Implementing screening and brief alcohol interventions in primary care : views from both sides of the consultation

Excessive drinking is a global health problem which is responsible for a wide range of both chronic and acute illness, and which costs the UK National Health Service (NHS) £1.7 billion annually. Current health policy aims to reduce alcohol-related problems by promoting early identification of risk followed by brief intervention to facilitate positive changes in drinking level or patterns of consumption. However, practical and philosophical barriers concerning screening and brief alcohol intervention have so far impeded its uptake in routine primary care. This qualitative study aimed to simultaneously explore and compare health professionals’ and patients’ views on the acceptability and feasibility of screening and brief alcohol intervention in primary care. Focus groups were held with (a) four primary care teams, (b) two general practitioner (GP) and two nurse groups and (c) six patient groups in the north-east of England. A thematic framework approach was used to analyse audio-taped data via transcripts. Both health professionals and patients reported that raising and discussing alcohol-related risk was acceptable in primary care, when combined with other lifestyle issues or linked to relevant health conditions. Targeted rather than universal screening was the most acceptable method of identifying alcohol-related risk and would fit well with existing practice. However, there was uncertainty among health professionals about the effectiveness of brief alcohol interventions and some disagreement with patients concerning who was best placed to deliver them. Health professionals felt that nurses were best placed for such work whilst patients reported that they would initially raise the subject with GPs. There was broad acceptance of brief intervention approaches but a lack of support and specific incentives for this work impeded its delivery in routine practice

Maxine Greene's arguments on aesthetic literacy and the imagination in the context of contemporary developments in South African education

Bibliography: leaves 81-89.Surely education today must be conceived as a mode of opening the world to critical judgement by the young and to their imaginative projections and, in time, to their transformative actions- Maxine Greene (1995, p. 56). Clues to the problem out of which the question for this thesis arises can be found in the above quote from Maxine Greene. Firstly, the problem emerges from the instability of our rapidly changing society. These changes are so complex that it would be impossible to attempt a comprehensive documentation of them here. I will however, argue that in South Africa we are experiencing immense local changes and global transformations. Globalisation and the proliferation of information and communications have had a profound effect on the political, social, economic and cultural arenas of our society. These changes have repercussions on the lives of most individuals who often find the rate of change quite overwhelming. Attempting to negotiate their way through these perplexities, many individuals simply contract into the "safety and the everydayness" of their own worlds. Unable to find their way through the nettles of uncertainty and change, many individuals feel trapped by the problems of contemporary society without sufficiently developed critical judgement, vision or imagination to tree themselves. As Greene points out, 'There is a withdrawal, a widespread speechlessness, a silence where there might be - where there ought to be - an impassioned dialogue' (1988, p. 7). Part of the problem also lies within the domain of education. It is up to education to provide the openings in which Greene's 'impassioned dialogue' can not only be encouraged but also take place. In order for this to happen, however, we need to educate with freedom in mind. By this I mean that education has to be conceived of as 'a mode of opening the world to critical judgement by the young and to their imaginative projections' . Should education not be concerned with developing critical, reflective and imaginative youngsters, then we might remain content with what is "given" from the outside and passive under the pressures of a fragmented existence. Unable to reflect critically on the world around us and to perceive imaginatively of 4 alternatives and possibilities, we will probably be incapable of 'tran::.formative action·. In a country like South Africa, developing youngsters with the courage and the ability to initiate change, should be a major educational goal. Greene writes that, 'An inability to conceive of a better order of things can give rise to a resignation that paralyzes and prevents people from acting to bring about change' ( 1995, p. 19). To 'conceive of a better order of things ' means being able to imagine and 'to call for imaginative capacity is to work for the ability to look at things as if they could be otherwise' (ibid) . Greene proposes the notion that the arts, and more specifically a form of aesthetic education incorporated into the curriculum at all levels. might be the best possible means for encouraging the development of imaginative youngsters. It is with this in mind that the question for this thesis arises: Are Maxine Greene's arguments on aesthetic literacy and the imagination pertinent to contemporary developments in South African education? In order to highlight the problem from which the question emerges, I will begin by providing a global picture of our changing society and what appear to be some of the problems consequent on these transformations. I will briefly discuss the emergence of postmodern thought and the unease of the climate accompanying it. I will also examine the effects that the proliferation of information and communications technology has on our society, looking particularly at the problem of technicist thinking and unreflective consumerism resulting in what has been referred to as a ' culture of contentment' (Galbraith, 1993)

Inequities in access to quality early care and education: Associations with funding and community context

The purpose of the current study was to examine program- and community-level characteristics related to total points earned by early care and education programs in North Carolina’s Tiered Quality Rating and Improvement System (TQRIS). Multiple statewide data sources, programand community-level characteristics were combined to better understand associations with total points awarded in the TQRIS. The concentration of state and federal funding at the program level, and the socioeconomics of the Q3 communities that programs resided were related to program quality. The current study demonstrated that there are inequities within the system where the highest quality early care and education programs are differentially available based on program funding characteristics, community socioeconomics, and interactions among the program and community variables. Future research and policy implications are discusse

The Day-to-Day Reality of Teacher Turnover in Preschool Classrooms: An Analysis of Classroom Context and Teacher, Director, and Parent Perspectives

The purpose of the current study is to examine teacher turnover comprehensively by triangulating the experiences of teachers, directors, parents, and children through actual, “real-time” turnover transitions. We intentionally examined turnover with a small sample size (N = 13 classrooms) to facilitate comprehensive data collection utilizing multiple qualitative and quantitative measures and to gain a rich understanding of the implications of teacher turnover on classroom quality, staff, and the parents and children with whom they work. The study utilized an interpretive paradigm to illuminate and juxtapose the experiences of teachers, directors, parents, and children through the turnover transition—as teachers departed and their replacements began. Strategies used to respond to turnover were identified at the program and classroom levels. Implications for early childhood classroom quality and policy are discussed

Teachers’ beliefs and practices regarding developmentally appropriate practices: A study conducted in India

The study assessed kindergarten teachers’ beliefs, stated practices and actual practices regarding developmentally appropriate practices (DAP) in India. Forty kindergarten teachers from the urban city of Mumbai (India) participated in the study. Overall, the results indicated that teachers’ beliefs were more developmentally appropriate than their stated practices or actual practices in the classroom. Further, teachers congruent in their developmentally appropriate beliefs and stated practices had classrooms with higher scores on actual practices. Lastly, group size was a significant predictor of teachers’ actual practices. The implications of these results for the early childhood education system of India are discussed in detail

“The Changers and the Changed”: Preparing Early Childhood Teachers to Work With Lesbian, Gay, Bisexual, and Transgender Families

The Census Bureau estimates that up to 14 million children under the age of 18 are being raised by lesbian, gay, bisexual, or transgender (LGBT) families. Just as heterosexual families require child care to enable work and want high-quality early childhood education to enhance their children's development, LGBT families experience the same needs and desires for their children. However, similar to other educational institutions, the early childhood field has either held negative beliefs regarding diverse family structures or ignored the unique needs of LGBT families. As part of an effort to address teachers' understandings of equity, faculty at a southeastern university sponsored a course designed to prepare early childhood teacher education students to offer welcoming, inclusive learning environments for LGBT families and their young children. The purpose of this article is to examine the learning process and transformation of students in this course. Findings from quantitative and qualitative data are presented, as is a discussion on how courses on family equity can and should be incorporated into teacher education programs

Child Care Work Environments: the Relationship with Learning Environments

The study explores the relationship between child care program administration, organizational climate, and global quality. The recently developed Program Administration Scale (PAS; Talan & Bloom, 2004) was utilized in the study. Both program administration and organizational climate were found to be positively correlated with preschool classroom global quality. There was also a significant relationship between organizational climate and a language/interaction factor of the ECERS-R. The level of education of the director was related to higher quality administrative practices and not-for-profit centers scored significantly better than for-profit centers did on the PAS. Additionally, a statistically significant relationship between the PAS and the Parents and Staff Subscale of the ITERS-R and ECERS-R was found

Teacher and Parent Perspectives on Looping

This manuscript describes the implementation of looping or continuity of care in a high-quality child care facility. Through interviews with parents and teachers, themes were identified including the advantages (stability and continuity of care, ease in transition, anticipating children's needs, parent friendships and networking) and challenges (caregivers' age group preference and skills, planning classroom activities, strained parent teacher relationship, transition from looping and philosophies, no opportunity to experience new things). The reality of implementing the practice of continuity of care and recommendation for implementation are discussed

Kindergarten Teachers' Perspectives on Developmentally Appropriate Practices (DAP): A Study Conducted in Mumbai (India)

A qualitative study examining teachers' beliefs regarding developmentally appropriate practices was conducted in the city of Mumbai, India. Twelve kindergarten teachers were interviewed for this study, and a constant comparative method was used to analyze the interviews. Six themes were identified within this study. The themes highlighted distinct differences between American and Indian cultures, as well as striking similarities, and pinpoint the importance of culture as the foundation for classroom practices. Themes included a focus on academics vs. play, the importance of worksheets, the importance of groups for socialization, and the difficulties of implementing a play-based curriculum. The description of these themes and its implication for the early childhood care and education of India are discussed in detail

SARS-COV-2 Testing Guidelines for Patients Admitted to MRH for Inpatient Rehabilitation

We implemented a clinical algorithmic approach with an emphasis on symptoms and risk to stratify patients into 3 groups: Acutely Ill COVID Rule Out/PUI Stable COVID Rule Out/PUI COVID OB