Assessment for Prehospital and Disaster Medicine by Centennial

Accessibility

Last updated: 9th April 2025

This accessibility statement applies to the www.cambridge.org/core/ website. This website is run by Cambridge University Press & Assessment. 

We want everyone who visits Cambridge Core to feel welcome and find the experience rewarding.  

We are committed to ensuring we do not discriminate against users with disabilities in relation to access to information, in accordance with the Equality Act 2010 (UK), European Accessibility Act (EU) and Section 508 of the Rehabilitation Act (US) amongst others. 

We are continually working to make Cambridge Core platform and content as accessible and usable as possible. To help us make it a positive place for everyone, this website undergoes regular testing against the Web Content Accessibility Guidelines (WCAG) 2.2 AA standard. 

Throughout the design and development workflows we ensure we consider users with accessibility needs. We also routinely audit and make fixes for accessibility issues that we may have missed, using internal and external auditors.

Platform Accessibility

You should be able to:

• Change colours, contrast levels and fonts by adjusting browser settings. Different browsers include these options under different menus – they can usually be found under Tools, Settings, Options, Content or Reading View depending on the browser. There are also browser extensions specifically dedicated to changing colours and contrast options, e.g. Change Colors for Google Chrome and Color Changer for Mozilla Firefox. 
• Zoom in up to 400% without the text spilling off the screen for most of the website. 
• View all content with sufficient colour contrast (the minimum ratio we aim for is 4.5:1)  
• Navigate most of the website using just keyboard. All page elements have a visible focus state indicator. 
• Navigate the page in logical reading order with the ability to skip to headings, regions and hyperlinks. There are also multiple ways to navigate the entire site including navigation menus and crumb trails. 
• Understand the meaning of images and icons described by meaningful alternative text which explains its purpose within the context of the content. Some content may not have text alternatives available for figures and other graphics. If you encounter an image that does not have a text alternative, and you need one, you can request alternative text for specific images by contacting us via the details below. Images that are decorative or incidental are given a ‘null’ alt attribute, so they are properly ignored by screen readers. 
• Understand the function of all form elements. All form fields have descriptive labels which explain their meaning and any that are mandatory to complete the form. In addition, buttons on forms have a descriptive value which explain their function before a form is submitted. 
• Skip directly to main content and other important pages. 
• Explore the content of mathematical formulae using MathML/MathJax (version 2.7.7) format, which is compatible with text-to-speech engines, can be magnified, converted to braille, and pasted into math equation editors and/or Microsoft Office documents. 
• Listen to most of the website using a screen reader (including the most recent versions of JAWS, NVDA and VoiceOver). 
• Use text to speech tools to read out website content in both PDF and HTML format (e.g. ClaroRead for Chrome browser). Text to speech tools are built into some browsers (e.g. Microsoft Edge) and are available as a plug-in for many others. Your phone, tablet or laptop accessibility settings are also likely to provide text to speech functionality. 

AbilityNet has advice on making your device easier to use if you have a disability. 

Content formats accessibility

Since we began publishing in 1534, much of our content is not available in accessible formats by default.  

The vast majority of our articles published since 2016 are available in HTML format, therefore are accessible by default. 

Our books and Elements are available in PDF format. From July 2025, we aim to:  

1. have all new books and Elements published to the site compliant with at least WCAG 2.0 A standard, and
2. include content-level accessibility information so it’s clear which accessibility features are available.

When content is not accessible by default, there’s an option to request alternative formats via our accessible format request form. We aim to respond to any requests within 5-7 working days. 

Known content accessibility gaps across the platform: 

• Some older archive content reproduced from original printed sources is presented in the form of scanned PDFs. 
• The PDF transformation service we currently use does not allow us to offer zooming up to 400% for PDF formatted content. 
• Most tables within HTML format content are generally presented as images. 
• Some content images and videos do not currently offer appropriate alternatives.  
• Third party software is used on the site to enhance the reading experience, for example: Code Ocean widget, HotJar user feedback tool and the Shareaholic social media linking tool. Whilst every effort is made to ensure that any third party we work with provide accessible software, we cannot guarantee full AA compliance.   
• In some areas, the heading structure is not consistent.
• Some textual links are not distinguishable from standard text without relying on colour

For more detailed information please see the Compliance section below. 

Copy and printing

The absence of Digital Rights Management software on our platform means assistive technology users should experience no barriers caused by print or copy restrictions – however normal copyright conditions still apply and can be found in our terms of use.

Reporting accessibility problems with this website

If you have difficulty using Cambridge Core, please get in touch. The best way to reach us is to submit a diagnostics form, which will put you in touch with our technical support team. If you are unable to complete the form or prefer to contact us by phone, please find our technical support phone number and email address on our contact information page.

Technical information about this website’s accessibility

Compliance status

This website is partially compliant with the Web Content Accessibility Guidelines version 2.2 AA standard, due to the non-compliances listed below.

Non-accessible functionality and/or content

1. In some areas, the heading structure is not consistent.  
   This fails WCAG success criterion 1.3.1 Info and Relationships and 2.4.6 Headings and Labels. 
2. Some textual links are not distinguishable from standard text without relying on colour. 
   This fails WCAG success criterion 1.4.1 Use of Color. 
3. In some areas, images of text have been used to display beneficial content, which cannot be modified to the users’ needs. 
   This fails WCAG success criterion 1.4.5 Images of Text (Level AA). 
4. In some areas, html lists are marked up incorrectly. 
   This fails WCAG success criterion 1.3.1 Info and Relationships (Level A) 
5. Some video content does not include all alternative methods of accessibility for users. 
   This fails WCAG success criterion 1.2.1 Audio-only and Video-only (Prerecorded), 1.2.3 Audio Description or Media Alternative and 1.2.5 Audio Description (Prerecorded). 
6. Some linked content images lack descriptive labels. 
   This fails WCAG success criterion 2.4.4 Link Purpose. 
7. Some YouTube and Vimeo player controls are not accessible for screen reader users.  
   This fails WCAG success criterion 4.1.2 Name, Role, Value. 
8. Some X (Twitter) hyperlinks don’t have accessible and descriptive labels, their colour contrast is insufficient, and they lack visible focus indicator.  
   This fails WCAG success criterion 2.4.4 Link Purpose (In Context), 4.1.2 Name, Role, Value, 1.4.11 Non-text Contrast and 2.4.7 Focus Visible. 
9. HotJar user feedback tool includes hyperlinks without descriptive labels. Some of its functionality cannot be activated with keyboard and its content is not available to screen reader users. Additionally, when zoomed in, the Feedback button partially obscures underlying content. 
   This fails WCAG success criterion 1.1.1 Non-text Content, 2.4.4 Link Purpose, 2.1.1 Keyboard and 1.4.4 Resize text. 
10. Shareaholic social media linking tool doesn’t manage focus correctly and some buttons are not correctly marked up. Additionally, some elements colour contrast is insufficient.  
    This fails WCAG success criterion 2.4.3 Focus Order, 4.1.2 Name, Role, Value and 1.4.11 Non-text Contrast. 
11. Code Ocean 3rd party widget is not fully keyboard accessible and reflowable. Additionally, the frame and buttons don’t have accessible names. 
    This fails WCAG success criterion 2.1.1 Keyboard, 1.4.10 Reflow and 4.1.2 Name, Role, Value. 
12. Some of our content which is in PDF format, hasn’t been designed for accessibility – for example, older archive content reproduced from original printed sources is presented in the form of scanned PDFs (where possible we offer an HTML alternative format). 
13. The PDF transformation service we currently use does not allow us to offer zooming up to 400% for PDF formatted content. 
    This fails WCAG success criterion 1.4.10 Reflow. 
14. Most tables within HTML format content are generally presented as images. 
    This fails WCAG success criterion 1.4.5 Images of Text and 1.1.1 Non-text Content. 
15. Some images and videos within book and journals content do not currently have alternative text descriptions. We are working with our authors to provide this information where possible. 
    This fails WCAG success criterion 1.1.1 Non-text Content.         
16. No audio descriptions are currently present for videos, but synchronised captions are present for most videos 
    This fails WCAG success criterion 1.2.5 Audio Description. 

Browser and mobile support

This site is optimised for modern browsers including Microsoft Edge, Mozilla Firefox, Apple Safari, and Google Chrome. You may experience unexpected behaviour in other browsers, although we use fully validated code which should work on any browser. However please note that we no longer support Internet Explorer 11. This site is responsive, it re-organises itself depending on the screen size and orientation of the device being used to view it. We test the experience on various devices including most popular IOS, Android and MS Windows phones and tablets.

Screen reader compatibility

This platform has been optimised for the following screen reader and browser combinations:

Desktop screen readers

• VoiceOver with Safari (macOS)  
• NVDA with Chrome  
• JAWS with Chrome  
• Narrator with Edge 

Mobile screen readers

• VoiceOver with Safari (iOS)  
• TalkBack with Chrome (Android)

Voluntary Product Accessibility Template (VPAT)

The Voluntary Product Accessibility Template (VPAT) is a document which evaluates how accessible a particular product is according to the Section 508 Standards in the US. It is a self-disclosing document produced by the vendor which details each aspect of WCAG 2.2 requirements and how the product supports each criterion. Download VPAT for Cambridge Core (PDF)

How we test this website

This website undergoes regular testing against the Web Content Accessibility Guidelines (WCAG) 2.2 AA standard by development and quality assurance teams. Working with in house accessibility specialists, any actions derived from the testing are taken and prioritised into our future work.  

In addition, we work with the Digital Accessibility Centre (DAC) who completed their latest audit process for the site against the Web Content Accessibility Guidelines (WCAG) 2.1 AA standard in January 2025.  

We also conduct testing with users who have a variety of different types of disability to ensure the website is optimised for use with assistive technologies.

Tools used for accessibility testing

• NVDA screen reader (with Chrome)  
• JAWS screen reader (with Chrome)  
• VoiceOver screen reader (with Safari)  
• Dragon speech recognition   
• Keyboard only journeys  
• High contrast mode (Windows)  
• Magnification  
• Browser testing on Safari, Chrome and Firefox  
• Axe DevTools  
• Accessibility Insights for Web  
• HeadingsMap  
• Text spacing tool  
• Contrast checker  
• Automated s/w (Cypress, Lambdatest)  
• Mobile devices  
• Mobile testing on Android and iPad (including in built screen readers)  
• Accessibility scanner for Android  

Engagement with external accessibility services

Beyond the work we do internally to optimise accessibility, Cambridge University Press have engaged with various accessibility initiatives and audits: 

• RNIB Bookshare collections (formerly Load2Learn) by donating digital files to the collection which ensures that accessible content reaches print disabled learners as fast as possible.
• The ASPIRE project [Opens in a new window]which aims to standardise accessibility statements so that readers know the benefits they can exploit or the barriers they need to work around when accessing texts in digital format. Cambridge Core won a gold ASPIRE badge in January 2020. You can read more about our involvement with ASPIRE here[Opens in a new window.