Background Physiotherapy is recommended for people with tennis elbow, but whilst a wide array of treatments is available, the optimal approach remains uncertain. We have therefore recently developed an optimised physiotherapy treatment package for tennis elbow based on a synthesis of the evidence, patient input and clinical consensus. It consists of detailed advice and education, a structured progressive exercise programme and provision of a counter-force elbow brace. Here, we report the protocol for our multicentre pilot and feasibility randomised controlled trial (RCT) designed to (a) examine the feasibility of our optimised physiotherapy treatment package and (b) to pilot trial processes for a future fully powered RCT to test clinical and cost-effectiveness compared with usual physiotherapy treatment. Methods A multicentre pilot and feasibility RCT will be conducted across three sites in England, recruiting up to 50 patients (or for a maximum of 12 months). Participants with tennis elbow, identified from physiotherapy clinic waiting lists and general practice surgeries, will be randomly allocated to receive the optimised physiotherapy treatment package or usual physiotherapy care. Analysis will focus on feasibility measures including consent rate, intervention fidelity, follow-up rate and outcome completion rate. A nested qualitative study will explore the acceptability of the study processes and patient and physiotherapist experiences of the new optimised intervention. Discussion This study will determine the feasibility of a new optimised physiotherapy treatment package for people with tennis elbow and pilot the processes for a future fully powered RCT. In the longer term, this treatment package may provide superior clinical outcomes for patients, in terms of pain and quality of life, and be more cost-effective for the health service. Trial registration Registered with the ISRCTN database 19/7/2021, https://www.isrctn.com/ISRCTN64444585

This article discusses the process and results of a junior school initiative from a local authority in the East of England, to ensure that vulnerable pupils in the school experience a successful transition to high school. The resulting project is the consequence of an inter-organisational collaboration between the junior school, a secondary school and the local educational psychology service. The transition intervention, which is the first product of this project, was borne from the ideas of year 7 students with special educational needs, which were analysed and presented visually into a transition booklet, later used in the intervention with year 6 pupils. At the end of the intervention, the year 6 pupils provided feedback, which informed first changes in the intervention. Overall, the intervention was successful and because of the interest drawn, it was decided to extend the initiative to other schools with year 6 pupils.

Using a comparative analysis of two rural school districts with similar demographic profiles in Mississippi, the impact on special education programming of disparate school district wealth was studied. The study revealed that the wealthy school district had far greater local revenues supporting special education that was not offset by either state or federal dollars. This revenue difference was most obvious in differences in the quality of special education personnel, with the wealthier district employing teachers with higher academic degrees and with more teaching experience. Implications for resource equalization are also discussed.