Now showing items 1-20 of 6100

    • Study protocol for the optimisation, feasibility testing and pilot cluster randomised trial of Positive Choices: a school-based social marketing intervention to promote sexual health, prevent unintended teenage pregnancies and address health inequalities in England

      Ponsford, Ruth; Allen, Elizabeth; Campbell, Rona; Elbourne, Diana; Hadley, Alison; Lohan, Maria; Melendez-Torres, G. J.; Mercer, Catherine H.; Morris, Steve; Young, Honor; et al. (BMC (part of Springer Nature), 2018-05-23)
      Background: Since the introduction of the Teenage Pregnancy Strategy (TPS), England's under-18 conception rate has fallen by 55%, but a continued focus on prevention is needed to maintain and accelerate progress. The teenage birth rate remains higher in the UK than comparable Western European countries. Previous trials indicate that schoolbased social marketing interventions are a promising approach to addressing teenage pregnancy and improving sexual health. Such interventions are yet to be trialled in the UK. This study aims to optimise and establish the feasibility and acceptability of one such intervention: Positive Choices. Methods: Design: Optimisation, feasibility testing and pilot cluster randomised trial. Interventions: The Positive Choices intervention comprises a student needs survey, a student/staff led School Health Promotion Council (SHPC), a classroom curriculum for year nine students covering social and emotional skills and sex education, student-led social marketing activities, parent information and a review of school sexual health services. Systematic optimisation of Positive Choices will be carried out with the National Children's Bureau Sex Education Forum (NCB SEF), one state secondary school in England and other youth and policy stakeholders. Feasibility testing will involve the same state secondary school and will assess progression criteria to advance to the pilot cluster RCT. Pilot cluster RCT with integral process evaluation will involve six different state secondary schools (four interventions and two controls) and will assess the feasibility and utility of progressing to a full effectiveness trial. The following outcome measures will be trialled as part of the pilot: 1. Self-reported pregnancy and unintended pregnancy (initiation of pregnancy for boys) and sexually transmitted infections, 2. Age of sexual debut, number of sexual partners, use of contraception at first and last sex and non-volitional sex 3. Educational attainment The feasibility of linking administrative data on births and termination to self-report survey data to measure our primary outcome (unintended teenage pregnancy) will also be tested. Discussion: This will be the first UK-based pilot trial of a school-wide social marketing intervention to reduce unintended teenage pregnancy and improve sexual health. If this study indicates feasibility and acceptability of the optimised Positive Choices intervention in English secondary schools, plans will be initiated for a phase III trial and economic evaluation of the intervention. Trial registration: ISRCTN registry (ISCTN12524938. Registered 03/07/2017).
    • Repeated test-taking and longitudinal test score analysis: editorial

      Green, Anthony; Van Moere, Alistair; University of Bedfordshire; MetaMetrics Inc. (Sage, 2020-09-27)
    • Increased epigenetic diversity and transient epigenetic memory in response to salinity stress in Thlaspi arvense.

      Geng, Yu-peng; Chang, Na; Zhao, Yuewan; Qin, Xiaoying; Lu, Shugang; Crabbe, M. James C.; Guan, Yabin; Zhang, Ti-Cao (Wiley, 2020-09-20)
      Epigenetic diversity could play an important role in adaptive evolution of organisms, especially for plant species occurring in new and stressful environments. Thlaspi arvense (field pennycress), a valuable oilseed crop, is widespread in temperate regions of the northern hemisphere. In this study, we investigated the effect of salinity stress on the epigenetic variation of DNA methylation and epigenetic stress memory in pennycress using methylation-sensitive amplification polymorphism (MSAP) markers. We examined how the status of DNA methylation changes across individuals in response to salinity stress and whether such an effect of maternal stress could be transferred to offspring for one or two generations in nonstressed environments. Our results based on 306 epiloci indicated no consistent change of DNA methylation status in specific epiloci across individuals within the same conditions. In contrast, we found that the epigenetic diversity at population level increased significantly in response to the stimulation of salinity stress; and this “stimulation effect” could be transferred partially in the form of stress memory to at least two generations of offspring in nonstressed environments. In addition, we observed a parallel change in functionally important traits, that is, phenotypic variation was significantly higher in plants grown under salinity stress compared with those of control groups. Taken together, our results provide novel clues for the increased spontaneous epimutation rate in response to stress in plants, of potential adaptive significance.
    • Demography in public health intelligence

      Gee, Ivan; Regmi, Krishna (Springer International Publishing, 2016-12-31)
      Demography is the scientific study of human population. For the last few decades, demographic models and methods have been frequently used to analyse or measure the births, deaths and migration within human populations. Public health practitioners and public health analysts regularly require information about health demography, which deals with the contents and methods of demography within the context of health and healthcare. In other words, health demography deals with the demographic attributes that may infl uence or concern health status and health behaviour, as well as the health-related phenomena which infl uence the demographic attributes of the population (Pol and Thomas 2013). Following an overview of health demography, this chapter will discuss the nature and extent of public health problems within the context of present and future patterns of demographic change. This chapter will also highlight some applications, concepts and methods related to health. After reading this chapter you should be able to: • Define the concept and meaning of populations • Discuss the nature and extent of public health problems within the context of present and future patterns of demographic change • Examine sources of population data and their strengths and weaknesses.
    • Synthesising public health evidence

      Gee, Ivan; Regmi, Krishna (Springer International Publishing, 2016-12-31)
      Public Health research is multi-disciplinary, complex and tries to understand problems in a 'real-world' context and this can make it hard to apply to practice and services that aim to improve health outcomes. Increasingly it has been realised that the mass of health evidence generated needs to be synthesised effectively. This chapter will explore the growing focus on this issue, the tools developed to synthesis evidence well and examples of evidence synthesis in practice. After reading this chapter you will be able to: • Define the meaning of research and research process • Understand the need for public health evidence synthesis • Describe the tools and techniques used to synthesise evidence effectively Before we can start to synth esise evidence we need to have some understanding of what evidence is and where the new evidence being explored comes from. Fundamentally as Lomas et al. (2005, p. 1) suggest 'evidence concerns facts (actual or asserted) intended for use in support of a conclusion.' Decision makers tend to view evidence colloquially, that is evidence is anything that can give a reason for believing something relevant is considered evidence. Researchers will tend to view evidence scientifically, it must be produced by robust, systematic and replicable methods that are clearly defined. So evidence is something that can be used to support a conclusion, but it is not the same as a conclusion (Lomas et al. 2005). Evidence can, and should, support decision making but the collection of evidence alone is not going to make the decisions. Evidence for Public Health impacts and interventions is generated through the process of research Research is about generating new information, doing some-thing new, collecting information to answer specific research questions and testing ideas or hypotheses. There are several characteristics of good research It should be: • Systematic: there is an agreed system for performing observations and measurement • Rigorous: the agreed system is followed exactly. • Reproducible: all the techniques, apparatus and materials used in making observations and measurements are written down in enough detail to allow other to reproduce the same process. • Repeatable: researchers often repeat their observations and measurements several times in order to increase the reliability of the data. (Bruce et al. 2008).
    • Public health intelligence: an overview

      Regmi, Krishna; Bendel, Neil; Gee, Ivan (Springer International Publishing, 2016-12-31)
      The notion that medical statistics could be used to assess and then identify potential risks or associated factors to be able to prevent avoidable human loss emerged sometime in the early seventeenth century (http://www.hsj.co.uk/ Journals/2/Files/2010/5/24/APHO%20supplement.pdf). John Snow's work in studying the pattern of disease in order to trace the source of a cholera outbreak in London in 1854 established many of the concepts of modern epidemiology and demonstrated the link between data analysis and the necessary action to tackle the underlying causes of disease and ill health. More recently, the emergence of public health intelligence as a specific public health discipline is a response to the increasing recognition of the need to ensure that the development of appropriate strategies and policies to improve the health of the population and reduce health inequalities is underpinned by a rigorous and robust evidence base. The manner in which public health intelligence has emerged as an accepted public health discipline means that it is not easy to identify a precise starting point or arrive at a commonly accepted definition. However, it is increasingly acknowledged that public health intelligence requires the application of a distinctive range and blend of analytic, critical and interpretive skills in order to generate meaningful information for decision-making. Many of the skills and techniques used to generate public health intelligence are shared with other domains of public health, such as epidemiology, and there is already a substantial body of literature and educational resources on these areas of practice. However, there is very little evidence and few resources available in the specific area of public health intelligence. By the end of this chapter, you should be able to: • Understand the concepts of public health and public health intelligence • Explore the nature and roles of public health intelligence in measuring health and health outcomes of a defined population • Examine some opportunities and challenging aspects of public health intelligence.
    • Epidemiology and public health intelligence

      Bray, Isabelle; Regmi, Krishna (Springer International Publishing, 2016-12-31)
      This chapter provides an introduction to epidemiology. It covers the key epidemiological concepts such as bias and confounding, as well as providing an overview of the nature, history and types of epidemiology. The main epidemiological study designs are described, including case series, ecological, cross-sectional, case-control, cohort, randomised controlled trial and systematic review. The advantages and disadvantages of each are summarised, and some of the ethical issues in doing research are considered. The 'hierarchy of evidence' framework is contrasted with an approach which recognises the most appropriate study design to answer different questions about population health. This chapter will examine the role of epidemiology in public health intelligence and develop students' or learners' knowledge and skills to carry out thorough, rigorous and meaningful research and investigation relevant to public health. After reading this chapter you should be able to: • Define epidemiology and differentiate between descriptive epidemiology and analytical epidemiology • Describe the basic study designs, principles and methods used in epidemiology • Explore key issues related to the design and conduct of studies • Recognise the role of epidemiology in public health intelligence.
    • The state of youth justice 2020: an overview of trends and developments

      Bateman, Tim; National Association for Youth Justice (National Association for Youth Justice, 2020-09-23)
      The report provides a comprehensive overview of trends in youth justice policy and developments in policy and provides a detailed analysis of what these mean for the treatment of children in trouble.
    • Australian social work research: an empirical study of engagement and impact

      Tilbury, Clare; Bigby, Christine; Fisher, Mike; Hughes, Mark; Griffith University; La Trobe University; University of Bedfordshire; Southern Cross University (Oxford University Press, 2020-09-23)
      Internationally, non-academic research impact is assessed by governments as part of evaluating the quality of publicly funded research. A case study method was used to investigate the non-academic impact of Australian social work research. Interviews were conducted with 15 leading researchers about outputs (research products, such as publications and reports), engagement (interaction between researchers and end-users outside academia to transfer knowledge, methods, or resources), and impact (social or economic contributions of research). Twelve case studies were prepared using a standardised template. Content analysis highlighted examples of impact, and theoretical and in-vivo coding uncovered processes of engagement and impact. Different types of engagements with research end-users influenced impact in three areas: legislation and policy; practices and service delivery; and quality of life of community members. Engagement and impact were intertwined as research altered policy discourses and illuminated hidden social issues, preparing ground for subsequent, more direct impact. Likewise, academic and non-academic impacts were intertwined as research rigour and academic credibility were perceived to leverage influence. There was no evidence of achieving impact simply through the trickle-down effect of scholarly publication. The findings broaden understandings of how research influences policy and practice and iterative and indirect relationships between engagement and impact.
    • Human resource development, creativity and innovation

      Loewenberger, Pauline Anne (Palgrave Macmillan, 2016-12-31)
      Human resource management (HRM) and development, learning, knowledge management and innovation represent complex and dynamic fields that draw upon multiple disciplines and emphasise the need for multilevel consideration. Such dynamic complexities present opportunities and challenges in an attempt to develop holistic theoretical approaches of how people management implications might contribute to sustainable innovation and performance. The various contributions to this book raise awareness and contribute to a shared understanding of innovation and HRM from multiple perspectives. They highlight the implications for people management through different lenses, including strategic and systems approaches at the level of the organisation, leadership, learning and the contribution of the broader national context to skill development.
    • Patchworks of practice: helping student counsellors develop coherence in personal and theoretical integration

      Meakin, Beverley Joan (University of BedfordshireUniversity of Bedfordshire, 2020-07)
      This thesis explores an area of my teaching practice with students on an integrative counselling course. Students work towards integrating differing counselling approaches with their personal values and beliefs. I devised a reflexive tool I refer to as Patchwork of Practice to facilitate this process. Patchwork aims to aid reflexivity around and within the interface between personal and professional experiences, thoughts and emotions. This raises awareness of values and beliefs and informs a counselling approach that is coherent with their way of being as a person (Anderson, 2001). The metaphor of Patchwork carries an idea of stitching together Patches of learning and experience to create an integrative approach that fits each student. Students create a Patch every few weeks, individually, then share this in small groups where other perspectives co-construct meaning and widen learning. A Patch can be in any media (writing, poetry, drawing, image) and represents an aspect of training or personal experience (past or present). To evaluate Patchwork of Practice, I explored student counsellors’ experience of using it over two years, through individual interviews and group discussions. In addition, interviews with qualified counsellors explored ongoing effects. To create congruence with the idea of stitching Patches together, I brought different research paradigms together in what I refer to as a Patchwork Methodology. Systemic Inquiry brought relational reflexivity, respect and curiosity in exploring participants’ stories, and attention to relational ethics of practitioner research. Themes were analysed using narrative portraiture (Lawrence-Lightfoot and Hoffman Davis, 1997) and informed teaching through ongoing Action Research reflexive cycles. The different stages of Heuristic research (Moustakas, 1990) provided a framework for these research activities. Additionally, Patchwork of Practice was adapted as autoethnography. I explored my integrating process, illustrated with examples of Patches. Here, Patchwork joined with ecology in a landscape metaphor — a rural landscape depicting how I see my life and practice. The structure of this thesis also evolved from the landscape metaphor. I found participants valued the freedom to use any media to create a Patch. This creative process, the Patch itself and sharing in a group, brought extended awareness of the influences that shaped their development as a person and as a counsellor. So, Patchwork of Practice was useful as a tool for reflexivity around personal and professional development. Other findings included benefits for self-care, for the participants as counsellors and for me as researcher. Patchwork of Practice was also used as self-supervision and adapted by participants to use with clients. One conclusion of this inquiry is to note the importance of connecting individual and group reflections focussed around a Patch. This combination opens a learning pathway that integrates individual and relational reflexivity. There is potential to use Patchwork of Practice as a reflexive tool in other professions and learning environments where awareness of personal influences on professional practice is important.
    • The Hockliffe Collection: representations of punishment in nineteenth-century stories for children

      Stenson, Sarah Elizabeth (University of BedfordshireUniversity of Bedfordshire, 2020-07)
      This thesis records the findings of a large-scale enquiry into over four hundred individual stories for children that were published during the nineteenth century and held in the Hockliffe Collection at the University of Bedfordshire. It critically examines how punishments are deployed in early children’s literature, adopting a methodological approach that includes texts as they appear within the archive, regardless of authorship or perceptions of literary merit. Donated by the Hockliffe family, the texts generally complement the tradition that favoured didacticism and moral guidance. The primary corpus is dominated by instructional works from the pre-1850s, an area currently neglected in the existing critical field. The preference for fantasy, more imaginative and canonised works, and those produced in the Golden Age of Children’s literature at the Victorian fin de siècle, has resulted in tales with an explicit pedagogical agenda being side-lined, a shortcoming this thesis addresses. Where there are lessons, there are punishments, and their inclusion emphasises a range of tensions and fears. Interrogating these moments provides a valuable insight into the sort of issues that were prioritised in books for children during this period. The methodology combines close reading and literary analysis with qualitative data gathering, which produces a rich set of findings. The inclusion of a substantial body of texts allows a network of conflicting ideological views to emerge, that are nuanced and complex. The results of the primary stage have been examined within a theoretical framework that comprises intersectional theories of gender and class. Adopting a Foucauldian lens enriches the analysis of punishment and its relation to the distribution of power. The thesis begins with a critical examination of the Hockliffe archive itself and, through extensive research of the British Newspaper Archive, presents the rationale for its editing processes and positions the Collection as a unique resource for scholars. The second chapter explores changing attitudes towards punishment through a comprehensive study of the punishment of giants which transitioned from violent to non-violent across the century. From here, there is a detailed examination of tales that incorporate a critique of mothers who are held accountable for the failure of their sons. There follows a chapter that explores a female-specific punishment by which women and girls are stripped and ejected from the home, and the following chapter builds on the former by looking at the implications of social class on punishments that involve the demotion of middle-class characters. The final chapter explores how children, animals and punishment collide in these stories before ending with the analysis of stories that feature punitive metamorphosis. This thesis critically engages with authors, stories, issues and themes that have received minimal attention to date and enriches our understanding of children’s literature during this period. The punishments are located within their historical context, revealing some of the many ways in which children’s literature addressed socio-political concerns during this period. The literary landscape is a broad expanse and the study of these rare neglected texts fills some of the spaces in between.
    • Collaborative teaching and learning of primary school physical education in England: a critical examination of the role and impact of external providers

      Smith, Max Granville (University of Bedfordshire, 2020-04-16)
      Background: Reporting on the use of the Primary PE and Sport Premium in schools is often limited to ‘official’ reports produced for and by the government. The use of public funds to improve the opportunities for pupils in PE and School Sport is not a new concept, previously receiving funding under ‘PESSCL’ and ‘PESSYP’ two major PESS strategies introduced between 2003-2010. The Primary PE and Sport Premium was introduced into primary schools in 2013 and saw a doubling of this money in 2017 as a beneficiary of the UK Government imposed ‘Sugar Tax’. What is limited in this field however is research on ‘how’ schools use the money and the decision-making process of headteachers and schools when it comes to spending/investing this ring-fenced allocation of funding. Purpose: The aim of this study is to contribute to the knowledge of ‘how’ schools spend, or invest, the funding they receive via the Primary PE and Sport Premium and to what extend they are able to satisfy the conditions of this grant. Research Setting: This study was undertaken across three primary schools in the South of England. Involving school staff that included the headteacher, the lead for PE and any external providers that the school used in the delivery of PESS. Methods: Data was collected through semi-structured interviews supplemented with observations, documentary analysis and field diaries. Data was coded and analysed by Grounded Theory. Findings: Coaches had good skill knowledge but lack critical pedagogical understanding while teachers lack confidence to teach PE. Head teachers should be accountable for PE but did not have the time or knowledge to effectively manage the Primary PE and Sport Premium. There were issues with the use of the funding, and outside of the permitted use as per the Primary PE and Sport Premium Guidelines. Conclusion: Schools were superficially using the funding to increase physical activity as opposed to Physical Education. Schools were spending the money on a service rather than investing their money for the purpose of sustainability.
    • Employee voice in the SME context

      Sameer, Muhammad; Özbilgin, Mustafa F. (Edward Elgar Publishing Ltd., 2014-04-25)
      In this chapter, we show that employee voice in small and medium-sized enterprises (SMEs) is largely absent in academic studies, representing a missing link in the theorization of employee voice. We present a general overview on important contemporary debates in the employee voice literature and locate it in industrial relations and human resource management literatures. Finally, we explore how employee voice in SMEs can be studied. We offer a number of suggestions for the academic and practitioner use of employee voice in the SME sector.
    • On touching and speaking in (post) (de) colonial discourse - from lessing to Marechera and Veit-Wild

      Piotrowska, Agnieszka (Taylor and Francis Inc., 2016-09-19)
      Jean-Luc Nancy in his seminal book on the body and its significance in history of philosophy Corpus makes a point that the body and the discussions about it ought to be open. He says that in reflecting on it he did not want to: produce the effect of a closed or finite thing, because when we talk about the body we talk about something entirely opposed to the closed and the finite. With the body, we speak about something open and infinite, about the opening of closure itself, the infinite of the finite itself. (2008: 122) This particular reflection came upon him whilst walking through the streets of Paris to give a lecture on the body. Suddenly, he heard about the atrocities in Bosnia and felt compelled to abandon his well-prepared talk and instead find an open space to talk about the links between the body, the soul and our place in the world. He says in his book, “Body is certitude shattered and blown to bits” (ibid.: 3), a phrase that in the age of terrorist attacks sounds particularly ominous.
    • Acute effects of a loaded warm-up protocol on change of direction speed in professional badminton players

      Maloney, Sean J.; Turner, Anthony; Miller, Stuart; ; University of Bedfordshire; Middlesex University (Human Kinetics Publishers Inc., 2014-10-31)
      It has previously been shown that a loaded warm-up may improve power performances. We examined the acute effects of loaded dynamic warm-up on change of direction speed (CODS), which had not been previously investigated. Eight elite badminton players participated in three sessions during which they performed vertical countermovement jump and CODS tests before and after undertaking the dynamic warm-up. The three warm-up conditions involved wearing a weighted vest (a) equivalent to 5% body mass, (b) equivalent to 10% body mass, and (c) a control where a weighted vest was not worn. Vertical jump and CODS performances were then tested at 15 seconds and 2, 4, and 6 minutes post warm-up. Vertical jump and CODS significantly improved following all warm-up conditions (P < .05). Post warm-up vertical jump performance was not different between conditions (P = .430). Post warm-up CODS was significantly faster following the 5% (P = .02) and 10% (P < .001) loaded conditions compared with the control condition. In addition, peak CODS test performances, independent of recovery time, were faster than the control condition following the 10% loaded condition (P = .012). In conclusion, the current study demonstrates that a loaded warm-up augmented CODS, but not vertical jump performance, in elite badminton players.
    • The solution structure of the complement deregulator FHR5 reveals a compact dimer and provides new insights into CFHR5 nephropathy

      Kadkhodayi-Kholghi, Nilufar; Gor, Jayesh; McDermott, Lindsay C.; Gale, Daniel P.; Perkins, Stephen J.; Bhatt, Jayesh S. (American Society for Biochemistry and Molecular Biology (United States), 2020-09-14)
      The human complement Factor H-related 5 protein (FHR5) antagonizes the main circulating complement regulator Factor H, resulting in the deregulation of complement activation. FHR5 normally contains nine short complement regulator (SCR) domains, but a FHR5 mutant has been identified with a duplicated N-terminal SCR-1/2 domain pair that causes CFHR5 nephropathy. To understand how this duplication causes disease, we characterized the solution structure of native FHR5 by analytical ultracentrifugation and small-angle X-ray scattering. Sedimentation velocity and Xray scattering indicated that FHR5 was dimeric, with a radius of gyration RG of 5.5 ± 0.2 nm and a maximum protein length of 20 nm for its 18 domains. This result indicated that FHR5 was even more compact than the main regulator Factor H which showed an overall length of 26-29 nm for its 20 SCR domains. Atomistic modelling for FHR5 generated a library of 250,000 physically-realistic trial arrangements of SCR domains for scattering curve fits. Only compact domain structures in this library fit well to the scattering data, and these structures readily accommodated the extra SCR-1/2 domain pair present in CFHR5 nephropathy. This model indicated that mutant FHR5 can form oligomers that possess additional binding sites for C3b in FHR5. We conclude that the deregulation of complement regulation by the FHR5 mutant can be rationalized by the enhanced binding of FHR5 oligomers to C3b deposited on host cell surfaces. Our FHR5 structures thus explained key features of the mechanism and pathology of CFHR5 nephropathy.
    • Veils and sensors: an artistic intervention with archival moving image material

      Egbe, Amanda (2020-09-15)
      This demonstration showcases experiments, and interventions with moving image archival materials by the author. The outcomes reflect a wider research into duplication practices in digital moving image archival practices. Artistic interventions are utilised to explore the technological and cultural gestures of these practices. The demonstrations are in the form of moving images artworks employing standard projection and mixed reality.
    • Applying the socio-cognitive framework: gathering validity evidence during the development of a speaking test

      Nakatsuhara, Fumiyo; Dunlea, Jamie; University of Bedfordshire; British Council (UCLES/Cambridge University Press, 2020-06-18)
      This chapter describes how Weir’s (2005; further elaborated in Taylor (Ed) 2011) socio-cognitive framework for validating speaking tests guided two a priori validation studies of the speaking component of the Test of English for Academic Purposes (TEAP) in Japan. In this chapter, we particularly reflect upon the academic achievements of Professor Cyril J Weir, in terms of: • the effectiveness and value of the socio-cognitive framework underpinning the development of the TEAP Speaking Test while gathering empirical evidence of the construct underlying a speaking test for the target context • his contribution to developing early career researchers and extending language testing expertise in the TEAP development team.
    • The Sign 4 Little Talkers intervention to improve listening, understanding, speaking, and behavior in hearing preschool children: outcome evaluation

      Davidson, Rosemary; Randhawa, Gurch; University of Bedfordshire (JMIR Publications, 2020-06-30)
      Gaining age-appropriate proficiency in speech and language in the early years is crucial to later life chances; however, a significant proportion of children fail to meet the expected standards in these early years outcomes when they start school. Factors influencing the development of language and communication include low income, gender, and having English as an additional language (EAL). This study aimed to determine whether the Sign 4 Little Talkers (S4LT) program improves key developmental outcomes in hearing preschool children. S4LT was developed to address gaps in the attainment of vocabulary and communication skills in preschool children, identified through routine monitoring of outcomes in early years. Signs were adapted and incorporated into storybooks to improve vocabulary, communication, and behavior in hearing children. An evaluation of S4LT was conducted to measure key outcomes pre- and postintervention in 8 early years settings in Luton, United Kingdom. A total of 118 preschool children were tested in 4 early years outcomes domains-listening, speaking, understanding, and managing feelings and behavior-as well as Leuven well-being scales and the number of key words understood and spoken. Statistically significant results were found for all measures tested: words spoken (P<.001) and understood (P<.001), speaking (P<.001), managing feelings and behavior (P<.001), understanding (P<.001), listening and attention (P<.001), and well-being (P<.001). Approximately two-thirds of the children made expected or good progress, often progressing multiple steps in educational attainment after being assessed as developmentally behind at baseline. The findings reported here suggest that S4LT may help children to catch up with their peers at a crucial stage in development and become school ready by improving their command of language and communication as well as learning social skills. Our analysis also highlights specific groups of children who are not responding as well as expected, namely boys with EAL, and who require additional, tailored support.