Restrictions into opportunities: how boundaries in the life course can shape educational pathways

This study explores relationships between experiences in initial education, subsequent life experiences/opportunities and the decision to return to education later in life. Semi-structured interviews with seven female returners to education, focused initially upon the women’s perceptions of their aspirations and motivations at various ages, how these related to the choices they felt they had available to them at different points in time, and their sense of agency. Subsequently, the interviewees considered the relationship between early educational experiences, post-school experiences, and their current choices. Thematic analysis of the interview transcripts led to the identification of four main themes: restrictions, opportunities, personal development, and an underlying theme of planning. Consideration of the relationships between these themes led to the conclusion that it was life experiences rather than initial education that both motivated and empowered the interviewees to take advantage of opportunities for higher education

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Children’s education in secure custodial settings: Towards a global understanding of effective policy and practice

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.This unique editorial paper is one of the first that discusses the education of incarcerated young people in an international education journal. We review the eleven papers in the Special Issue on children’s education in secure custodial settings to provide key insights with the aim of moving towards a global understanding of what effective policy and practice may look like. In examining the range of cross-disciplinary papers from a range of different cultural contexts including the UK, Germany, UAE, US, Nigeria and South Africa, we are able to illuminate some of the commonalities in the education of young people who are incarcerated as well as some of the background characteristics – many of which are strikingly similar. We employed the ideas of the bio-socio-ecological systems model to explore the proximal and distal systems that interact to affect the educational experiences of the young people. These included at the microsystemic level the importance of relationships in engaging the young people with education and learning and that, the relationships between the key actors (mesosystem) as well as the importance of effective leadership (exosystem) were critical elements in improving the experience of education in custodial settings. But rather predictably, the structural disadvantages (macrosystem) that young people who come into contact with youth justice face and how these are not appropriately addressed that came into sharp focus, possibly because many countries take a punitive approach to youth offending. We argue that there are things that can be done at each systems level but that in order to make the changes to genuinely improve the lives of these young people, we make a bold call upon the global community (macrosystem), through the UNCRC to challenge themselves for a radical overhaul of youth justice approaches which put the child as child first and offender second in order to meet the commitment in Article 28

Children's education in secure custodial settings: Towards a global understanding of effective policy and practice

This unique editorial paper is one of the first that discusses the education of incarcerated young people in an international education journal. We review the eleven papers in the Special Issue on children's education in secure custodial settings to provide key insights with the aim of moving towards a global understanding of what effective policy and practice may look like. In examining the range of cross-disciplinary papers from a range of different cultural contexts including the UK, Germany, UAE, US, Nigeria and South Africa, we are able to illuminate some of the commonalities in the education of young people who are incarcerated as well as some of the background characteristics – many of which are strikingly similar. We employed the ideas of the bio-socio-ecological systems model to explore the proximal and distal systems that interact to affect the educational experiences of the young people. These included at the microsystemic level the importance of relationships in engaging the young people with education and learning and that, the relationships between the key actors (mesosystem) as well as the importance of effective leadership (exosystem) were critical elements in improving the experience of education in custodial settings. But rather predictably, the structural disadvantages (macrosystem) that young people who come into contact with youth justice face and how these are not appropriately addressed that came into sharp focus, possibly because many countries take a punitive approach to youth offending. We argue that there are things that can be done at each systems level but that in order to make the changes to genuinely improve the lives of these young people, we make a bold call upon the global community (macrosystem), through the UNCRC to challenge themselves for a radical overhaul of youth justice approaches which put the child as child first and offender second in order to meet the commitment in Article 28

Developing social and emotional competencies in incarcerated young people in seven countries in Europe, through the use of active games and sport

Social and emotional competencies, such as self-regulation, coping with challenges and positive relationships are related to positive life outcomes. Children and young people who come into conflict with the law have not always had the opportunities to develop these competencies due to a range of disadvantages they are likely to have encountered. This research seeks to explore the extent to which identified competencies can be developed through specially designed active games for children and young people in (custodial) youth justice settings. Qualitative and quantitative data were collected to assess the effectiveness of the games in seven European countries including, Italy, Spain, Portugal, Hungary, Romania, Turkey, and the UK, making it an especially unique project developing bespoke materials suitable in secure settings and then testing them across different country contexts. A total of 326 young people participated across 17 settings with a total of 105 educators trained in the methodology. The findings suggest that participation in the active games had demonstrable impact on those who participated, both overall, and for the specific identified competencies. Participation in such programmes can support the holistic development of social and emotional competencies which can facilitate readiness and openness to learning to other interventions. It is this which is a key finding and contributes to dis/engagement theory. Such programmes should form the basis of a suite of interventions designed to support the educational (re)engagement and development of children and young people in conflict with the law. These findings have currency for developing policy which promote positive outcomes for children and young people on release back into the community across a range of national contexts

The Role of Assessment Feedback in Developing Academic Buoyancy

This research focuses on the everyday challenge in academic learning of assessment, and argues that academic buoyancy is a key factor in academic success. To scaffold students’ learning and effectively support academic buoyancy, there is arguably a need for a better understanding of: (i) what students find most and least useful in their assessment feedback; (ii) how students use feedback to approach future assessments; and (iii) how students respond to feedback in terms of what they think, feel and do. Key findings from survey responses of 91 undergraduate students were that students use their feedback more than anticipated and look for specific information to help their future performance. In addition, five indicators of academically buoyant behaviour were identified: an internal locus of control, understanding the grade, being forward looking, being improvement focused and being action orientated. These indicators suggested a distinction between students who were academically buoyant because they were constructive in their response to feedback, and those who appeared less so because they were not action orientated, but more focused on their emotional response. These findings have implications for the provision of assessment feedback in higher education and offer insight into opportunities for the development of academic buoyancy

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

BackgroundTranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding.MethodsWe did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124.FindingsBetween July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98).InterpretationWe found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial.</div