A social pedagogical intervention to support children in care:Back on Track

This paper focuses on an intervention project, Back on Track (BoT), implemented as a part of the Resilience Revolution: HeadStart Blackpool (RR:HS) programme in the UK. Whilst it is a famous family holiday resort, Blackpool is also one of the most deprived towns in England. This makes life challenging for young people (YP) to maintain wellbeing and reach their potential. Blackpool also has an above average and growing proportion of children in care. They are at a higher risk of developing mental health difficulties and of being permanently excluded from school. BoT aimed to support fostered children who have been referred by schools or social workers to the project for having emotional and behavioural struggles. As a consequence of their difficulties, they were at risk of permanent exclusion from the school. The intervention was grounded in a social pedagogical approach and Resilient Therapy. Resilience Coaches (i.e., wellbeing practitioners) had the role of enhancing communication between YP, family, social care, and school, whilst working with YP to co-produce coping strategies. Between November 2016 and June 2021, 39 YP (61.5% male) aged 10 to 15 (M = 12.74, SD = 1.60) received BoT support over a period lasting between 4 months to 2.5 years (M = 14 months, SD = 6.8 months). Using a mixed-methods design, this paper explored the BoT implementation. YP completed questionnaires before and after BoT. Triangulation interviews were conducted with a randomly selected YP, foster parent and the Resilience Coach. Results showed the benefit of equipping YP with ‘resilient moves’ and joining up systems to work together and better support YP and families. YP reported reduced difficulties, improved strengths (i.e., prosocial behaviour) and educational outcomes. This helped build resilience and reduce the risk of permanent exclusions from school. Policy and practice implications for children in care are discussed

Learning spaces:built, natural and digital considerations for learning and learners

Learning spaces: Built, natural and digital considerations for learning and learner

COVID-19: Third dose booster vaccine effectiveness against breakthrough coronavirus infection, hospitalisations and death in patients with cancer: A population-based study

Purpose: People living with cancer and haematological malignancies are at increased risk of hospitalisation and death following infection with acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronavirus third dose vaccine boosters are proposed to boost waning immune responses in immunocompromised individuals and increase coronavirus protection; however, their effectiveness has not yet been systematically evaluated. Methods: This study is a population-scale real-world evaluation of the United Kingdom’s third dose vaccine booster programme for cancer patients from 8th December 2020 to 7th December 2021. The cancer cohort comprises individuals from Public Health England’s national cancer dataset, excluding individuals less than 18 years. A test-negative case-control design was used to assess third dose booster vaccine effectiveness. Multivariable logistic regression models were fitted to compare risk in the cancer cohort relative to the general population. Results: The cancer cohort comprised of 2,258,553 tests from 361,098 individuals. Third dose boosters were evaluated by reference to 87,039,743 polymerase chain reaction (PCR) coronavirus tests. Vaccine effectiveness against breakthrough infections, symptomatic infections, coronavirus hospitalisation and death in cancer patients were 59.1%, 62.8%, 80.5% and 94.5% respectively. Lower vaccine effectiveness was associated with a cancer diagnosis within 12 months, lymphoma, recent systemic anti-cancer therapy (SACT) or radiotherapy. Lymphoma patients had low levels of protection from symptomatic disease. In spite of third dose boosters, following multivariable adjustment, individuals with cancer remain at increased risk of coronavirus hospitalisation and death compared to the population control (OR 3.38, 3.01 respectively. p<0.001 for both). Conclusions: Third dose boosters are effective for most individuals with cancer, increasing protection from coronavirus. However, their effectiveness is heterogenous, and lower than the general population. Many patients with cancer will remain at increased risk of coronavirus infections, even after 3 doses. In the case of patients with lymphoma, there is a particularly strong disparity of vaccine effectiveness against breakthrough infection and severe disease. Breakthrough infections will disrupt cancer care and treatment with potentially adverse consequences on survival outcomes. The data support the role of vaccine boosters in preventing severe disease, and further pharmacological intervention to prevent transmission and aid viral clearance to limit disruption of cancer care as the delivery of care continues to evolve during the coronavirus pandemic

Future Experiences: Sustainable Development and the Global South

The Sustainable Development and the Global South project was jointly conceived by the Innovation School at Glasgow School of Art in partnership with the Sustainable Futures in Africa Network (SFA), and the University of Glasgow. Graduating final year BDes Product Design students from the Innovation School were presented with a challenge-based project to produce a vision of the future based on current trends that relate to Sustainable Development work and the Global South. This project involved working closely with researchers, academics and professionals specialising in human geography, education, health, environment, engineering, cultural practice and community engagement who are part of the Sustainable Futures in Africa Network which includes a Scottish hub, led from the University of Glasgow. Included in the network was a representative from an NGO that builds schools in Malawi, an entrepreneur who runs an ethical clothing company that partners with producers in the Global South, a senior governance officer from the UK Government’s Department for International Development (DFID), a research network administrator, and international graduate students from Africa based at Scottish institutions. In addition to the SFA, external experts from design studio AndThen and GOODD design consultancy were engaged. The objective of this project was to investigate, in both analytical and speculative ways, future forms and functions of Sustainable Development work in relation to the Global South in ten years from now, to develop future scenarios and design the artefacts, services and the experiences associated with these future visions. On completion of the project and learning experience it was intended that the students would be able to recognise and articulate the impact and sustainability of their design propositions, consider the life-cycle of their proposals and the values these might create for the intended users, communities and contexts. The project was completed in January 2020, as the Covid-19 pandemic was just beginning its spread around the world. This unprecedented catastrophe reinforced the importance of supporting those most in need – the citizens of developing regions in the Global South. In April 2020, the heads of all the UN’s major agencies issued an open letter warning of the risks the virus posed to the world’s most vulnerable countries. It called on wealthier nations to increase funding and help to tackle issues such as the cessation of aid as a result of cancelled flights and disrupted supply routes. These and many other concerns highlighted during the crisis are among the topics explored in this project, which feels even more relevant and urgent than when it was initiated in the summer of 2019. One of the most significant societal shifts currently taking place within the field of sustainable development work is its transformation from being understood as a process of growth or, at its most benign, poverty alleviation, to one of community empowerment and civic participation. The public’s role is developing beyond once-passive community members and recipients of aid, into stakeholders valued for their local knowledge, lived experiences, participation in development projects, and contribution towards policy-making and decision-making. This new dynamic is changing the traditional North-South relationship and holds the potential to challenge the geopolitical hegemony of International Development. The impetus for this shift is a decolonial, collaborative approach to development, research and practice; increased local empowerment, and sustainable solutions to problems that are co-created in context with those affected by and affecting the issue in question. This project asked students to consider what happens in this global landscape ten years from now where Sustainable Development has evolved to the extent that new forms of work and communities of practice transform how people engage, learn and interact with each other, with stakeholders and with the global community around them. The brief gave students the opportunity to explore the underlying complexities regarding sustainable futures, the post-colonial dynamic between ‘norths’ and ‘souths’, post-capitalism and human agency, to envision a future world context, develop it as an experiential exhibit, and produce the designed products, services and experiences for the people who might live and work within it. The project was divided into two sections: The first was a collaborative stage where groups of students were assigned a specific domain to collectively research one aspect of the project challenge, these domains included; Health, Energy, Mobility, Economies, Education, Societal Structures and Environment. Each of these domains were examined through the lenses of Social, Technological, Economic, Ethical, Educational, Values, Political, Legal and Ecological (STEEEVPLE) and were tailored in use, as appropriate per domain. The groups focused on researching and exploring their specific domain and gathering as much information and understanding while working with the external experts to further their knowledge. This group stage culminated in a series of Future World exhibits which tangibly manifest the cohort’s collective knowledge and collaborative understanding of what the future could look like in 10 years from now, after exploring the possible consequences of current actions. The second stage saw students explore their individual response to the Future World that had been created in the first stage. Each student developed their own response to the research by iteratively creating a design outcome that was appropriate to the subject matter. This culminated in each student producing a designed product, service or system and a visual communication of the future experience which they had created. A visual summary of the journey and stages (Project Journey Map) is included within the repository and outlines the collaborative process of designing and the innovative nature of the project’s pedagogical model. The project aims to reveal and address the emerging possibilities collaboratively created by Sustainable Development professionals and designers interacting and learning from each other, to present preferable futures which reveal socio-ecological innovations in development work with the Global South in the near future. The deposited materials are arranged as follows: Readme files - two readme files relate to stage one and stage two of the project as outlined above. Project Journey Map - gives a visual overview of the pedagogical structure and timeline of the project. Data folders - the data folders for stage one of the project are named by the domains through which each group explored possible futures. The data folders for stage two of the project are named for the individual students who conducted the work

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Humans of Interiors – Diversity by Design

Within the disciplines of Interior Architecture and Design, visual depiction of spaces is a powerful tool to communicate use, users and qualities of the designed/proposed spaces. With a mixture of techniques we can produce images capable of plunging viewers directly into these imagined spaces. Visual depictions of people demonstrate social norms and values, teaching viewers how the world works and their place within it via symbolic socialisation. Such visualisations, so provocative and seductive, are carefully designed to communicate the atmosphere that the designer is aiming to create, but if they fail to include a fair representation of the people those spaces are designed for, they misrepresent the aim of the project. This distinct lack of diversity and inclusivity within visuals is indicative of both a lack of consideration of the existence of people who are not the same as the designers themselves (who are overwhelmingly young, white and able- bodied1) and an equally problematic lack of understanding of the needs of these populations. The paper is the account of a collaboration, a research project and a series of workshops conducted over the last few years by the University of Lincoln and Middlesex University London. Humans of Interiors/Diversity by Design aims at promoting a discussion across education and industry on the impact that visualization has on the representation of future spaces and whom these spaces are addressed and designed for: a discourse about social sustainability of spatial design. The research activities underpinning Humans of Interiors/Diversity by Design and the workshops devised internationally, help establish EDI as an integral part of the design process and enable participants to apply their own critically reflective knowledge and understanding of these principles to the development of their design

Normality sensing licenses local T cells for innate-like tissue surveillance

The increasing implication of lymphocytes in general physiology and immune surveillance outside of infection poses the question of how their antigen receptors might be involved. Here, we show that macromolecular aggregates of intraepidermal γδ T cell antigen receptors (TCRs) in the mouse skin aligned with and depended on Skint1, a butyrophilin-like (BTNL) protein expressed by differentiated keratinocytes (KCs) at steady state. Interruption of TCR-mediated ‘normality sensing’ had no impact on γδ T cell numbers but altered their signature phenotype, while the epidermal barrier function was compromised. In addition to the regulation of steady-state physiology, normality sensing licensed intraepidermal T cells to respond rapidly to subsequent tissue perturbation by using innate tumor necrosis factor (TNF) superfamily receptors. Thus, interfering with Skint1-dependent interactions between local γδ T cells and KCs at steady state increased the susceptibility to ultraviolet B radiation (UVR)-induced DNA damage and inflammation, two cancer-disposing factors

Pedagogía social : revista interuniversitaria

Resumen basado en el de la publicaciónTítulo, resumen y palabras clave en inglés, español y portuguésMonográfico con el título: “Resiliencia y educación en los márgenes de la sociedad”Título del monográfico en inglés: “Resilience and education at the margins of society”Título del monográfico en portugués: “Resilliência e educação à margem da sociedade”Se trata de un proyecto de intervención, Back on Track (BoT), implementado como parte del programa Resilience Revolution: HeadStart Blackpool (RR:HS) en el Reino Unido. Si bien es un famoso centro vacacional familiar, Blackpool es también una de las ciudades más desfavorecidas de Inglaterra. Esto hace que la vida de los jóvenes (YP) sea un desafío para mantener el bienestar y alcanzar su potencial. Blackpool también tiene una proporción superior a la media y creciente de niños bajo tutela. Corren un mayor riesgo de desarrollar problemas de salud mental y de ser excluidos permanentemente de la escuela. BoT tenía como objetivo apoyar a los niños acogidos que han sido referidos por escuelas o trabajadores sociales al proyecto por tener problemas emocionales y de comportamiento. Como consecuencia de sus dificultades, estaban en riesgo de exclusión permanente de la escuela. La intervención se basó en un enfoque pedagógico social y Terapia Resiliente. Los entrenadores de resiliencia (es decir, profesionales del bienestar) tenían el papel de mejorar la comunicación entre YP, la familia, la atención social y la escuela, mientras trabajaban con YP para coproducir estrategias de afrontamiento. Entre noviembre de 2016 y junio de 2021, 39 YP (61.5% hombres) de 10 a 15 años (M = 12.74, SD = 1.60) recibieron apoyo de BoT durante un período que duró entre 4 meses y 2.5 años (M = 14 meses, SD = 6.8 meses). Usando un diseño de métodos mixtos, este documento exploró la implementación de BoT. YP completó cuestionarios antes y después de BoT. Se realizaron entrevistas de triangulación con un YP seleccionado al azar, un padre adoptivo y el Entrenador de Resiliencia. Los resultados mostraron el beneficio de equipar a YP con ‘movimientos resilientes’ y unir sistemas para trabajar juntos y brindar un mejor apoyo a YP y sus familias. YP informó dificultades reducidas, fortalezas mejoradas (es decir, comportamiento prosocial) y resultados educativos. Esto ayudó a desarrollar resiliencia y reducir el riesgo de exclusiones permanentes de la escuela. Se discuten las implicaciones políticas y prácticas para los niños bajo cuidado.ES