Inclusive early childhood education : an analysis of 32 European examples

This report is part of the three-year Inclusive Early Childhood Education (IECE) project run by the European Agency for Special Needs and Inclusive Education (the Agency) from 2015 to 2017. The project aims to identify, analyse and subsequently promote the main characteristics of quality inclusive pre-primary education for all children from three years of age to the start of primary education. This report presents the results of a qualitative analysis of 32 descriptions of examples of IECE provisions across Europe. The descriptions were submitted to the project in August 2015. The findings represent European practitioners’ perceptions of and practices for IECE. An inductive thematic data analysis method was used, in that themes or issues were initially derived from reading the descriptions. This inductive process was, however, also intertwined with relevant theory, particularly the Agency’s ‘ultimate vision for inclusive education systems’ that: ... ensure that all learners of any age are provided with meaningful, high‐quality educational opportunities in their local community, alongside their friends and peers(European Agency, 2015, p. 1). In total, 25 subthemes were identified. These were organised into a new Ecosystem Model of Inclusive Early Childhood Education, which is also presented in a comprehensive diagram (Figure 1). Two major perspectives previously used in describing the quality of ECE settings inspired this new model. These are the Outcome-Process-Structure model and the Ecological Systems model. The subthemes were subsequently grouped into five main themes: • Theme 1: The first main and central theme is ‘Child belongingness, engagement and learning’, often generally understood as active participation. This participation is regarded as both the main outcome and process of IECE. • Theme 2: Five major processesinvolving the child’s direct experience in the IECE setting enable this central outcome and process. These processes are: − Positive interaction with adults and peers − Involvement in play and other daily activities − A child-centred approach − Personalised assessment for learning − Accommodations, adaptations and support. • Theme 3: These processes are in turn supported by structural factors, consisting of the physical, social, cultural and educational environment. These factors may operate at different ecological levels. Some operate within the ECE setting and include: − A warm welcome for every child and family − Family involvement within the ECE setting. − A holistic curriculum designed for all children’s needs − An environment designed for all children − Staff who are appropriately qualified for IECE − A culturally-responsive social and physical environment − Inclusive leadership committed to respect and engagement for all individuals − Collaboration and shared responsibility among all stakeholders. • Theme 4: Inclusive processes experienced by the child are also influenced by more distant structural factors in the community surrounding the ECE setting. These include: − Collaboration between the ECE setting and the children’s families − Relevant in-service training for ECE staff − Wider community commitment and support for serving all children − Inter-disciplinary and inter-agency co-operation of services from outside the ECE setting that serve the children in the pre-school − Organising smooth transitions between home and the ECE setting. • Theme 5: Finally, the analysis found a number of structural factors operating at the macro-system level. These factors were not in direct contact with the ECE setting. However, they still influenced inclusive processes in the setting. They are: − A rights-based approach to ECE − Provision of mainstream ECE access for all − Setting up regional/national standards for a holistic IECE curriculum − Availability of initial education for teachers and other staff for IECE − Good governance and funding systems for IECE − Procedures for regular monitoring and evaluation. This overview of the ecosystem of outcomes, processes and structures for IECE is presented in the Results chapter. Five evidence-based chapters, dedicated to each of the five main themes, follow this. Each chapter presents a brief description of each of the outcome, process or structural factors within each main theme. These are accompanied by one to five quotations from each of the 32 example descriptions. The quotations illustrate and provide concrete evidence of what constitutes quality outcomes, processes and structures that are prevalent across Europe. The quotations were chosen both to reflect the different types of IECE concepts and practices, and to reflect the variety of countries and cultures where they occur. They are intended to stimulate inclusive developments in research, policy and practice in Europe and internationally. Finally, the Conclusion highlights the added value that this analysis contributes to IECE research, policy and practice. Four new insights are addressed: 1. The development of the new Ecosystem Model of IECE, inspired by two previous major models, should clarify the understanding of the issues related to quality ECE. 2. The analysis shows how, within an inclusive perspective, IECE’s primary goal is best conceived as that of ensuring quality outcomes for all children in terms of participation. This is described here as belongingness, engagement and learning. 3. The analysis shines a new light on the major processes in which children are directly involved and which mostinfluence each child’s participation and learning. These need to be a major focus of any intervention to improve ECE quality. 4. The analysis clarifies the structural factors needed to support the development of more inclusive ECE settings. It also shows how these factors are related to local and national policies and practices. Situating the structures at the ECE setting, community and regional/national levels isimportant in levering them to bring about the changes needed to enable each child to participate and learn.peer-reviewe

A Bias-Aware EnKF Estimator for Aerodynamic Flows

Ensemble methods can integrate measurement data and CFD-based models to estimate the state of fluid systems in a robust and cost-efficient way. However, discretization errors can render numerical solutions a biased representation of reality. Left unaccounted for, biased forecast and observation models can lead to poor estimator performance. In this work, we propose a low-rank representation for the bias whose dynamics is represented by a colorednoise process. System state and bias parameters are simultaneously corrected on-line with the Ensemble Kalman Filter (EnKF) algorithm. The proposed methodology is demonstrated to achieve a 70% error reduction for the problem of estimating the state of the two-dimensional low-Re flow past a flat plate at high angle of attack using an ensemble of coarse-mesh simulations and pressure measurements at the surface of the body, compared to a bias-blind estimator. Strategies to determine the bias statistics and to deal with nonlinear observation functions in the context of ensemble methods are discussed

Inclusive early childhood education new insights and tools – contributions from a European study

Quality in early childhood education is a prominent concern for policy-makers, and has recently become a priority concern for many international and European organisations. These include the OECD, UNESCO, UNICEF, the European Commission, Eurydice and the European Agency for Special Needs and Inclusive Education, among others. Over the past three years (2015–2017), the European Agency for Special Needs and Inclusive Education (the Agency) has examined the latest policy documents and relevant research in this field. This has been a springboard for exploring the main characteristics of quality inclusive early childhood education (IECE) for all children from three years of age to the start of primary education. The project data from across Europe has provided an opportunity to closely examine how, within the inclusion perspective, early childhood education provisions are addressing the quality principles set out by the European Commission and the OECD. Sixty-four inclusive early childhood education experts from across Europe contributed to the project. They participated in data collection and analysis through descriptions of example provisions, as well as observations and discussions during field work and case study visits. This report first sets out the main policy and practice developments towards inclusive early childhood education, with particular reference to European policy issues (Chapters 2–3). It then presents the project’s three new contributions towards improving quality inclusive early childhood education (Chapters 4–6). These are: 1. A clear rationale for and an analysis of the implications of adopting an inclusive vision and goals as the main standards of inclusive early childhood policy and provision. The project found that high-quality services that benefited all children were guided by an inclusive vision and worked towards inclusive goals. As their primary outcome, they sought to ensure each child’s belongingness, engagement and learning. This reflects the changes in early childhood intervention in recent decades. The focus has shifted from ‘working with the child’ towards a holistic approach that creates an inclusive environment for all children’s engagement and learning. The report thus refers to quality early childhood education (ECE) as ‘inclusive early childhood education’ (IECE). It only uses the terms ‘early childhood education’ (ECE) or ‘early childhood education and care’ (ECEC) when referring to the literature. 2. A new Self-Reflection Tool for improving inclusive early childhood education settings. This enables practitioners to review their service’s quality in terms of the inclusiveness of the physical, social and other learning environments it offers to children and families. The tool has been validated by project experts and additional ecological studies. It is ready for use by practitioners in inclusive early childhood education settings in different education systems and countries across Europe and beyond. 3. A new Ecosystem Model of Inclusive Early Childhood Education for policy-makers and other stakeholders wishing to collaborate towards effective action in this field. This model can support policy-makers and practitioners to collaborate in planning, reviewing and improving quality IECE services. The model is founded on the project data. It is inspired by three major frameworks for quality IECE, namely: (1) The structure-process-outcome framework used by European and international policy-makers (European Commission, 2014; OECD, 2015; European Agency, 2009) (2) The ecological systems framework (Bronfenbrenner and Morris, 2006) (3) The inclusive education perspective (European Agency, 2015). It incorporates all the principles of the EU and OECD frameworks for quality early childhood education. However, it enhances their applicability by locating them at different ecological levels (inclusive early childhood education setting, home/community and regional/national levels). Finally, the report gives an account of the lessons learned during the three-year project and the resulting recommendations (Chapter 7). These are presented within the framework of the new Ecosystem Model of IECE. They are mainly directed at policy- makers, but they also point to the implications for practitioners. Indeed, they are formulated in terms of how policy-makers can support practitioners to ensure quality provisions.peer-reviewe

Inclusive early childhood education environment self-reflection tool

This Self-Reflection Tool was developed as part of the Inclusive Early Childhood Education (IECE) project, conducted by the European Agency for Special Needs and Inclusive Education from 2015 to 2017 (www.european-agency.org/agency-projects/inclusive-early- childhood-education). The project’s overall goal was to identify, analyse and subsequently promote the main characteristics of quality IECE for all children. To that end, a need was detected for a tool that all professionals and staff could use to reflect on their setting’s inclusiveness, focusing on the social, learning and physical environment. This tool is intended to help improve settings’ inclusiveness.peer-reviewe

Population assessment of future trajectories in coronary heart disease mortality.

Background: Coronary heart disease (CHD) mortality rates have been decreasing in Iceland since the 1980s, largely reflecting improvements in cardiovascular risk factors. The purpose of this study was to predict future CHD mortality in Iceland based on potential risk factor trends. Methods and findings: The previously validated IMPACT model was used to predict changes in CHD mortality between 2010 and 2040 among the projected population of Iceland aged 25–74. Calculations were based on combining: i) data on population numbers and projections (Statistics Iceland), ii) population risk factor levels and projections (Refine Reykjavik study), and iii) effectiveness of specific risk factor reductions (published meta-analyses). Projections for three contrasting scenarios were compared: 1) If the historical risk factor trends of past 30 years were to continue, the declining death rates of past decades would level off, reflecting population ageing. 2) If recent trends in risk factors (past 5 years) continue, this would result in a death rate increasing from 49 to 70 per 100,000. This would reflect a recent plateau in previously falling cholesterol levels and recent rapid increases in obesity and diabetes prevalence. 3) Assuming that in 2040 the entire population enjoys optimal risk factor levels observed in low risk cohorts, this would prevent almost all premature CHD deaths before 2040. Conclusions: The potential increase in CHD deaths with recent trends in risk factor levels is alarming both for Iceland and probably for comparable Western populations. However, our results show considerable room for reducing CHD mortality. Achieving the best case scenario could eradicate premature CHD deaths by 2040. Public health policy interventions based on these predictions may provide a cost effective means of reducing CHD mortality in the future

Editor's Choice - Assessment of International Outcomes of Intact Abdominal Aortic Aneurysm Repair over 9 Years

Background: Case mix and outcomes of complex surgical procedures vary over time and between regions. This study analyses peri-operative mortality after intact abdominal aortic aneurysm (AAA) repair in 11 countries over 9 years. Methods: Data on primary AAA repair from vascular surgery registries in 11 countries for the years 2005-2009 and 2010-2013 were analysed. Multivariate adjusted logistic regression analyses were carried out to adjust for variations in case mix. Results: A total of 83,253 patients were included. Over the two periods, the proportion of patients >= 80 years old increased (18.5% vs. 23.1%; p <.0001) as did the proportion of endovascular repair (EVAR) (44.3% vs. 60.6; p <.0001). In the latter period, 25.8% of AAAs were less than 5.5 cm. The mean annual volume of open repairs per centre decreased from 12.9 to 10.6 between the two periods (p <.0001), and it increased for EVAR from 10.0 to 17.1 (p <.0001). Overall, peri-operative mortality fell from 3.0% to 2.4% (p <.0001). Mortality for EVAR decreased from 1.5% to 1.1% (p <.0001), but the outcome worsened for open repair from 3.9% to 4.4% (p = .008). The peri-operative risk was greater for octogenarians (overall, 3.6% vs. 2.1%, p <.0001; open, 9.5% vs. 3.6%, p <.0001; EVAR, 1.8% vs. 0.7%, p <.0001), and women (overall, 3.8% vs. 2.2%, p <.0001; open, 6.0% vs. 4.0%, p <.0001; EVAR, 1.9% vs. 0.9%, p <.0001). Peri-operative mortality after repair of AAAs Conclusions: In this large international cohort, total peri-operative mortality continues to fall for the treatment of intact AAAs. The number of EVAR procedures now exceeds open procedures. Mortality after EVAR has decreased, but mortality for open operations has increased. The peri-operative mortality for small AM treatment, particularly open surgical repair, is still considerable and should be weighed against the risk of rupture. (C) 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Amended Classification of the Open Abdomen

Background: In 2009, a classification system for the open abdomen was introduced. The aim of such a classification is to aid the (1) description of the patient's clinical course; (2) standardization of clinical guidelines for guiding open abdomen management; and (3) facilitation of comparisons between studies and heterogeneous patient populations, thus serving as an aid in clinical research. Methods: As part of the revision of the definitions and clinical guidelines performed by the World Society of the Abdominal Compartment Syndrome, this 2009 classification system was amended following a review of experiences in teaching and research and published as part of updated consensus statements and clinical practice guidelines in 2013. Among 29 articles citing the 2009 classification system, nine were cohort studies. They were reviewed as part of the classification revision process. A total of 542 patients (mean: 60, range: 9-160) had been classified. Two problems with the previous classification system were identified: the definition of enteroatmospheric fistulae, and that an enteroatmospheric fistula was graded less severe than a frozen abdomen. Results: The following amended classification was proposed: Grade 1, without adherence between bowel and abdominal wall or fixity of the abdominal wall (lateralization), subdivided as follows: 1A, clean; 1B, contaminated; and 1C, with enteric leak. An enteric leak controlled by closure, exteriorization into a stoma, or a permanent enterocutaneous fistula is considered clean. Grade 2, developing fixation, subdivided as follows: 2A, clean; 2B, contaminated; and 2C, with enteric leak. Grade 3, frozen abdomen, subdivided as follows: 3A clean and 3B contaminated. Grade 4, an established enteroatmospheric fistula, is defined as a permanent enteric leak into the open abdomen, associated with granulation tissue. Conclusions: The authors believe that, with these changes, the requirements on a functional and dynamic classification system, useful in both research and training, will be fulfilled. We encourage future investigators to apply the system and report on its merits and constraints.Peer reviewe

Editor's Choice - Carotid Stenosis Treatment : Variation in International Practice Patterns

Objectives: The aim was to determine current practice for the treatment of carotid stenosis among 12 countries participating in the International Consortium of Vascular Registries (ICVR). Methods: Data from the United States Vascular Quality Initiative (VQI) and the Vascunet registry collaboration (including 10 registries in Europe and Australasia) were used. Variation in treatment modality of asymptomatic versus symptomatic patients was analysed between countries and among centres within each country. Results: Among 58,607 procedures, octogenarians represented 18% of all patients, ranging from 8% (Hungary) to 22% (New Zealand and Australia). Women represented 36%, ranging from 29% (Switzerland) to 40% (USA). The proportion of carotid artery stenting (CAS) among asymptomatic patients ranged from 0% (Finland) to 26% (Sweden) and among symptomatic patients from 0% (Denmark) to 19% (USA). Variation among centres within countries for CAS was highest in the United States and Australia (from 0% to 80%). The overall proportion of asymptomatic patients was 48%, but varied from 0% (Denmark) to 73% (Italy). There was also substantial centre level variation within each country in the proportion of asymptomatic patients, most pronounced in Australia (0-72%), Hungary (5-55%), and the United States (0-100%). Countries with fee for service reimbursement had higher rates of treatment in asymptomatic patients than countries with population based reimbursement (OR 5.8, 95% CI 4.4-7.7). Conclusions: Despite evidence about treatment options for carotid artery disease, the proportion of asymptomatic patients, treatment modality, and the proportion of women and octogenarians vary considerably among and within countries. There was a significant association of treating more asymptomatic patients in countries with fee for service reimbursement. The findings reflect the inconsistency of the existing guidelines and a need for cooperation among guideline committees all over the world. (C) 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Realisation of magnetically and atomically abrupt half-metal/semiconductor interface: Co2FeSi0.5Al0.5/Ge(111)

Halfmetal-semiconductor interfaces are crucial for hybrid spintronic devices. Atomically sharp interfaces with high spin polarisation are required for efficient spin injection. In this work we show that thin film of half-metallic full Heusler alloy Co2FeSi0.5Al0.5 with uniform thickness and B2 ordering can form structurally abrupt interface with Ge(111). Atomic resolution energy dispersive X-ray spectroscopy reveals that there is a small outdiffusion of Ge into specific atomic planes of the Co2FeSi0.5Al0.5 film, limited to a very narrow 1 nm interface region. First-principles calculations show that this selective outdiffusion along the Fe-Si/Al atomic planes does not change the magnetic moment of the film up to the very interface. Polarized neutron reflectivity, x-ray reflectivity and aberration-corrected electron microscopy confirm that this interface is both magnetically and structurally abrupt. Finally, using first-principles calculations we show that this experimentally realised interface structure, terminated by Co-Ge bonds, preserves the high spin polarization at the Co2FeSi0.5Al0.5/Ge interface, hence can be used as a model to study spin injection from half-metals into semiconductors