Developing sexual competence? Exploring strategies for the provision of effective sexualities and relationships education

School-based sexualities and relationships education (SRE) offers one of the most promising means of improving young people's sexual health through developing 'sexual competence'. In the absence of evidence on whether the term holds the same meanings for young people and adults (e.g. teachers, researchers, policy-makers), the paper explores 'adult' notions of sexual competence as construed in research data and alluded to in UK Government guidance on SRE, then draws on empirical research with young people on factors that affect the contexts, motivations and outcomes of sexual encounters, and therefore have implications for sexual competence. These data from young people also challenge more traditional approaches to sexualities education in highlighting disjunctions between the content of school-based input and their reported sexual experience. The paper concludes by considering the implications of these insights for developing a shared notion of what SRE is trying to achieve and suggestions for recognition in the content and approaches to SRE.</p

Becoming an English language teacher:linguistic knowledge, anxieties and the shifting sense of identity

English Language is a fast growing and popular subject at A level but the majority of qualified secondary teachers in the UK have subject expertise and backgrounds in literature. This paper reports on interviews with seven secondary English teachers who discuss the strategies they used when taking on the responsibility of A level English Language teaching for the first time. It highlights the shifting sense of identity that these teachers felt they went through, and as such, explores some emerging issues related to identity from a narrative/personal history perspective. The study reveals that despite feelings of anxiety and low self-confidence, teachers felt that the experience had been a positive one in terms of their own developing identity as an English teacher and had impacted on other aspects of their teaching. The paper raises questions about the value of language-based work for English teachers and has implications for UK initial and continuing teacher education in English

Preparing isiXhosa home language teachers for the 21st century classroom: Student teachers' experiences, challenges and reflections

The aim of the article is to identify the gaps between theory and practice in pre-service teacher training with special reference to the teaching of isiXhosa as a home language in the Further Education and Training (FET) phase (Grades 10–12) in some Western Cape high schools. The article is based on data that was collected from Postgraduate Certificate in Education (PGCE) students taking isiXhosa (home language) as one of their teaching method subjects as part of their pre-service training. The data were collected by means of an open-ended questionnaire, semi-structured interviews and an analysis of student teachers’ reflective journals. The article provides an analysis of PGCE students’ experiences and reflections on the teaching of isiXhosa as a home language in schools. It argues that if there is a gap between theory underpinning initial pre-service training and actual practice in schools, there will be no significant improvement in the teaching of isiXhosa as a home language. It concludes by proposing ways of improving both pre-service and in-service teacher education practice to develop African languages as academic or intellectual languages at school level

Supporting adolescent emotional health in schools: a mixed methods study of student and staff views in England

<p>Abstract</p> <p>Background</p> <p>Schools have been identified as an important place in which to support adolescent emotional health, although evidence as to which interventions are effective remains limited. Relatively little is known about student and staff views regarding current school-based emotional health provision and what they would like to see in the future, and this is what this study explored.</p> <p>Methods</p> <p>A random sample of 296 English secondary schools were surveyed to quantify current level of emotional health provision. Qualitative student focus groups (27 groups, 154 students aged 12-14) and staff interviews (12 interviews, 15 individuals) were conducted in eight schools, purposively sampled from the survey respondents to ensure a range of emotional health activity, free school meal eligibility and location. Data were analysed thematically, following a constant comparison approach.</p> <p>Results</p> <p>Emergent themes were grouped into three areas in which participants felt schools did or could intervene: emotional health in the curriculum, support for those in distress, and the physical and psychosocial environment. Little time was spent teaching about emotional health in the curriculum, and most staff and students wanted more. Opportunities to explore emotions in other curriculum subjects were valued. All schools provided some support for students experiencing emotional distress, but the type and quality varied a great deal. Students wanted an increase in school-based help sources that were confidential, available to all and sympathetic, and were concerned that accessing support should not lead to stigma. Finally, staff and students emphasised the need to consider the whole school environment in order to address sources of distress such as bullying and teacher-student relationships, but also to increase activities that enhanced emotional health.</p> <p>Conclusion</p> <p>Staff and students identified several ways in which schools can improve their support of adolescent emotional health, both within and outside the curriculum. However, such changes should be introduced as part of a wider consideration of how the whole school environment can be more supportive of students' emotional health. Clearer guidance at policy level, more rigorous evaluation of current interventions, and greater dissemination of good practice is necessary to ensure adolescents' emotional health needs are addressed effectively within schools.</p

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

Background: The EMPA KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. Methods: EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. Findings: Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5–2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62–0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16–1·59), representing a 50% (42–58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all &gt;0·1). Interpretation: In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. Funding: Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council

Tailoring the transmission of liquid-core waveguides for wavelength filtering on a chip

The combination of integrated optics and microfluidics in planar optofluidic devices carries the potential for novel compact and ultra-sensitive detection in liquid and gaseous media. Single molecule fluorescence detection sensitivity in planar beam geometry was recently demonstrated in liquid-core antiresonant reflecting optical waveguides (ARROWs) fabricated on a silicon chip. A key component of a fully integrated single-molecule sensor is the addition of an optical filtering capability to separate excitation beams from much weaker generated fluorescence or scattering signals. This capability will eventually allow for integration of the photodetector on the same chip as the optofluidic sensing part. It has been theoretically shown that the wavelength-dependent transmission of liquid-core ARROWs can be tailored to efficiently separate excitation and fluorescence. Here, we present the wavelength dependent transmission of air-core ARROW waveguides, using a highly nonlinear photonic crystal fiber to generate a broadband excitation spectrum, and the design of liquid-core ARROW waveguides with integrated filter function. The air-core waveguide loss shows pronounced wavelength dependence in good agreement with the design, demonstrating the potential of tailoring the optical properties of liquid-core waveguides to accommodate single-molecule sensing on a chip. We also present an ARROW design to produce wavelength-dependent transmission that is optimized for fluorescence resonance energy transfer (FRET) studies with high transmission at 573 nm and 668 nm, and low transmission at 546 nm