BACKGROUND:Academic pressure could increase the risk of adolescent depression and self-harm. However, there are few longitudinal studies of this association, and those that exist have limitations. We aimed to investigate associations between perceived levels of academic pressure and subsequent depressive symptoms and self-harm from adolescence to early adulthood. Our hypothesis was that higher levels of academic pressure would be associated with higher levels of depressive symptoms and self-harm. METHODS:In this longitudinal study, we used data from the Avon Longitudinal Study of Parents and Children (Avon, UK) that includes adolescents born in 1991-92. Our primary exposure of interest was academic pressure measured at age 15 years, using items from a school experiences questionnaire (total scores 0-9). Outcomes were depressive symptoms assessed with the Short Mood and Feelings Questionnaire at five timepoints between age 16 years and 22 years (total scores 0-26), and a self-harm questionnaire at four timepoints between age 16 years and 24 years. Analyses were linear (depressive symptoms) and logistic (self-harm in the previous year) multilevel models in samples with multiply imputed data, before and after adjustments. FINDINGS:We included 4714 adolescents (2725 [57·8%] female, 1989 [42·2%] male). In fully adjusted models, a 1-point increase in academic pressure at age 15 years was associated with a 0·43 (95% CI 0·36-0·51) point increase in depressive symptoms. This association was largest when depressive symptoms were assessed at age 16 years (0·53, 0·42-0·64), but remained at age 22 years (0·35, 0·23-0·47). For self-harm, in fully adjusted models, each 1-point increase in academic pressure was associated with an 8% higher odds of self-harm (adjusted odds ratio 1·08, 1·01-1·16), with no differences over time. INTERPRETATION:Our findings support the hypothesis that academic pressure is a potential modifiable risk factor for adolescent depressive symptoms, and possibly self-harm. Interventions to reduce academic pressure could be developed and evaluated. FUNDING:Sir Henry Dale Fellowship, Wellcome Trust, and Royal Society.

Purpose There is evidence that academic pressure has been rising among adolescents in the UK. While this may be a modifiable risk factor for mental health problems, there are few validated measures of academic pressure and all have limitations. Methods With secondary-school students, we co-produced a student-reported measure of academic pressure, the 7-item Academic Pressure Questionnaire (APQ). This was included in the baseline survey of students aged 12-13 within the Positive Choices trial, a whole-school intervention to promote sexual health in English secondary schools. We ran factor analyses and assessed internal consistency, associations with sex and depressive symptoms, and variation in academic pressure between schools. Results We extracted one factor (Cronbach's alpha 0.76). Female students had higher APQ scores than males (mean difference = 2.18, 95% CI: 1.88 to 2.49). Higher APQ scores were associated with more depressive symptoms (coefficient = 0.51, 95% CI: 0.48 to 0.55) and associations were larger in female than male students (p value for interaction <0.001). School-level factors explained 2.6% of variation in APQ scores after adjusting for individual-level factors (ICC = 0.026, 95% CI: 0.01 to 0.06). Conclusion The APQ is a valid and reliable tool to investigate academic pressure in secondary-school adolescents.

A hypothesized benefit of social participation is that it encourages people to be more physically active. However, limited evidence exists on the association between social participation over the life-course and physical activity in midlife. We sought to apply a life-course framework to examine the association of social participation and device measured physical activity in midlife in the UK. We used the 1970 British Birth Cohort Study (BCS70), which includes all people born in Britain during a single week in 1970. Social participation was assessed at ages 16, 30, 34 and 42. Physical activity was measured by accelerometery at age 46, as mean daily step count and time spent in moderate to vigorous physical activity (MVPA). The associations of social participation and physical activity were tested using two different life-course models: the sensitive period model and the accumulation model. Individuals with medium and high participation compared to no social participation over their life-course had higher mean daily step count and MVPA in midlife, supporting the accumulation model. In the sensitive period model, only those that actively participated at age 42 had higher mean daily steps and MVPA compared to those who did not participate. Our study provides empirical evidence on the importance of sustaining social participation at all ages over the life-course rather than at a particular timepoint of someone’s life. If our findings reflect causal effects, interventions to promote social participation throughout the life-course could be an avenue to promote physical activity in middle life.

Athena Swan was established in 2005 with the goal of advancing the careers of women in STEMM (Science, Technology, Engineering, Mathematics and Medicine) subjects in higher education. Since then, it has expanded its remit in various ways and has generated some controversy. This paper explains how Athena Swan operates as a policy-scoring scheme, requiring universities to submit plans for policy improvement in order to receive a bronze, silver or gold award. We explain that the implications of rewarding plans for improvement have not been widely understood. We document Athena Swan's changing policies on sex and data collection, which for a period discouraged data collection on sex. We demonstrate the way in which activists were able to capture Athena Swan's policy development process and argue that policy-scoring schemes can lead to groupthink and pose risks to academic freedom. The outsourcing of equalities work to such schemes does not encourage evidence-based prioritisation and discussion of the needs of competing characteristics.

Using data from British cohorts born in 1958 and 1970, we used quantile regression to investigate the impact of 'mild' and 'severe' teenage conduct problems on months spent in paid employment or paid employment, education, and training (EET) between ages 17 and 42. Those with conduct problems spent significantly less time in employment or EET by age 42. The penalty grows in one's 20s and tends to persist thereafter. Among men, the participation gap was greatest among those with 'severe' teenage conduct problems and among those in the lower half of the participation distribution. There was no participation penalty arising from teenage conduct problems among the older generation of men in the top quartile of the participation distribution. Among women, conduct problems were associated with less time in employment and EET across the whole distribution of the participation distribution, and these penalties were greatest for women in the younger 1970 cohort.

This paper investigates the level of LGBT+ representation among staff and students in higher education in England and Wales. We compare data from the 2021 England and Wales Census to Higher Education Statistics Agency (HESA) data. We find that LGBT+ people are more highly represented in higher education among all staff groups and students than in relevant comparator groups according to age and educational level in the general population. LGBT+ representation among students and STEM academics is modestly higher than the general population comparator group, while representation among non-STEM academics is substantially higher than one would expect from the general population comparator group. We found no statistically significant under-representation in any particular higher education institution.

BACKGROUND:Education is thought to benefit health. However, existing studies have predominantly focused on educational attainment-the type of institution attended has been overlooked, despite being an important indicator of education resources, quality, and future socioeconomic outcomes. In this study, we investigated associations between type of high school or university attended and multiple adult health outcomes. METHODS:The 1970 British Cohort Study was used (n=8107). Associations between high school (comprehensive, grammar, private) and university (classified as normal or higher status (Russell Group)) attended with 10 health outcomes that capture cardiometabolic risks, physical capabilities and cognitive function at age 46 years were investigated. Multivariable regression models were used, adjusting for sex and childhood socioeconomic, health and cognitive factors. RESULTS:Both private school and higher-status university attendance were related to favourable health outcomes. After adjusting for potential confounders, associations between private school attendance and cardiometabolic risks remained; associations for higher-status university attendance and cognitive function remained, while associations with other outcomes were largely attenuated. For example, after full adjustment, private school attendance was associated with a 0.14 SD (95% CI: 0.04 to 0.23) lower body mass index and higher-status university attendance with a 0.16 SD (0.07 to 0.26) better memory recall. CONCLUSION:The type of educational institution attended was associated with multiple health outcomes, suggesting it might be a relevant factor to consider in future health inequality research-particularly in contemporary populations which have high overall attainment levels. Further research is warranted to test the causal nature of this relationship and its generalisability to other contexts.

Objectives To test the hypothesis that, controlling for age, natal-sex differences in running performance are lower among non-binary athletes than in the rest of the population. To test the hypothesis that natal-male non-binary athletes outperform natal-female non-binary athletes.Methods A secondary analysis of 166 race times achieved by non-binary athletes within a data set of 85 173 race times derived from races with a non-binary category in the New York Road Runners database. The natal sex of non-binary athletes was modelled probabilistically using US Social Security Administration data when it could not be derived from previous races. Race times were used as the outcome variable in linear models with explanatory variables derived from natal sex, gender identity, age and the event being raced. Statistical significance was estimated using Monte Carlo methods as the model was not Gaussian.Results There was no evidence that controlling for age, natal-sex differences in running performance are lower among non-binary athletes. Natal-male non-binary athletes outperform natal-female non-binary athletes at a confidence level of p=0.1%.Conclusions Both natal sex and gender identity may be useful explanatory variables for the performance of athletes in mass-participation races. It is, therefore, valuable to include both variables in data collection.

Background Education is thought to benefit subsequent health. Existing studies have shown that a higher level of education is favourably associated with a wide range of health outcomes in adulthood. However, existing studies have predominantly focused on educational attainment while the type of educational institution attended (which is related to the quality of education received) has been overlooked. In this study, we investigated associations between type of high school or university attended and multiple subsequent health outcomes in mid-adulthood. Methods Data from the 1970 British Cohort Study were used (N=8107). Type of high school attended (comprehensive; grammar; private) was ascertained at age 16 and type of university (classified as higher (Russell Group) or normal-status) was reported at age 42. We investigated ten health measures that capture cardiometabolic risks, physical capabilities, and cognitive function measured at age 46. Multivariable regression models were used, adjusting for sex and childhood socioeconomic, health and cognitive factors. Outcomes were converted to standard deviation (SD) units to aid comparability. Results In unadjusted models, private school and higher-status university attendance were favourably associated with most health outcomes compared with comprehensive school and normal-status university attendance. After adjusting for potential confounders, associations between private school attendance and cardiometabolic risks and cognitive function remained, with private school attendance associated with lower body mass index (BMI) and blood pressure (BMI: -0.16 SD, 95% confidence interval (CI): -0.06, -0.25; blood pressure: -0.11, -0.02, -0.20) and better performance in all cognitive tasks compared with comprehensive school attendance. No major differences were found between private school and grammar school attendance. At the university level, associations for higher-status university attendance and health outcomes were largely attenuated, except for cognitive function. For example, higher-status university attendance was associated with a 0.17 SD (0.07, 0.27) better performance in memory (word list recall task) compared with normal-status university attendance. Conclusion The type of educational institution attended was associated with multiple health outcomes—it could therefore be an important under-researched component of health inequalities. Further research is warranted to explore heterogeneity in the associations across different health outcomes and to test the causal nature of the relationship.

BACKGROUND:This paper examined whether distinct life-course trajectories of psychological distress from adolescence to midlife were associated with poorer mental health outcomes during the pandemic. METHODS:We present a secondary analysis of two nationally representative British birth cohorts, the 1958 National Child Development Study (NCDS) and 1970 British Cohort Study (BCS70). We used latent variable mixture models to identify pre-pandemic longitudinal trajectories of psychological distress and a modified Poisson model with robust standard errors to estimate associations with psychological distress, life satisfaction and loneliness at different points during the pandemic. RESULTS:Our analysis identified five distinct pre-pandemic trajectories of psychological distress in both cohorts. All trajectories with prior symptoms of psychological distress irrespective of age of onset, severity and chronicity were associated with a greater relative risk of poorer mental health outcomes during the pandemic and the probability of poorer mental health associated with psychological distress trajectories remained fairly constant. The relationship was not fully attenuated when most recent pre-pandemic psychological distress and other midlife factors were controlled for. CONCLUSIONS:Whilst life-course trajectories with any prior symptoms of psychological distress put individuals at greater risk of poor mental health outcomes during the pandemic, those with chronic and more recent occurrences were at highest risk. In addition, prior poor mental health during the adult life-course may mean individuals are less resilient to shocks, such as pandemics. Our findings show the importance of considering heterogeneous mental health trajectories across the life-course in the general population in addition to population average trends.

This article addresses the question of whether attending a private school affects voting behaviour and political attitudes in adulthood in Britain. The analysis is based upon the British Cohort Study, a nationally representative cohort of children born in one week in April 1970. The 'effect' of attending a private school on the tendency to vote Conservative in four consecutive General Elections, and on the expression of conservative attitudes in mid-life is assessed using path analysis. The model includes multiple indicators for a range of antecedents: social origins at birth, cultural and material capital, academic achievements and early social class destination. Once these antecedents are included in the model, for both men and women a direct positive relationship remains between attending private school and voting Conservative and holding right-leaning attitudes. The main significance of these findings follows from the high proportion of private school alumni in influential positions in public life.

Objectives: Athena Swan awards are designed to recognize higher education institutions’ (HEIs’) commitment to advancing ‘gender equality’. A previous study, published in BMJ Open, sought to identify quantitatively whether Athena Swan awards were associated with an increased proportion of women in senior positions over the period 2012-2018. We show that the statistical analysis in that paper was flawed. The current study addresses problems with the previous analysis in order to assess the relationship between Athena Swan awards and changes in women’s representation.Design: Retrospective cohort study based on the UK HEIs.Participants: 166 HEIs who provided staff data to the Higher Education Statistics Agency (HESA) on consecutive years between 2012 and 2019.Outcome Measures: 1) The change in the proportion of women in senior leadership positions or professorial posts over a year.2) Athena Swan award levels of institutions.Results: We did not find any impact of Athena Swan awards on changes in the number of women in senior positions over the time-period studied. This is in contrast to the previous study which claimed “Athena SWAN members showed greater and faster growth in female representations”. Institutions with a low proportion of women in senior positions are more likely to be members of Athena Swan and are more likely to hold an award.Conclusions: Institutions should not participate in the Athena Swan programme purely in the expectation of easily measured short-term improvements in female representation in senior roles.

The 1970 British Cohort Study (BCS70) began in 1970 with data collection on the births and social circumstances of over 17 000 babies born in the UK. Cohort members who were born in Northern Ireland were included in the birth survey but dropped from the study in all subsequent sweeps. At the time of writing, the cohort members are in their early fifties. The initial BCS70 birth study had a particular focus on perinatal mortality. The focus of the study has broadened over time, reflecting the interest of both social science and health disciplines in each life stage, as the cohort has moved through childhood into adolescence, adulthood and mid-life. Sullivan, Brown and Bann describe the history and context of the cohort from birth to mid-life. BCS70 is the third of a series of UK national birth cohorts which began with the 1946 National Survey of Health and Development (NSHD), followed by a second cohort in 1958, the National Child Development Study (NCDS). The Millennium Cohort Study began 30 years after BCS70. The Key Features

Background: Academic pressure is a potential contributor to adolescent mental health problems, but international evidence on this association has never been synthesised.Methods: We conducted the first systematic review of the association between academic pressure and adolescent depression, anxiety, self-harm, suicidality, suicide attempts and suicide. We searched MEDLINE, PsycINFO, ERIC and Web of Science (core collection) up to November 24, 2022, for studies of school-going children or adoles-cents, which measured academic pressure or timing within the school year as the exposure and depression, anxiety, self-harm, or suicidal ideation, attempts or suicide as outcomes. Risk of bias was assessed using the Mixed Methods Appraisal Tool. We used narrative synthesis to summarise the evidence. The review was pro-spectively registered with PROSPERO (CRD42021232702).Results: We included 52 studies. Most studies assessed mixed anxiety and depressive symptoms (n = 20) or depressive symptoms (n = 19). Forty-eight studies found evidence of a positive association between academic pressure or timing within the school year and at least one mental health outcome.Limitations: Most studies were cross-sectional (n = 39), adjusted for a narrow range of confounders or had other limitations which limited the strength of causal inferences.Conclusions: We found evidence that academic pressure is a potential candidate for public health interventions which could prevent adolescent mental health problems. Large population-based cohort studies are needed to investigate whether academic pressure is a causal risk factor that should be targeted in school-and policy-based interventions.Funding: UCL Health of the Public; Wellcome Institutional Strategic Support Fund.

PurposeFinancial adversity in times of economic recession have been shown to have an unequal effect on individuals with prior mental health problems. This study investigated the relationship between mental health groupings across the adult life-course and change in financial situation and employment status during the COVID-19 pandemic, as well as the use of financial measures to mitigate the economic shock.MethodsUsing two nationally representative British birth cohorts, the National Child Development Study (1958) n = 17,415 and 1970 British Cohort Study n = 17,198, we identified 5 different life-course trajectories of psychological distress from adolescence to midlife which were similar but not identical across the two cohorts. We explored their relation to changes in financial and employment circumstances at different stages during the pandemic from May 2020 to March 2021, applying multinomial logistic regression and controlling for numerous early life covariates, including family socio-economic status (SES). In addition, we ran modified Poisson models with robust standard errors to identify whether different mental health trajectories were supported by government and used other methods to mitigate their financial situation.ResultsWe found that the financial circumstances of pre-pandemic trajectories of psychological distress with differential onset, severity, and chronicity across the life-course were exacerbated by the COVID-19 economic shock. The 'stable-high' (persistent severe symptoms) and 'adult-onset' (symptoms developing in 30s, but later decreasing) groups were vulnerable to job loss. Compared to pre-pandemic trajectory groupings with no, minor, or psychological distress symptoms in early adulthood, the 'stable-high', 'midlife-onset' (symptoms developing in midlife), and 'adult-onset' trajectory groups were more likely to seek support from the UK governments economic response package. However, trajectories with pre-pandemic psychological distress were also at greater risk of reducing consumption, dis-saving, relying on increased financial help from family and friends, and also taking payment holidays (agreements with lenders to pause mortgage, credit card or loan payments for a set period) and borrowing.ConclusionThis work highlights different trajectories of pre-pandemic psychological distress, compared to groups with no symptoms were more vulnerable to pandemic-related economic shock and job loss. By adopting unsustainable mitigating measures (borrowing and payment holidays) to support their financial circumstances during COVID-19, these mental health trajectories are at even more risk of lasting adverse impacts and future economic difficulties.

Culture wars are often understood simply as the agenda of conservative forces.Much more frequently, however, they are conflicts with two sides.These two sides have differing compositions, agendas, and goals, and each considers itself to be a long way from the other.But the form of culture wars makes the sides closer than they would like to think.Culture wars have a strange, shadowy existence.To write about them and label this or that conflict a "culture war" means somehow to participate.This is even more the case if one accepts the "sides" of these conflicts and their supposed permanent existence, or if one accepts their labels, the most common being "conservatives" and "liberals."There is a strong degree of fluidity, however: the actors and their self-definition change.From an insider point of view, there are vast differences on both "sides," if we even accept the existence of "sides."From an external point of view, and even more from the point of view of the opposite side, the differences are not very important; the other side is often united in its hostility.In this essay, I will try to characterize the form of culture wars by comparing it with the concept of moral panic.While in the case of moral panic there is a united and powerful society hunting minority "folk devils," in the case of culture wars, society is split into two camps that struggle in more or less symmetrical conflict and to some extent mirror each other.In the next section, I will present three cases of such content mirroring: in images of decline, in revolutionary spirit (denied but present), and in the accentuation of identity shaped by the imaginary of the market.The final section will try to situate contemporary culture wars in space (semi-globalized U.S. metropolitan provincialism) and time (the era of individualism). Symmetrically Produced Moral PanicsFrom the end of the 1960s, moral panic was an important concept of critical social analysis.The image of a population, led by its leaders and by "moral enterpreneurs," attacking an unpopular minority that the population considered to be a threat to basic moral values-and sometimes even to the existence of society-captured the Western imagination.The role of the Nowadays, the term "Culture Wars" is commonplace in titles and headlines.Why is that?I will approach this question through the lens of my own research and by looking at contemporary debates and developments.

What is happening with sex-based data collection? Alice Sullivan addresses contemporary confusions and controversies

The UK Government's Higher Education (Freedom of Speech) Bill is currently progressing through Parliament. The bill is designed to strengthen free speech and academic freedom in higher education, in response to what former Education Secretary Gavin Williamson describes as ‘the rise of intolerance and cancel culture upon our campuses’. But is there really a crisis of academic freedom in British universities? To see that there is, say Judith Suissa and Alice Sullivan, we need only look at the contemporary reality of suppression of debate on sex and gender. The evidence they catalogue of suppression of research, of blacklisting, harassment and smear campaigns, of no-platforming, disinvitations and shutting down of events, is incontrovertible. The recent experience of scholars and students wishing to discuss the material reality and political salience of sex makes complacency about academic freedom a luxury we cannot afford. Suissa and Sullivan set out a powerful argument for the role of academic freedom in pursuing truth within the academy and developing democracy beyond it. They effectively counter attempts to narrow the scope of academic freedom so as to render it compatible with no-platforming. And they lay out a series of practical steps administrators can take to ensure that universities are places where an expansive and pluralistic intellectual climate prevails. This is a timely and compelling intervention in a vexed but urgent public debate. For their clear-sighted diagnosis of where and how academic freedom has been eroded in our universities, and for their judicious account of what must be done to rebuild it, Suissa and Sullivan deserve a wide and attentive hearing.