Young children playing together: A choice of engagement

This article highlights the findings of an empirical research project, using an ethnographic approach, taking place over one academic year. It investigates the different forms of engagement that children may present, when acting in free play situations in a nursery in NW England, without direct adult intervention. This range of engagement includes passive, intermittent and two forms of cooperative play, termed divergent and convergent. In the latter, children developed collaborations, using inter-subjectivity, through a series of phases. In this form of engagement, young children are able to develop and sustain play episodes, particularly where they are familiar and friendly with their play partner. Young children playing in peer dyads are the most common grouping for convergent play to occur, although the exclusivity of this grouping may appear to contradict practitioners’ pro-social agendas

Developing Early Years leadership: Examining the practice of facilitation in and through action research

This article examines the use of first-person action research to improve the facilitation of a continuing professional development (CPD) project in Early Years leadership. The intention of this project was to support Early Years Leaders (EYLs) from a diverse range of Early Years settings in NW England, including those in children’s centres and the private, voluntary and independent sector, to improve their practice and hence strengthen the quality of Early Years provision. The project, carried out in five separate phases, gave rise to a nested action research inquiry carried out by both EYLs and the lead facilitator of the CPD. As the EYLs used the approaches offered by the facilitator to articulate and evaluate their own experiences of leading Early Years provision, their sayings, the articulation of their xpertise and their burgeoning confidence in using that expertise, challenged the facilitator to find her own locus of knowledge. The article focuses on this process of building respectful partnerships for reflexive learning and how the facilitator, using her own overarching inquiry, developed insights into the process of facilitation itself. The concept of practice architectures (Kemmis et al 2014) was used as a framework to analyse the data. Findings include the importance of recognising the importance of diverse forms of expertise and where this lay and the emotional labour of relinquishing control of the process to enable authentic shared enquiry

Observation, assessment and planning practices in a children's centre

This paper reports on the research process and findings of a commissioned study of a Sure Start Children's Centre based in the North West of England. The study focused specifically on how child observations were being carried out in the Children's Centre to inform assessment and planning. It was imperative that the research process should not be perceived as something being “done” to staff of the Children's Centre but as one in which there was a willing engagement with a view to making use of the research findings to build on their own practice. The led to the practitioners starting a cycle of action research themselves that informed the implementation of new approaches in the carrying out of child observations. It was useful for the research team to relate this course of action both to a personal and practical dimension so that practitioners could be supported in their own research-informed practice. This study identified that the practitioners are open to new ideas and are willing and eager to explore new procedures to facilitate effective practice. While the current process of observation, assessment and planning that is being followed for individual children is encouraging, it has its limitations because some children may not be observed on a regular basis and therefore information about their current needs, interests and abilities may be missed. The use of observations to assess children's progress is seen by most of the practitioners as a challenge. This study has revealed important insights into the ways in which outsider researchers can inspire early years practitioners to reflect upon their own practice and provision

Informal community support for parents of pre-school children: A comparative study investigating the subjective experience of parents attending community-based toddler groups in different socio-economic situations

"Within the United Kingdom, the importance of the appropriate parenting of children in their early years has received significant political support. However, it has been found that positive outcomes for young children, in terms of their present experience and future life chances, are often significantly weakened by the impact of poverty. A phenomenological scoping study was undertaken to explore the reasons why parents living in poverty access informal social support networks, in the form of community-based toddler groups. The study found that engagement with these networks has value for parents in terms of their mental well-being and their peer education, both of which support their ability to parent a young child appropriately.

Imagining an Imperial Modernity: Universities and the West African Roots of Colonial Development

© 2016 Informa UK Limited, trading as Taylor & Francis GroupThis article takes the formation and work of the ‘Elliot’ Commission on Higher Education in West Africa (1943–45) to reconsider the roots of British colonial development. Late colonial universities were major development projects, although they have rarely been considered as such. Focusing particularly on the Nigerian experience and the controversy over Yaba Higher College (founded 1934), the article contends that late colonial plans for universities were not produced in Britain and then exported to West African colonies. Rather, they were formed through interactions between agendas and ideas with roots in West Africa, Britain and elsewhere. These debates exhibited asymmetries of power but produced some consensus about university development. African and British actors conceptualised modern education by combining their local concerns with a variety of supra-local geographical frames for development, which included the British Empire and the individual colony. The British Empire did not in this case forestall development, but shaped the ways in which development was conceived

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

An issue of social justice: bullying in schools.

An issue of social justice: bullying in schools

The securitisation of values: early years leaders experiences of the implementation of the prevent strategy.

This contribution examines the implementation of the ‘British’ values agenda within Early Childhood Care and Education (ECEC) settings in England, as introduced by the Prevent Duty. It begins by tracing the rise of the ECEC setting as the primary place of education of the young child, as this has shifted from the home environment. It examines the place of values education, culminating in the Government directive on the promotion of ‘British’ values, and how these values must be seen as integral to effective ECEC provision. Using a case study of two focus groups and subsequent in-depth semi-structured interviews, the implications of the introduction of this strategy are identified, focusing in particular on the relationships between the ECEC leaders and parents. This presents clear evidence of the potential for a negative impact on interpersonal professional relationships