The ‘four resources model' in South Africa: An analysis of an in-service teacher training intervention for literacy at foundation phase level and its uptake by teachers at a Cape Flats school

Despite a wide range of teacher training literacy interventions in South Africa at foundation phase level, literacy results have declined according to local and international tests. This research outlines the basis of these interventions and then compares them with a new teacher training intervention based on what has been called “the four resources model” (Luke and Freebody, 1990). This intervention, designed by a specialised teacher trainer and offered by a Western Cape based NGO, is currently taking place in some schools that have achieved poor literacy results at foundation phase and is sponsored by the Western Cape Education Department. The research outlines what an intervention based on the four resources model involves, where the approach is compatible with the CAPS specifications for literacy teaching and where it diverges from the CAPS, and explores how foundation phase teachers at one school respond to the intervention in their teaching. This programme has not yet been researched and is the only teacher intervention programme in South Africa that is based on the four resources model. It differs from other interventions because it emphasises the importance of meaning making and of writing (particularly shared writing) in literacy development, as well as the role of higher order thinking, as opposed to decoding and comprehension which are emphasised in the literacy curriculum and pedagogy and in other teacher intervention programmes. Data was collected through observations of teacher workshops and classroom visits of the teacher trainer, teacher trainer interviews, classroom observations and teacher interviews. Refracted through the reflections of the teacher trainer on her decades of experience in literacy training and on the current programme design, the analysis probes the value of experimenting with an enlarged understanding of literacy as outlined in the four resources model. It charts the ways in which teachers' understanding of literacy pedagogies slowly changes and adapts, revealing how teachers start to see the possibilities of creative engagement with text types, critical thinking, engagement with children's prior knowledge and linguistic resources. While the hope is that the intervention will improve tests scores, the research was not able to verify this since the timing of the intervention does not correlate with the systemic testing schedule and release of results, nor the next international benchmark tests. The research reveals that the four resources model intervention does emphasise higher order thinking skills, in contrast to other interventions, and that this could have a positive effect on the PIRLS tests results, in the schools where it is offered. It also shows that there are limitations to the four resources model, in that it does not address the inclusion of multimodal pedagogies nor does it consider the realities of multilingual classes in South Africa

Framing the detection of elder financial abuse as bystander intervention: Decision cues, pathways to detection and barriers to action

This article is (c) Emerald Group Publishing and permission has been granted for this version to appear here (http://bura.brunel.ac.uk/handle/2438/8569). Emerald does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Emerald Group Publishing Limited.This article has been made available through the Brunel Open Access Publishing Fund.Purpose – The purpose of this paper is to explore the detection and prevention of elder financial abuse through the lens of a “professional bystander intervention model”. The authors were interested in the decision cues that raise suspicions of financial abuse, how such abuse comes to the attention of professionals who do not have a statutory responsibility for safeguarding older adults, and the barriers to intervention. Design/methodology/approach – In-depth interviews were conducted using the critical incident technique. Thematic analysis was carried out on transcribed interviews. In total, 20 banking and 20 health professionals were recruited. Participants were asked to discuss real cases which they had dealt with personally. Findings – The cases described indicated that a variety of cues were used in coming to a decision that financial abuse was very likely taking place. Common to these cases was a discrepancy between what is normal and expected and what is abnormal or unexpected. There was a marked difference in the type of abuse noticed by banking and health professionals, drawing attention to the ways in which context influences the likelihood that financial abuse will be detected. The study revealed that even if professionals suspect abuse, there are barriers which prevent them acting. Originality/value – The originality of this study lies in its use of the bystander intervention model to study the decision-making processes of professionals who are not explicitly charged with adult safeguarding. The study was also unique because real cases were under consideration. Hence, what the professionals actually do, rather than what they might do, was under investigation.Economic and Social Research Counci

Management of atraumatic shoulder instability in physiotherapy (MASIP): a survey of physiotherapy practice

© The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License.Background: The impact of atraumatic shoulder instability (ASI) on patients can be extensive, its management complex, with a biopsychosocial approach recommended. Currently how physiotherapists manage ASI is unknown or the extent to which current clinical practice aligns with existing evidence. At the time of this study no national guidelines or consensus to direct practice existed.  Methods: A cross-sectional electronic survey was distributed between July-September 2018, targeting UK-based physiotherapists managing shoulder pathology. Respondents were invited to describe their management of ASI, and rate their awareness and utilisation of various treatment techniques on a Likert-scale; median and interquartile ranges were calculated. Free text survey items were analysed using quantitative content analysis (QCA) to identify codes and categories. Means and percentages were calculated to summarise QCA and descriptive data.  Results: Valid survey responses were analysed (n = 135). Respondents had between 2 and 39 years of physiotherapy experience (mean = 13.9 years); the majority (71.1 %) reported that ASI made up 90 % citing the Stanmore Classification. Physiotherapists adapted their management according to clinical presentation, responding to differing biopsychosocial needs of the patient scenario. Most respondents (> 80 %) did not use a protocol to guide their management. Exercise was the most utilised management approach for ASI, followed by education; novel treatment strategies, including cortical rehabilitation, were also reported.  Conclusion: Findings indicate physiotherapists utilise a wide range of treatment strategies and respond to biopsychosocial cues when managing patients with ASI. The majority reported not being very confident in managing this condition, however only a minority use rehabilitation protocols to support their management. Some interventions that respondents reported using lacked evidence to support their use in ASI management and further research regarding effectiveness is required. Guidelines have been published since this survey; the impact of these will need evaluating to determine their effectiveness in the future.Peer reviewedFinal Published versio

Identifying the deficits in cancer care for people with intellectual disabilities

No abstract available

Maximising engagement, motivation and long term change in a Structured Intensive Education Programme in Diabetes for children, young people and their families: Child and Adolescent Structured Competencies Approach to Diabetes Education (CASCADE).

BACKGROUND: This trial aims to evaluate effective delivery and cost effectiveness of an innovative structured psycho-educational programme (CASCADE) for young people and their families living with diabetes. The increase in numbers of people being diagnosed with diabetes is posing a challenge for both the UK and the rest of the world. The peak age for diagnosis is between 10 and 14 years of age. There is clear evidence that improved diabetes control from diagnosis in childhood can reduce the incidence and progression of long-term complications. However, despite the development of improved insulin regimens and delivery methods, the overall metabolic control in children and adolescents has improved little in the UK in the past decade. Therefore there is a need for novel interventions and health delivery mechanisms aimed at young people and their families to help improve control and reduce complications, illness burden and costs to the NHS. METHODS/DESIGN: The CASCADE trial is a multi-centre randomised control trial with 26 clinics randomised to control or intervention groups, with 572 children and young people involved in the study. The intervention will be delivered in 4 group sessions, over a 4 month period. A developmentally appropriate curriculum will be delivered to groups of 3 - 4 families, focusing on achievement of increasing competency in self-management of diabetes. The control group will receive standard care from their clinical team, usually consisting of regular 3-monthly clinic visits and telephone contact as required with the clinical nurse specialist and consultant. The primary outcomes of the trial will be change in HbA1c between baseline and 12 months and 24 months post recruitment. Secondary outcomes will include measures related to the economic evaluation, psychosocial outcomes, outcomes related to management of diabetes outcomes, and adherence to the intervention. DISCUSSION: The trial will be run by independent research and service delivery teams and supervised by a trial steering committee. A data monitoring and ethics committee has been put in place to monitor the trial and recommend stopping/continuation according to a Peto-Haybittle rule. The trial will be conducted according to the principles of MRC Good Clinical Practice (GCP) Guidelines and CTRU Phase III Trial Standard Operating procedures. TRIAL REGISTRATION: Current Controlled Trials ISRCTN52537669

A review of policy analysis: gender equality in Saudi Arabia’s mental health policy

This study employs the Walt and Gilson Policy Triangle Method to analyse the mental health policy in Saudi Arabia and explore the position of gender equality within the content context, process and development of mental health. Four relevant articles were reviewed, focusing on policy development, legislation, human rights, financing, organisational integration, and women's mental health challenges. The national mental health policy in Saudi Arabia highlights access to care, quality of services, awareness, prevention, and family support, with 4% of the healthcare budget allocated to mental health services. However, gender-specific needs and experiences of women may need to be adequately addressed. Contextual factors such as cultural norms, religious beliefs, and gender segregation shape mental health policy in Saudi Arabia. The process of policy development involves collaboration between the Ministry of Health and various stakeholders, incorporating international guidelines. The study also underlines the Transformational Plan of Saudi Vision 2030 and its influence on mental health policy. However, gender equality actions are not explicitly addressed in the current policies. The research shows the need for comprehensive policy improvements to ensure gender equality in mental health care and provide appropriate support for women's mental health needs in Saudi Arabia

Factors used in the detection of elder financial abuse: A judgement and decision-making study of social workers and their managers

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2011 Sage Publications Ltd.Factors social workers use in practice to detect elder financial abuse are currently unknown. A critical incident technique was applied within a judgement analysis approach to elicit cue use. Only three factors were key to decision-making: who raises concern, the elder’s mental capacity and the nature of the financial anomaly occurring.Economic and Social Research Counci

Making a case for an autism-specific multimorbidity index: a comparative cohort study

Autistic people experience challenges in healthcare, including disparities in health outcomes and multimorbidity patterns distinct from the general population. This study investigated the efficacy of existing multimorbidity indices in predicting COVID-19 mortality among autistic adults and proposes a bespoke index, the ASD-MI, tailored to their specific health profile. Using data from the CVD-COVID-UK/COVID-IMPACT Consortium, encompassing England's entire population, we identified 1,027 autistic adults hospitalized for COVID-19, among whom 62 died due to the virus. Employing logistic regression with 5-fold cross-validation, we selected diabetes, coronary heart disease, and thyroid disorders as predictors for the ASD-MI, outperforming the Quan Index, a general population-based measure, with an AUC of 0.872 versus 0.828, respectively. Notably, the ASD-MI exhibited better model fit (pseudo-R2 0.25) compared to the Quan Index (pseudo-R2 0.20). These findings underscore the need for tailored indices in predicting mortality risks among autistic individuals. However, caution is warranted in interpreting results, given the limited understanding of morbidity burden in this population. Further research is needed to refine autism-specific indices and elucidate the complex interplay between long-term conditions and mortality risk, informing targeted interventions to address health disparities in autistic adults. This study highlights the importance of developing healthcare tools tailored to the unique needs of neurodivergent populations to improve health outcomes and reduce disparities

A study on prescriptions contributing to the risk of high anticholinergic burden in adults with intellectual disabilities: retrospective record linkage study

Background: People with intellectual disabilities may face a disproportionate risk of experiencing high anticholinergic burden, and its negative sequalae, from a range of medications, and at younger ages than the general population, but there has been little previous study. Our aim was to determine the source of anticholinergic burden from prescribed medication. Methods: Retrospective matched observational study using record linkage. Adults with (n = 4,305), and without (n = 12,915), intellectual disabilities matched by age-, sex- and neighbourhood deprivation. The main outcome measure was the prescription of long-term (approximately 12 months use) anticholinergic medications overall (classified according to the Anticholinergic Risk Scale [ARS]), by drug class, individual drugs, and polypharmacy. Results: Adults with n = 1,654 (38.4%), and without n = 3,047 (23.6%), intellectual disabilities were prescribed medications long-term with anticholinergic effects. Of those on such drugs, adults with intellectual disabilities were most likely to be on central nervous system (62.6%), gastrointestinal (46.7%), and cardiovascular (28.4%) medications. They were prescribed more central nervous system, gynaecological/urinary tract, musculoskeletal, and respiratory medications, and less cardiovascular, infection, and endocrine medications than their matched comparators. Regardless of age, sex, or neighbourhood deprivation, adults with intellectual disabilities had greater odds of being prescribed antipsychotics (OR = 5.37 [4.40–6.57], p < 0.001), antiepileptics (OR = 2.57 [2.22–2.99], p < 0.001), and anxiolytics/hypnotics (OR = 1.28 [1.06–1.56], p = 0.012). Compared to the general population, adults with intellectual disabilities were more likely to be exposed to overall anticholinergic polypharmacy (OR = 1.48 [1.33–1.66], p < 0.001), and to psychotropic polypharmacy (OR = 2.79 [2.41–3.23], p < 0.001). Conclusions: Adults with intellectual disabilities are exposed to a greater risk of having very high anticholinergic burden through polypharmacy from several classes of medications, which may be prescribed by several different prescribers. There is a need for evidence-based recommendations specifically about people with intellectual disabilities with multiple physical and mental ill-health conditions to optimise medication use, reduce inappropriate prescribing and adverse anticholinergic effects