Who Has The Potential To Benefit From Higher Education?

Higher Education is framed as something that should benefit the many opposed to the few. This is emphasised in policy that supports the belief that everyone who has the potential to benefit from Higher Education should be able to (HEFCE and OFFA, 2014a). This notion of ‘potential’ however is adopted in varying ways across institutions. This paper draws on a Critical Discourse Analysis (CDA) of two access agreements from two institutions (one pre-1992 and one post-1992) situated within the same city. Whilst there were many differences within these agreements, this paper focuses on the notion of potential and who is targeted for these interventions. Examining this in the context of recent evidence on student attainment trajectories within compulsory education, this paper will explore how errant assumptions relating to how to identify potential may contribute to reproductions of inequality opposed to widening participation within Higher Education

Making internal conversations public: reflexivity of the connected doctoral researcher and its transmission beyond the walls of the academy

Advances in digital technologies, especially those associated with Web 2.0 such as blogs and Twitter, have created new spaces for discussion and to encourage the development of ideas. These advances have the ability to reduce the isolation of the doctoral researcher who may have previously been limited to discussions restricted to physical spaces such as departmental offices and at conferences. Whilst moving these conversations into public spaces can offer benefits, it also presents a distinct set of challenges. This paper adopts an autoethnographic approach in order to explore my experiences of using digital technologies to support my development as a doctoral researcher. Drawing on Archer’s (2003; 2007) theories of reflexivity and the internal conversation, it explores two critical incidents (Tripp, 1993) during my first year as a doctoral researcher. The first focuses on making sense of the rejection of a conference paper and the second on making sense of what ‘can’ and ‘should’ be said in a digital space as the result of tweeting and blogging at a conference. In doing so, this paper highlights the ways in which digital technologies have the capacity to support an individual’s varied modes of reflexivity. Through this, it also illuminates how bringing these conversations into a public space can also offer a form of public scholarship, opening up the inner workings of the academy to a wider public, challenging traditional academic practices. Consequently, the paper concludes with suggestions for future research and training needed to support digital scholarship for doctoral researchers

How institutional doxa shapes access to higher education through framings of ‘potential’

Access to higher education is a global concern due to its dual role in transforming individual lives and value for global economic systems. However, pre-entry interventions to improve access often make comparatively little impact on who attends certain types of universities. Drawing upon a study that examined policy and practice relating to access to higher education conducted in 2016–2017 in England, this article furthers a theoretical discussion relating to the role institutional norms play in maintaining this status quo and why inequities endure especially in elite universities. In doing so, it highlights how institutional doxa can illuminate how taken-for-granted ideals shape policy and practice. This article theorises that institutional doxa shapes notions of who is seen as having ‘potential’, examines why doxic positions in relation to ‘potential’ endure and are rarely impacted by practices. This theorisation offers an important contribution to research on access to higher education as by foregrounding the central role played by these assumptions within marketised higher education systems this enables them to be challenged and deconstructed in order to effect meaningful progress on issues of access to higher education

Working with/in institutions: how policy enactment in widening participation is shaped through practitioners’ experience

Widening participation in higher education is driven by policy that is then enacted by individual practitioners. Practitioners bring with them a wealth of personal and employment experiences which shape their interpretations and enactments. Drawing on 16 in-depth semi structured interviews with practitioners across seven universities in England, a classification is developed in order to conceptualise their orientations to policy enactment. Whilst nationally focused, this study has international resonance especially in marketised higher education systems where policies are similarly enacted. The model developed within the article proposes that personal and professional experience can cause practitioners to orient towards the interests of the institution or the individuals they work with. This orientation can be in compliance with institutional policy or adopt a more transgressive stance. Through deeper theorisation of practitioner positions, we can better understand how to ensure work in this area better serves the individuals whom it is targeted at

Stripping back the novelty: A critical reflection on the dual use of a comic-based approach to engage participants and publics

There has been increasing use of comic-based approaches within qualitative research as part of an increase in creative and visual methods more generally within social science research. However, whilst increasingly prevalent in dissemination, their use within data collection is less common. This paper examines the dual use of a comic-based approach embedded within a study that explored widening participation in higher education. Initially developed for the triangulation of emergent research findings with a wider group of participants, a comic panel was developed to be used as a focus of discussions within a workshop with 11 practitioners. This was then further developed for wider dissemination and to create a space for dialogue and to engage wider publics with the study’s recommendations. Both uses are critically examined, highlighting the affordances of comic-based approaches such as their capacity for supporting dissemination to a wider audience by distilling the findings and presenting them in an engaging way. Furthermore, it argues that the form can allow for creating points of ambiguity that create spaces for the audience to challenge and question taken for granted assumptions on a topic. The paper also sets out possible challenges such the need for specialist skills, the potential for oversimplification and misrepresentation of complex issues. This paper argues that with careful planning, comic-based approaches can add significant value and increase engagement with research. Finally, it offers suggestions for how this approach could be developed by future researchers

Confidence and the effectiveness of creative methods in qualitative interviews with adults

This paper examines two contrasting creative methods; a drawing task and a LEGO building task used in a study exploring the gap between policy and practice in widening participation to higher education across two different types of university in England. These creative methods were used within 16 semi-structured interviews in seven universities to attempt to explore deeper understandings of everyday policy and what they mean in practice and to make comparisons across types of institutions. This paper examines the role that creative confidence played in the effectiveness of both methods through exploring the successes and failures of each arguing that understanding these barriers can improve the successful use of these methods, especially with adults. When these barriers are overcome, the paper also demonstrates how creative methods encouraged more reflective discussion of everyday issues, increased levels of rapport, and shared engagement in the interview process

Internalizing the Present in the Articulation of the Future: Masculinity, Inequality, and Trying On New Possible Selves

Young men, especially from working-class backgrounds, often lack the space, capacity, or opportunity to reflect upon masculinities and their role in shaping future trajectories. By devising mechanisms to engage young men differently in creative activities, participants in our project were supported to think beyond assumed futures and explore new possibilities. Mobilizing the theory of possible selves, this article draws on data across three creative university outreach workshops in England with 18 participants who were given the opportunity to explore masculinities using creative writing, photography, and dance/movement. Combining artifact analysis and semi-structured interviews, the article argues that these workshops created safe spaces for young men to articulate their concerns and fears about harm and risk in everyday life while facilitating an exploration of alternative possible selves

Exploring the Transitions of Neurodivergent Access Students to Level One Study: Narratives of Study Skills and Support

The higher education journey of any student in a distance learning university is a challenging one but this is more so for neurodivergent students. Neurodivergent students have been found to require both academic (Jackson et al. 2018; Ness 2013) and non-academic support (Gelbar et al. 2015) around them to enable to achieve and reach their academic goals. Access programs in The Open University have a widening participation agenda and enrol many Neurodivergent students with diagnoses of autism, ADHD, Dyslexia, Asperger’s syndrome, and Dyspraxia. The study focused on the following three research questions: 1.What forms of support do neurodivergent students transitioning from Access to Level 1 study value? 2.What barriers to success may the current access curriculum create for neurodivergent students? 3.How can neurodivergent students transitioning from Access to level 1 be better supported? Students from the three access modules moving to any level 1 module were included in the sample. This paper focuses on the findings from the five remotely conducted in-depth interviews and an associated photo-elicitation task. Through a thematic analysis, a number of key themes were developed: Finding their own way, Support, quality of tutor support, wider systems of support, understanding assessment, facing new systems, the jump, language of learning and referencing issues. The paper explores these with examples and highlights how these might inform future practice to improve transitions for neurodivergent students. The paper also highlights the limitations institutional focused research with these groups places upon the scope of this kind of research

Antimicrobial-impregnated central venous catheters for prevention of neonatal bloodstream infection (PREVAIL) : an open-label, parallel-group, pragmatic, randomised controlled trial

BACKGROUND: Bloodstream infection is associated with high mortality and serious morbidity in preterm babies. Evidence from clinical trials shows that antimicrobial-impregnated central venous catheters (CVCs) reduce catheter-related bloodstream infection in adults and children receiving intensive care, but there is a paucity of similar evidence for babies receiving neonatal intensive care. METHODS: This open-label, parallel-group, pragmatic, randomised controlled trial was done in 18 neonatal intensive care units in England. Newborn babies who needed a peripherally inserted CVC (PICC) were allocated randomly (1:1) to receive either a PICC impregnated with miconazole and rifampicin or a standard (non-antimicrobial-impregnated) PICC. Random allocation was done with a web-based program, which was centrally controlled to ensure allocation concealment. Randomisation sequences were computer-generated in random blocks of two and four, and stratified by site. Masking of clinicians to PICC allocation was impractical because rifampicin caused brown staining of the antimicrobial-impregnated PICC. However, participant inclusion in analyses and occurrence of outcome events were determined following an analysis plan that was specified before individuals saw the unblinded data. The primary outcome was the time from random allocation to first microbiologically confirmed bloodstream or cerebrospinal fluid (CSF) infection between 24 h after randomisation and 48 h after PICC removal or death. We analysed outcome data according to the intention-to-treat principle. We excluded babies for whom a PICC was not inserted from safety analyses, as these analyses were done with groups defined by the PICC used. This trial is registered with ISRCTN, number 81931394. FINDINGS: Between Aug 12, 2015, and Jan 11, 2017, we randomly assigned 861 babies (754 [88%] born before 32 weeks of gestation) to receive an antimicrobial-impregnated PICC (430 babies) or standard PICC (431 babies). The median time to PICC removal was 8·20 days (IQR 4·77-12·13) in the antimicrobial-impregnated PICC group versus 7·86 days (5·00-12·53) days in the standard PICC group (hazard ratio [HR] 1·03, 95% CI 0·89-1·18, p=0·73), with 46 (11%) of 430 babies versus 44 (10%) of 431 babies having a microbiologically confirmed bloodstream or CSF infection. The time from random allocation to first bloodstream or CSF infection was similar between the two groups (HR 1·11, 95% CI 0·73-1·67, p=0·63). Secondary outcomes relating to infection, rifampicin resistance in positive blood or CSF cultures, mortality, clinical outcomes at neonatal unit discharge, and time to PICC removal were similar between the two groups, although rifampicin resistance in positive cultures of PICC tips was higher in the antimicrobial-impregnated PICC group (relative risk 3·51, 95% CI 1·16-10·57, p=0·018). 60 adverse events were reported from 49 (13%) patients in the antimicrobial-impregnated PICC group and 50 events from 45 (10%) babies in the standard PICC group. INTERPRETATION: We found no evidence of benefit or harm associated with miconazole and rifampicin-impregnated PICCs compared with standard PICCs for newborn babies. Future research should focus on other types of antimicrobial impregnation of PICCs and alternative approaches for preventing infection. FUNDING: UK National Institute for Health Research Health Technology Assessment programme

Antimicrobial-impregnated central venous catheters for preventing neonatal bloodstream infection : the PREVAIL RCT

BACKGROUND:Clinical trials show that antimicrobial-impregnated central venous catheters reduce catheter-related bloodstream infection in adults and children receiving intensive care, but there is insufficient evidence for use in newborn babies. OBJECTIVES:The objectives were (1) to determine clinical effectiveness by conducting a randomised controlled trial comparing antimicrobial-impregnated peripherally inserted central venous catheters with standard peripherally inserted central venous catheters for reducing bloodstream or cerebrospinal fluid infections (referred to as bloodstream infections); (2) to conduct an economic evaluation of the costs, cost-effectiveness and value of conducting additional research; and (3) to conduct a generalisability analysis of trial findings to neonatal care in the NHS. DESIGN:Three separate studies were undertaken, each addressing one of the three objectives. (1) This was a multicentre, open-label, pragmatic randomised controlled trial; (2) an analysis was undertaken of hospital care costs, lifetime cost-effectiveness and value of information from an NHS perspective; and (3) this was a retrospective cohort study of bloodstream infection rates in neonatal units in England. SETTING:The randomised controlled trial was conducted in 18 neonatal intensive care units in England. PARTICIPANTS:Participants were babies who required a peripherally inserted central venous catheter (of 1 French gauge in size). INTERVENTIONS:The interventions were an antimicrobial-impregnated peripherally inserted central venous catheter (coated with rifampicin-miconazole) or a standard peripherally inserted central venous catheter, allocated randomly (1 : 1) using web randomisation. MAIN OUTCOME MEASURE:Study 1 - time to first bloodstream infection, sampled between 24 hours after randomisation and 48 hours after peripherally inserted central venous catheter removal. Study 2 - cost-effectiveness of the antimicrobial-impregnated peripherally inserted central venous catheter compared with the standard peripherally inserted central venous catheters. Study 3 - risk-adjusted bloodstream rates in the trial compared with those in neonatal units in England. For study 3, the data used were as follows: (1) case report forms and linked death registrations; (2) case report forms and linked death registrations linked to administrative health records with 6-month follow-up; and (3) neonatal health records linked to infection surveillance data. RESULTS:Study 1, clinical effectiveness - 861 babies were randomised (antimicrobial-impregnated peripherally inserted central venous catheter, n = 430; standard peripherally inserted central venous catheter, n = 431). Bloodstream infections occurred in 46 babies (10.7%) randomised to antimicrobial-impregnated peripherally inserted central venous catheters and in 44 (10.2%) babies randomised to standard peripherally inserted central venous catheters. No difference in time to bloodstream infection was detected (hazard ratio 1.11, 95% confidence interval 0.73 to 1.67; p = 0.63). Secondary outcomes of rifampicin resistance in positive blood/cerebrospinal fluid cultures, mortality, clinical outcomes at neonatal unit discharge and time to peripherally inserted central venous catheter removal were similar in both groups. Rifampicin resistance in positive peripherally inserted central venous catheter tip cultures was higher in the antimicrobial-impregnated peripherally inserted central venous catheter group (relative risk 3.51, 95% confidence interval 1.16 to 10.57; p = 0.02) than in the standard peripherally inserted central venous catheter group. Adverse events were similar in both groups. Study 2, economic evaluation - the mean cost of babies' hospital care was £83,473. Antimicrobial-impregnated peripherally inserted central venous catheters were not cost-effective. Given the increased price, compared with standard peripherally inserted central venous catheters, the minimum reduction in risk of bloodstream infection for antimicrobial-impregnated peripherally inserted central venous catheters to be cost-effective was 3% and 15% for babies born at 23-27 and 28-32 weeks' gestation, respectively. Study 3, generalisability analysis - risk-adjusted bloodstream infection rates per 1000 peripherally inserted central venous catheter days were similar among babies in the trial and in all neonatal units. Of all bloodstream infections in babies receiving intensive or high-dependency care in neonatal units, 46% occurred during peripherally inserted central venous catheter days. LIMITATIONS:The trial was open label as antimicrobial-impregnated and standard peripherally inserted central venous catheters are different colours. There was insufficient power to determine differences in rifampicin resistance. CONCLUSIONS:No evidence of benefit or harm was found of peripherally inserted central venous catheters impregnated with rifampicin-miconazole during neonatal care. Interventions with small effects on bloodstream infections could be cost-effective over a child's life course. Findings were generalisable to neonatal units in England. Future research should focus on other types of antimicrobial impregnation of peripherally inserted central venous catheters and alternative approaches for preventing bloodstream infections in neonatal care. TRIAL REGISTRATION:Current Controlled Trials ISRCTN81931394. FUNDING:This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 57. See the NIHR Journals Library website for further project information