Patient-based benefit-risk assessment of medicines: development,refinement, and validation of a content search strategy to retrieve relevant studies

Introduction:Poor indexing and inconsistent use of terms and keywords may prevent efficient retrieval of studies on the patient-based benefit-risk assessment (BRA) of medicines. We aimed to develop and validate an objectively derived content search strategy containing generic search terms that can be adapted for any search for evidence on patient-based BRA of medicines for any therapeutic area.Methods:We used a robust multistep process to develop and validate the content search strategy: (1) we developed a bank of search terms derived from screening studies on patient-based BRA of medicines in various therapeutic areas, (2) we refined the proposed content search strategy through an iterative process of testing sensitivity and precision of search terms, and (3) we validated the final search strategy in PubMed by firstly using multiple sclerosis as a case condition and secondly computing its relative performance versus a published systematic review on patient-based BRA of medicines in rheumatoid arthritis.Results:We conceptualized a final search strategy to retrieve studies on patient-based BRA containing generic search terms grouped into two domains, namely the patient and the BRA of medicines (sensitivity 84%, specificity 99.4%, precision 20.7%). The relative performance of the content search strategy was 85.7% compared with a search from a published systematic review of patient preferences in the treatment of rheumatoid arthritis. We also developed a more extended filter, with a relative performance of 93.3% when compared with a search from a published systematic review of patient preferences in lung cancer.     

Exclusion and the strategic leadership role of SENCos in England: planning for Covid-19 and future crises

A small-scale study investigated the role of SENCos in England immediately prior to, during and following the first closure of schools nationally in March 2020 due to the Covid-19 pandemic. A mixed-methods research strategy comprising semi-structured interviews and a national online survey generated data related to SENCos' involvement in strategic planning for crisis conditions, focusing specifically on students with special educational needs and disabilities (SEND) and concerns about exclusionary practices. Findings suggest that pandemic conditions have exacerbated familiar issues related to the SENCo role and SEND provision in English schools, such as engagement in reactive firefighting, onerous workloads, uneven SENCo involvement in strategic planning, and schools' failure to prioritise students with SEND. Minimal evidence of ‘advocacy leadership’ or of SENCos challenging exclusionary practices was found. As in earlier research, evidence was also found for disparities between anecdotal and published data relating to illegal exclusion.     

Primary initial teacher trainees' perceptions of and perspectives on the role of the teaching assistant in English primary contexts

This article focuses on exploring initial teacher trainees' experiences and perspectives on the role of the teaching assistant (TA) in mainstream primary contexts. A backdrop of shrinking school budgets coupled with a ‘mainstream for all’ political agenda is contributing to growing uncertainty about the role of TAs in education. This article presents the results of a small-scale empirical study, involving 75 initial teacher trainees at the University of Cambridge. Trainees' perspectives regarding the roles/responsibilities that TAs have been seen to undertake and perceptions regarding the impact of the TAs they worked with were ascertained, with the aim of exploring how well current ITT content prepares students for an effective teacher/TA working relationship. Concept modelling was used as an analysis tool, to present visual representations of these perceptions. Trainees emphasised the administrative, pedagogical and pastoral roles that TAs were perceived to undertake and specifically highlighted the perceived ability of TAs to support students displaying needs relating to social, emotional and mental health. The findings highlight that the vague nature of current ITT content in relation to the role of TAs continues to serve as a barrier to students building coherent and consistent understandings of the successful deployment of TAs in English primary contexts.     

Evaluating a method for eliciting children's voice about educational support with children with speech,language and communication needs

This article reports the development and evaluation of a toolkit‐based approach to eliciting children's experiences of educational support, where the children in question experience speech and communication needs. The ‘Your Voice Your Choice’ approach was evaluated using a cross‐case analysis methodology, which represents a novel approach to critical examination of the effectiveness of such resources. We explored seven case studies within a critical realist framework. We found that the toolkit was effective at supporting most (although not all) of the children with speech and communication needs to explore their school learning and support experiences through a scaffolded emotion‐based ‘dialogue’, which was corroborated by observations and other data sources. The toolkit facilitated access to children's voice as they revealed how they felt across a number of relational, learning and support areas, which could be used by services to focus provision and consider how to better support children's social and emotional needs.     

Introduction

This special issue focuses on the role of context in scaling up educational change. The featured articles explore interventions from across the globe examining the central question of what facilitates scaling up an intervention, whether adopted externally or homegrown. Each of the articles address a unique set of factors that play a role in scaling up innovations and the mutual influence between local context and new or external interventions. The four articles focus on large-scale interventions and draw attention to the role of context—inclusive of culture, values, beliefs, traditional practices, and educator voice. The issue leaves readers with illustrative case studies, guiding questions, and lessons learned that can inform both practitioners and policymakers.