• Workload intensity and rest periods in professional ballet: Connotations for injury

      Kozai, Andrea; Twitchett, Emily; Morgan, Sian; Wyon, Matthew (Thieme, 2020-03-31)
      Fatigue and overwork have been cited as the main cause of injury with the dance profession. Previous research has shown a difference in workload between professional dancers of different rank, but the role of sex has not been examined. The purpose of this study was to determine workload intensity, rest, and sleep profiles of professional ballet dancers. 48 professional ballet dancers (M=25, F=23) took part in an observational design over 7-14 days using triaxial accelerometer devices. Minutes in METS at different intensities, total time asleep and rest breaks were analysed. Significant main effects for rank (p<0.001) and rank by sex (p=0.003) for total PA, working day activity, post work activity and sleep. Sleep ranged between 2.4-9.6 hours per night. All participants spent more time between 1.5-3 METS outside of work. Significant amounts of exercise where carried out outside of their work day, therefore when injury is reported per 1000 hours dance activity, this extra-curricular activity might need to be included. When looking at potential causes of injury in dance, a global perspective of physical activity is required that includes activity outside of work and sleep patterns, all activities that influence physiological recovery.
    • Weight-management in children living with asthma: a qualitative study of the experiences of paediatric healthcare professionals

      Clarke, R; Heath, G; Pattison, H; Farrow, C; Department of Psychology, Aston University , Birmingham , UK. (Taylor & Francis, 2018-11-16)
      © 2018, © 2018 Taylor & Francis Group, LLC. Objective: Weight loss has been found to improve the symptoms of asthma in children who are overweight. However, many paediatric weight management programmes do not address the challenges associated with living with asthma. The aim of this study was to explore the views and experiences of paediatric healthcare professionals concerning weight management advice and support offered to families of children living with asthma. Methods: In-depth individual interviews with 10 healthcare professionals who work with a paediatric asthma population (n = 4 Respiratory Consultants, 3 Respiratory Nurses, 3 General Paediatricians). Data were analysed using a Framework approach. Results: Healthcare professionals highlighted that families’ perceptions of weight, their approach to physical activity and nutrition, the family’s social context and perceptions of asthma and asthma treatment all influence weight management in children living with asthma. Initiating weight management conversations and referring to weight management support were perceived as challenging. It was thought that tailoring weight management to the needs of children living with asthma and locating support within the community were important to the success of a family-centred intervention. Conclusions: The results highlight the added complexity of responding to excessive weight in a paediatric population with asthma. Training and referral guidance for healthcare professionals may help overcome weight management support challenges. Addressing family beliefs about the factors influencing paediatric asthma and exploring families’ motivations for behaviour change may enhance engagement with weight management.
    • Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings: Protocol for a systematic review of qualitative studies

      Farre, A; Bem, D; Heath, G; Shaw, K; Cummins, C; Institute of Applied Health Research, University of Birmingham, Birmingham, UK Research and Development, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK. (BMJ, 2016-07-08)
      © 2016 Published by the BMJ Publishing Group Limited. For permission to use. Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.
    • How do stakeholders experience the adoption of electronic prescribing systems in hospitals? A systematic review and thematic synthesis of qualitative studies

      Farre, Albert; Heath, Gemma; Shaw, Karen; Bem, Danai; Cummins, Carole; School of Nursing and Health Sciences, University of Dundee, Dundee, UK. (BMJ, 2019-07-29)
      BACKGROUND:Electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of health services, but the translation of this into reduced harm for patients remains unclear. This review aimed to synthesise primary qualitative research relating to how stakeholders experience the adoption of ePrescribing/CPOE systems in hospitals, to help better understand why and how healthcare organisations have not yet realised the full potential of such systems and to inform future implementations and research. METHODS:We systematically searched 10 bibliographic databases and additional sources for citation searching and grey literature, with no restriction on date or publication language. Qualitative studies exploring the perspectives/experiences of stakeholders with the implementation, management, use and/or optimisation of ePrescribing/CPOE systems in hospitals were included. Quality assessment combined criteria from the Critical Appraisal Skills Programme Qualitative Checklist and the Standards for Reporting Qualitative Research guidelines. Data were synthesised thematically. RESULTS:79 articles were included. Stakeholders' perspectives reflected a mixed set of positive and negative implications of engaging in ePrescribing/CPOE as part of their work. These were underpinned by further-reaching change processes. Impacts reported were largely practice related rather than at the organisational level. Factors affecting the implementation process and actions undertaken prior to implementation were perceived as important in understanding ePrescribing/CPOE adoption and impact. CONCLUSIONS:Implementing organisations and teams should consider the breadth and depth of changes that ePrescribing/CPOE adoption can trigger rather than focus on discrete benefits/problems and favour implementation strategies that: consider the preimplementation context, are responsive to (and transparent about) organisational and stakeholder needs and agendas and which can be sustained effectively over time as implementations develop and gradually transition to routine use and system optimisation.
    • Improving reference equations for cardiorespiratory fitness using multiplicative allometric rather than additive linear models: Data from the Fitness Registry and the Importance of Exercise National Database Registry

      Nevill, Alan M; Myers, Jonathan; Kaminsky, Leonard A; Arena, Ross (Elsevier, 2019-11-22)
      New improved reference equations for cardiorespiratory fitness have recently been published, using Data from the Fitness Registry and the Importance of Exercise National Database (FRIEND Registry). The new linear equation for VO2max (ml.kg−1.min−1) was additive, derived using multiple-linear regression. An alternative multiplicative allometric model has also been published recently, thought to improve further the quality of fit. The purpose of the current study was to compare the accuracy and quality/goodness-of-fit of the linear, additive model with the multiplicative allometric model using the FRIEND database. The results identified that the allometric model out performs the linear model based on all model-comparison criteria. The allometric model demonstrates; 1) greater explained variance (R2 = 0.645; R = 0.803) vs. (R2 = 0.62; R = 0.79), 2) residuals that were more normally distributed, 3) residuals that yielded less evidence of curvature, 4) superior goodness-of-fit statistics i.e., greater maximum log-likelihood (MLL) and smaller Akaike Information Criterion (AIC) statistics, 5) less systematic bias together with smaller unexplained standard error of estimates. The Bland and Altman plots also confirmed little or no evidence of curvature with the allometric model, but systematic curvature (lack-of-fit) in the linear model. The multiplicative allometric model to predict VO2max was; VO2max (ml.kg−1.min−1) = M-0.854 · H1.44 · exp. (0.424–0.346 · (sex) -0.011.age), where M = body mass and H = height (R2 = 0.645; R = 0.803) and sex is entered as a [0,1] indicator variable (male = 0 and female = 1). Another new insight obtained from the allometric model (providing construct validity) is that the height-to-body-mass ratio is similar to inverse body mass index or the lean body mass index, both associated with leanness when predicting VO2max. In conclusion adopting allometric models will provide more accurate predictions of VO2max (ml.kg−1.min−1) using more plausible, biologically sound and interpretable models.
    • Postdiagnosis sedentary behavior and health outcomes in cancer survivors: A systematic review and meta‐analysis

      Swain, Christopher TV; Nguyen, Nga H; Eagles, Tobyn; Vallance, Jeff K; Boyle, Terry; Lahart, Ian M; Lynch, Brigid M (Wiley, 2019-11-12)
      Background High levels of sedentary behavior may negatively affect health outcomes in cancer survivors. A systematic review and meta‐analysis was performed to clarify whether postdiagnosis sedentary behavior is related to survival, patient‐reported outcomes, and anthropometric outcomes in cancer survivors. Methods The Ovid MEDLINE, EMBASE, CINAHL (The Cumulative Index to Nursing and Allied Health Literature), and SPORTDiscus databases were searched from study inception to June 2019. Studies of adults who had been diagnosed with cancer that examined the association between sedentary behavior and mortality, patient‐reported outcomes (eg, fatigue, depression), or anthropometric outcomes (eg, body mass index, waist circumference) were eligible for inclusion. Meta‐analyses were performed to estimate hazard ratios for the highest compared with the lowest levels of sedentary behavior for all‐cause and colorectal cancer‐specific mortality outcomes. The ROBINS‐E (Risk of Bias in Nonrandomized Studies‐of Exposures tool) and the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system were used to assess the risk of bias and the strength of evidence, respectively. Results Thirty‐three eligible publications from a total of 3569 identified articles were included in the review. A higher level of postdiagnosis sedentary behavior was associated with an increased risk of all‐cause mortality (hazard ratio, 1.22; 95% CI, 1.06‐1.41; heterogeneity [I2 statistic], 33.8%) as well as colorectal cancer‐specific mortality (hazard ratio, 1.53; 95% CI, 1.14‐2.06; I2, 0%). No clear or consistent associations between sedentary behavior and patient‐reported or anthropometric outcomes were identified. The risk of bias in individual studies ranged from moderate to serious, and the strength of evidence ranged from very low to low. Conclusions Although avoiding high levels of sedentary behavior after a cancer diagnosis may improve survival, further research is required to help clarify whether the association is causal.
    • Development of inclusive education in England: Impact on children with special educational needs and disabilities

      Williams-Brown, Zeta; Hodkinson, Alan (Springer, 2019-07-29)
      This chapter considers a historical account of the development of inclusion in England and the changes made to the education of children with SEND since the 1940s. The chapter details the development of inclusive education, the complexity of defining inclusion, and what inclusion has come to mean in current practice. This historical account is considered alongside the development and dominance of the standards agenda. In considering inclusion in this manner, the original intentions of its agenda are questioned against the practical implementation of inclusive education in current practice. The chapter concludes by proposing that significant progress has not been made with inclusion because it has not been possible to accommodate it within the competing political agendas replete in England’s education system.
    • The technical and vocational provision in England: A comparative study with the Austrian secondary system

      Starr, Sean; Bartram, Brendan (Routledge, 2017-08-07)
      This chapter reviews the reintroduction of apprenticeships in England, with a focus on education into employment. This is achieved by comparing English secondary schools with the Austrian system. The Austrian system was chosen due to its having over 40 years of very diverse educational provision, including a significant vocational and apprenticeship programme. The curriculum offer in England is determined by the national curriculum and supported by governmental accountability measures, which focus on academic subjects. Technical and vocational education and training (TVET) has been neglected in England, regardless of the student's interests, passion or abilities. With the introduction of more specialised TVET provision in England, it may possibly allow for routes to represent 'vocationalised' general education. The Austrian education system is run by the individual federal states and therefore there is no national curriculum standard as such. Intermediate and upper secondary technical and vocational schools/colleges offer pupils the possibility of choosing between different study courses.
    • Challenges to concordance: theories that explain variations in patient responses

      Green, Julie; Jester, Rebecca (Mark Allen Group, 2019-10-23)
      Failing to establish a collaborative relationship between patient and health professional can be a significant obstacle to recovery. Julie Green and Rebecca Jester delve into the psychology behind patient responses and present methods to empower patients.
    • Granulated sugar treatment for leg ulcers: a case report

      Murandu, Moses Donald (RCN Publishing Ltd., 2016-02-02)
      The use of sugar in the treatment of wounds dates back to Ancient Egypt. This article begins with a summary of that history and, in the case study that follows, a patient describes his 13-year experience of living with leg ulcers. The patient explains the challenges these ulcers have brought to his day-to-day life and the particular problems he encountered with pain management. He discusses different approaches by doctors and district nurses to manage the ulcers and how, by chance, a newspaper article led to a meeting with a PhD student researching sugar and wound care – a meeting that was to lead to a new lease of life for the patient.
    • Try before you buy: a small business employer (SME) perspective of international student mobility in England

      Sutherland, Matthew; Thompson, David; Edirisingha, Prabash (Informa UK Limited, 2019-10-25)
      Attracting international students has become a strategic priority for UK immigration policy as well as for British universities. However, research shows that there are emergent intercultural barriers that challenge international students’ carrier aspirations and inhibit their ability to find employment. Also, small business employers (SMEs) are becoming a significant force in the post-Brexit UK economy and integral to creating innovation and employment opportunities. Despite this significance, we do not know what SME owners view the value of international students and how these perceptual discourses shape international student experience and mobility. In response, this research investigates small business employer discourses relating to international student employability. We base our data collection in strategically important North East of England and draw from semi-structured in-depth interviews with small business employers from the region. Our findings discuss their perception of international students as well as universities and discuss how these prevailing discourses influence international students’ employability. We specifically show how socio-cultural dispositions of international students, dominant British employer and market discourses, and universities strategic pursuits interplay and contribute to challenges international students confront within the highly competitive and dynamic higher education environment.
    • Schools, food and social learning

      Lalli, Gurpinder Singh (Routledge, 2019-10-08)
      This book explores the potential of school dining halls as spaces of social learning through interactions between students and teachers. Schools, Food and Social Learning highlights the neglect of school dining halls in sociological research and the fact that so much can be gained from fostering interpersonal relations with other students and the school staff over meals. The book focuses primarily on social and life skills that students develop during lunch-hour meetings, modelling behaviors while eating and conversing in the school space known as the ‘restaurant’. With case studies based in the UK, the book takes a social constructivist approach to dealing with the tensions and challenges between the aims of the school – creating an eating space that promotes social values and encourages the development of social skills, and the activities of teachers and catering assistants of managing and providing food for many students daily. The book carries snippets of interviews with children, dining hall attendants, teachers, parents and the school leadership team, offering a new way of thinking about social learning for both scholars and students of Social Anthropology, Sociology, Social Policy, Food Policy, Education Studies and Childhood Studies.
    • Online risk for people with intellectual disabilities

      Chadwick, Darren (Emerald, 2019-10-05)
      Purpose The purpose of this paper is to summarise the current state of empirical knowledge pertaining to online risk and cybercrime relating to people with intellectual disabilities (ID). Design/methodology/approach This narrative review summarises, synthesises and critically evaluates the current literature and state of knowledge and offers suggestions for extending current knowledge and practice. Findings Evidence regarding risk for people with ID is limited but growing. Existing findings highlight that: risk may increase contingent upon higher levels of sociability, loneliness, anxiety and depression, poorer insight, judgement, discrimination and ability to detect deception online and reduced experience and life opportunities; people without ID perceive high online risk for people with ID, which may lead to gatekeeping restrictions and controlling digital access; restriction may potentially impede online self-determination, participation and development by people with ID; and experience of risk may enhance awareness, independence and resilience in managing future online risk amongst people with ID. Further research work is needed in this area to enhance understanding of risk experience and effective support strategies. Originality/value This review of current knowledge has highlighted the necessity for more research to better understand the propensity for engagement in different risky online behaviours and to better inform support practices to help people with ID to manage risk whilst maintaining digital inclusion.
    • Only connect: indigenous digital learning

      Traxler, John (Scuola IaD, 2019-10-31)
      There is now a unique interdisciplinary opportunity to work across the various digital technology development communities, for example ICT4D and m4d, albeit with their conservative conceptions of learning, and the innovative digital learning communities breaking away from institutional e-learning formats, for example the open learning movement, at a time when many indigenous communities in the global South have considerable experience, access, ownership and familiarity with personal and social digital systems and when the decolonising movement provide the impetus and processes to develop new tools and techniques to work together for an accurate and authentic understanding of learning needs and the methods to address them. This is timely and urgent since digital technologies, produced by Anglophone global corporations and promoting the global knowledge economy, threaten fragile cultures and languages and promote the Fourth Industrial Revolution whilst in fact delivering the next wave of epistemicides. This paper sets out the case for urgent, collective and coherent action.
    • ‘We’re the lassies from Lancashire’: Manchester Corinthians Ladies FC and the use of overseas tours to defy the FA ban on women’s football

      Williams, Jean (Taylor & Francis, 2019-10-15)
      The FA banned women’s football from the grounds of Association-affiliated clubs in 1921, on the grounds that the organisation perceived that football was ‘unsuitable’ for women and too much money raised for charity had been absorbed in player expenses. But women continued to play. This article analyses how Manchester Corinthians Ladies Football Club, which had been formed in 1949, was able to sustain a varied range of overseas tours and domestic matches in spite of the ban. Using a range of methods, including oral history, family history interviews, a reunion of the surviving players and player memorabilia, firstly, the article provides a history of Corinthians and Nomads from 1949 onwards. Secondly, the article uses oral history to reflect what the players felt about playing for the club and particularly its overseas tours, and charity work. Not all of the players are represented due to constraints of space, but this is an introduction to a larger ongoing project to reclaim the teams’ history. Finally, the article argues that it is important to examine the 1950s and 1960s, decades when women’s football was an unregulated activity, in order to understand that which followed once the FA ban was lifted in 1969.
    • The prevention of arboviral diseases using mobile devices: a preliminary study of the attitudes and behaviour change produced by educational interventions

      Traxler, John; Bond, Carol; Matheson, David; Santos, Silvana; Santos-Silva,, Tais; Olinda,, Ricardo; Mangueira,, Francisco; Smania-Marques,, Roberta; Albino, Victor (Wiley, 2019-10-18)
      Objectives In Brazil, the National Policy for Dengue Control seeks to incorporate the lessons of national and international experience in dengue control, emphasizing the need for health education activities. The objective of this study was to evaluate and compare knowledge, attitudes and behaviours related to the prevention of arboviruses before and after a two‐month educational intervention using a learning platform on mobile devices. Methods This quasi‐experimental study corresponds to the first phase of the project "Impact of mobile learning in the prevention and management of complications caused by arboviruses (Zika, Dengue, Chikungunya) – ZIKAMOB”, sponsored as part of the British Council Newton Fund. Results Thirty of the 93 participants were first‐year undergraduate university students (36.7% male) and 63 were police officers (84.1% male). The pattern of attitudes and behaviour was very similar in both groups before the intervention. The students changed their attitudes and behaviour (p=0.032) in relation to their engagements in actions for the prevention of arboviral diseases and several other activities related to house inspections and precautions with water tanks (p<0.01). However, recycling and surveillance activities were not as effective in changing behaviour. Female participants showed more motivation to participate in preventive activities, but living alone and working were barriers to participation. Individuals who already perform selective waste collection and are cultivating gardens demonstrated both a positive attitude and positive behaviour towards actions for the prevention of arboviral diseases. Conclusion Mobile learning and behaviour change theories might be successful as the basis for school‐based and community‐based interventions to avoid arboviruses. These outcomes need to be confirmed in broader future studies.
    • Signage interventions for stair climbing at work: more than 700,000 reasons for caution

      Puig-Ribera, Anna; Señé-Mir, Anna M.; Taylor-Covill, Guy A. H.; De Lara, Núria; Carroll, Douglas; Daley, Amanda; Holder, Roger; Thomas, Erica; Milà, Raimon; Eves, Frank F (MDPI AG, 2019-10-08)
      Increased stair climbing reduces cardiovascular disease risk. While signage interventions for workplace stair climbing offer a low-cost tool to improve population health, inconsistent effects of intervention occur. Pedestrian movement within the built environment has major effects on stair use, independent of any health initiative. This paper used pooled data from UK and Spanish workplaces to test the effects of signage interventions when pedestrian movement was controlled for in analyses. Automated counters measured stair and elevator usage at the ground floor throughout the working day. Signage interventions employed previously successful campaigns. In the UK, minute-by-minute stair/elevator choices measured effects of momentary pedestrian traffic at the choice-point (n = 426,605). In Spain, aggregated pedestrian traffic every 30 min measured effects for ‘busyness’ of the building (n = 293,300). Intervention effects on stair descent (3 of 4 analyses) were more frequent than effects on stair climbing, the behavior with proven health benefits (1 of 4 analyses). Any intervention effects were of small magnitude relative to the influence of pedestrian movement. Failure to control for pedestrian movement compromises any estimate for signage effectiveness. These pooled data provide limited evidence that signage interventions for stair climbing at work will enhance population health.
    • Physiological characteristics of musical theatre performers and the effect on cardiorespiratory demand whilst singing and dancing

      Wyon, Matthew; Stephens, Nicola (Science & Medicine, Inc., 2019-12-31)
      Musical Theatre (MT) combines acting, singing and dancing within a performance. The purpose of the current study was two-fold; firstly, to report on the cardiorespiratory fitness of pre-professional MT dancers and secondly, to examine the cardiorespiratory demand of singing whilst dancing. Twenty-one participants (F=16, M=5; 20 ±1.23 yrs; 169.1 ±9.24cm; 62.7 ±10.56kg) in their final year of pre-professional training volunteered for the study. All participants carried a maximal aerobic capacity test on a treadmill using a portable breath-by-breath gas analyser. Nine participants completed a 4-minute section from Chorus Line twice; singing and dancing, and just dancing, in a randomised order whilst wearing the same portable gas analyser. Blood lactate was measured at the end of each trial. Male participants had significantly greater peak oxygen consumption (M vs. F; 67.6 ±2.30 vs. 55.6 ±4.42 ml.kg-1 .min-1 , p<0.001) and anaerobic threshold (% of peak VO2) (M vs. F; 54.6 ±4.04% vs. 43.1 ±3.68% p<0.001) whilst maximum heart rate and heart rate at anaerobic threshold were similar. The physiological demands of dancing vs. singing+dancing were similar with the exception of the singing+dancing trial having significantly reduced mean breathing frequency and increased lactate (p<0.01). MT dancers’ aerobic capacity is greater than that observed in other theatre-based dance genres. The observed breathing frequency and lactate differences in the Chorus-line trails could be due to singing reducing breathing frequency thereby influencing cardiorespiratory recovery mechanics and subsequently blood lactate levels.
    • 'Caution, this treatment is a placebo. It might work, but it might not': why emerging mechanistic evidence for placebo effects does not legitimise complementary and alternative medicines in sport

      Beedie, C; Whyte, G; Lane, AM; Cohen, E; Raglin, J; Hurst, P; Coleman, D; Foad, A; School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK. (BMJ, 2017-07-19)
      Complementary and alternative medicines (CAM) are treatments for which either evidence is lacking, or for which evidence suggests no effect over a placebo treatment. When a non-evidence-based treatment is used alongside conventional medicine, it is considered ‘complementary’. When a non- evidence-based treatment is used instead of conventional medicine, it is considered ‘alternative’. Many forms of CAM have origins and/or a history of use beyond evidence-based medicine. Further, many CAM treatments are based on principles and/or evidence that are not recognised by the majority of independent scientists. When a person uses CAM and experiences an improvement in symptoms, this may be due to the placebo effect.
    • Effective early learning: a praxeological and participatory approach to evaluating and improving quality in early childhood education

      Pascal, Chris; Bertram, Tony (Revista da FAEEBA, 2018-04-30)
      This paper acknowledges the importance of providing high quality early education to young children if positive long term child outcomes and social mobility for the less advantaged are to be achieved. It offers a strategy to improve pedagogical quality in early childhood settings worldwide where quality remains low for many children and sets out an alternative praxeological model of quality assessment and improvement that is democratic, participatory, inclusive and culturally sensitive rather than universalised and metricised. The Effective Early Learning (EEL) quality evaluation and improvement programme embodies this participatory approach and has been successfully implemented across UK, Portugal and the Netherlands, where evidence has shown its impact in enhancing child wellbeing, child involvement and child dispositions to learn through improving the quality of pedagogical processes and the enabling educative context in which these occur.