified published evidence, the extent of discussion of PIN domains, and literature gaps for the ISPIN definition of PIN. Methods. Sources included peer-reviewed literature published between 2018 to 2025 from CINAHL and PubMed. Gray literature through Google Scholar and ISPIN archived publications were also searched. These were identified by two researchers and a PRISMA flow diagram was developed. No registered protocol was utilized. Search and MeSH terms included “professional identity,” “nurs*,” and “ISPIN.” Findings. Thirty-seven articles met inclusion criteria and were extracted from 16,295 initially identified articles, with the majority with authors from the United States. There were very few research papers and a noticeable dearth using quantitative methodologies. Twenty-eight of the retrieved articles were considered expert accounts, conceptual discussion or opinions, common for a relatively new concept. Discussion. Nurse as leader was discussed in 34 of 37 articles. Professional comportment was discussed in 31 articles. Both knowledge and value and ethics were discussed in 28 articles. Conclusion. This narrative review highlights the nature and prevalence of the ISPIN definitions and its four domains in current literature and can be visualized through diagramming. Minimal quantitative studies and a higher volume of discussion articles present limitations to its strength and applicability. Results suggests the need for further research in all domains, particularly in knowledge and values and ethics, and its implications in strengthening nursing practice and education