Guidelines for the planning and development of childcare facilities

Local governments across Australia make a vital contribution in strengthening the economy and securing the well-being of children and families. Ensuring existing and future communities have access to adequate child care is an ongoing challenge. To address this challenge, the Commonwealth Department of Education engaged the UTS Centre for Local Government and Australian Centre of Excellence for Local Government to develop national Guidelines for the Planning and Development of Child Care Facilities. These guidelines are now available for local governments, developers and child care providers.  They enable councils to plan better for the future child care needs of their community through their strategic planning, land use planning and development assessment functions.  The guidelines provide evidence-based guidance and easy to use checklists to help local governments build capacity to plan systematically and strategically. Supporting councils to work in partnership with a range of stakeholders to improve the availability of child care is also an important objective of the guidelines. All local governments can shape the availability of child care through strategic planning, land use planning and development assessment processes.  Through these functions, they help decide the priority of child care in their locality, where it is located and the size and the type of child care provided.  Local governments work within a broader context of state and national policy, legislation and regulations which govern the land use planning and service approval processes.  Within this framework, access to child care can be facilitated by local governments planning in collaboration with other government agencies, child care providers and the local community.  The information contained in the Guidelines for the Planning and Development of Child Care Facilities can also inform discussions with state level organisations responsible for the establishment and delivery of child care services.  The ultimate objective is to promote more streamlined mechanisms for development and service approval. • Guidelines for the Planning and Development of Childcare Facilities won a Planning Institute of Australia (NSW) Planning Excellence Award in 2014. This original resource provides up-to-date, inter- jurisdictional planning advice and resources for councils looking to increase the availability of child-care centres within their municipalities.&nbsp

Child-Care-Facilities-Planning-and-Development.pdf

These are the national planning and development guidelines for child care facilities, developed by ACELG with Federal Government Support. They enable councils to plan better for the future child care needs of their community through their strategic planning, land-use planning, and development assessment functions

Amalgamation in action: Participant perspectives on the Armidale regional council merger process

Under its Fit for the Future reform programme, in May 2016 the New South Wales (NSW) government forcibly merged a number of municipalities, including the Armidale Dumaresq Council and the Guyra Shire Council in the New England region of northern NSW. Whilst scholarly attention has focused on the likely impact of municipal mergers on council performance at the system‐wide level (Bell, Dollery & Drew 2016; Economic Papers: A journal of applied economics and policy, 35, 99), much less effort has been devoted to the analysis of the perspectives of council managers and employees involved in forced consolidation. In order to address this gap in the literature, in this paper we present a case study of compulsory council consolidation of the Armidale and Guyra councils based on interviews with senior managers as well as a survey of council workers

Improvement in risk prediction, early detection and prevention of breast cancer in the NHS Breast Screening Programme and family history clinics: a dual cohort study

Background: In the UK, women are invited for 3-yearly mammography screening, through the NHS Breast Screening Programme (NHSBSP), from the ages of 47–50 years to the ages of 69–73 years. Women with family histories of breast cancer can, from the age of 40 years, obtain enhanced surveillance and, in exceptionally high-risk cases, magnetic resonance imaging. However, no NHSBSP risk assessment is undertaken. Risk prediction models are able to categorise women by risk using known risk factors, although accurate individual risk prediction remains elusive. The identification of mammographic breast density (MD) and common genetic risk variants [single nucleotide polymorphisms (SNPs)] has presaged the improved precision of risk models. Objectives: To (1) identify the best performing model to assess breast cancer risk in family history clinic (FHC) and population settings; (2) use information from MD/SNPs to improve risk prediction; (3) assess the acceptability and feasibility of offering risk assessment in the NHSBSP; and (4) identify the incremental costs and benefits of risk stratified screening in a preliminary cost-effectiveness analysis. Design: Two cohort studies assessing breast cancer incidence. Setting: High-risk FHC and the NHSBSP Greater Manchester, UK. Participants: A total of 10,000 women aged 20–79 years [Family History Risk Study (FH-Risk); UK Clinical Research Network identification number (UKCRN-ID) 8611] and 53,000 women from the NHSBSP [aged 46–73 years; Predicting the Risk of Cancer At Screening (PROCAS) study; UKCRN-ID 8080]. Interventions: Questionnaires collected standard risk information, and mammograms were assessed for breast density by a number of techniques. All FH-Risk and 10,000 PROCAS participants participated in deoxyribonucleic acid (DNA) studies. The risk prediction models Manual method, Tyrer–Cuzick (TC), BOADICEA (Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm) and Gail were used to assess risk, with modelling based on MD and SNPs. A preliminary model-based cost-effectiveness analysis of risk stratified screening was conducted. Main outcome measures: Breast cancer incidence. Data sources: The NHSBSP; cancer registration. Results: A total of 446 women developed incident breast cancers in FH-Risk in 97,958 years of follow-up. All risk models accurately stratified women into risk categories. TC had better risk precision than Gail, and BOADICEA accurately predicted risk in the 6268 single probands. The Manual model was also accurate in the whole cohort. In PROCAS, TC had better risk precision than Gail [area under the curve (AUC) 0.58 vs. 0.54], identifying 547 prospective breast cancers. The addition of SNPs in the FH-Risk case–control study improved risk precision but was not useful in BRCA1 (breast cancer 1 gene) families. Risk modelling of SNPs in PROCAS showed an incremental improvement from using SNP18 used in PROCAS to SNP67. MD measured by visual assessment score provided better risk stratification than automatic measures, despite wide intra- and inter-reader variability. Using a MD-adjusted TC model in PROCAS improved risk stratification (AUC = 0.6) and identified significantly higher rates (4.7 per 10,000 vs. 1.3 per 10,000; p < 0.001) of high-stage cancers in women with above-average breast cancer risks. It is not possible to provide estimates of the incremental costs and benefits of risk stratified screening because of lack of data inputs for key parameters in the model-based cost-effectiveness analysis. Conclusions: Risk precision can be improved by using DNA and MD, and can potentially be used to stratify NHSBSP screening. It may also identify those at greater risk of high-stage cancers for enhanced screening. The cost-effectiveness of risk stratified screening is currently associated with extensive uncertainty. Additional research is needed to identify data needed for key inputs into model-based cost-effectiveness analyses to identify the impact on health-care resource use and patient benefits. Future work: A pilot of real-time NHSBSP risk prediction to identify women for chemoprevention and enhanced screening is required. Funding: The National Institute for Health Research Programme Grants for Applied Research programme. The DNA saliva collection for SNP analysis for PROCAS was funded by the Genesis Breast Cancer Prevention Appeal

Thinking disability orientation : practicing affirmation

Introduction: Occupational therapy’s theoretical base is informed by beliefs in empowerment, partnership, choice and hope — all key components in client-centred practice (Sumsion and Law 2006). In order to be client-centred, it is important to appreciate an individual’s perception of their own disability, known as their disability orientation. Disability orientation, as described by Darling and Heckert (2010), includes three aspects: disability identity; adherence to a particular model of disability, and involvement in disability rights activism. Each type of disability orientation will affect the disabled person’s beliefs and feelings about themselves, their impaired bodies and their disabled lives. This, in turn, is likely to influence their expectations of and satisfaction with occupational therapy services. Therefore, occupational therapists aiming to work within a client-centred approach should be cognisant of this concept and consider its possible impact on their therapeutic approach. This seminar will: – Explore the concept of disability orientation and discuss examples of different orientations; – Examine the affirmative disability orientation as it relates to occupational therapy; – Enable participants to analyse and understand their clients’ disability orientation; – Discuss strategies to provide intervention informed by a client’s disability orientation. Case studies will be used to promote discussion and explore practical ways to ascertain an individual’s disability orientation. The affirmative disability orientation will be discussed in particular. Impact on service users: Understanding disability orientation could lead to enhanced client-centred and culturally sensitive practice. Implications for occupational therapy: Contribution to the improvement of practice through the development of culturally sensitive therapeutic strategies