School-Based Services for Traumatized Refugee Children

In 1991, civil war raged in Somalia and the country’s infrastructure began to disintegrate. Since then, millions have fled the violence and instability. Many Somali refugees have settled in the United States; Ohio now has the second larg- est settlement of Somali refugees in the country. Most of these refugees reside in the Columbus area, where numerous out- reach services have been developed. The Somalis are one of many refugee popula- tions that have enrolled children in Ohio schools. In such cases, there is often little or no warning of the children’s arrival and thus little time to prepare a comprehen- sive school-based service delivery plan. The purpose of this article is to inform school psychologists of specific stressors faced by refugee children and to describe school-based plans that can help meet their needs

Impact of the English Directly Enhanced Service (DES) for Learning Disability

Final Report to the Department of Healt

A qualitative study of staff perspectives of patient non-attendance in a regional primary healthcare setting.

BackgroundNon-attendance at health appointments reduces health service efficiency, is costly to services, and can risk patient health. Reminder systems are widely used to overcome forgetfulness, the most common reason for non-attendance; however, other factors, such as patient demographics and service accessibility, may also affect attendance rates.AimsThere is limited primary research on the reasons for patient non-attendance in the Australian healthcare setting, although the success of preventative health initiatives requires ongoing monitoring of patients. This study aims to improve our understanding of the Australian experience by examining staff perspectives.MethodThis qualitative study explored staff perspectives of the reasons for non-attendance in a large, regional general practice super clinic, which has a low socioeconomic catchment, and serves a large Aboriginal population.ResultsThe practical barriers to attendance of travel, cost, and waiting times had largely been overcome with transport provision, free medical care and responsive appointment times, but paradoxically, these were seen to devalue allocated appointments and reinforce the expectations of “on-demand” health care. For Aboriginal patients specifically, a distrust of authority, combined with poor health literacy was perceived to impact negatively on the uptake of diagnostic tests, filling of prescriptions, health monitoring, and adherence to medication.ConclusionThe results suggest a complex interplay between poor health literacy and low patient self-worth; a funding system that encourages “5-minute medicine” without enabling doctors to get to the root cause of patient problems or having the ability to provide health education

Evaluation and attribution of OCO-2 XCO_2 uncertainties

Evaluating and attributing uncertainties in total column atmospheric CO_2 measurements (XCO_2) from the OCO-2 instrument is critical for testing hypotheses related to the underlying processes controlling XCO_2 and for developing quality flags needed to choose those measurements that are usable for carbon cycle science. Here we test the reported uncertainties of version 7 OCO-2 XCO_2 measurements by examining variations of the XCO_2 measurements and their calculated uncertainties within small regions (∼  100 km  ×  10.5 km) in which natural CO_2 variability is expected to be small relative to variations imparted by noise or interferences. Over 39 000 of these small neighborhoods comprised of approximately 190 observations per neighborhood are used for this analysis. We find that a typical ocean measurement has a precision and accuracy of 0.35 and 0.24 ppm respectively for calculated precisions larger than  ∼  0.25 ppm. These values are approximately consistent with the calculated errors of 0.33 and 0.14 ppm for the noise and interference error, assuming that the accuracy is bounded by the calculated interference error. The actual precision for ocean data becomes worse as the signal-to-noise increases or the calculated precision decreases below 0.25 ppm for reasons that are not well understood. A typical land measurement, both nadir and glint, is found to have a precision and accuracy of approximately 0.75 and 0.65 ppm respectively as compared to the calculated precision and accuracy of approximately 0.36 and 0.2 ppm. The differences in accuracy between ocean and land suggests that the accuracy of XCO2 data is likely related to interferences such as aerosols or surface albedo as they vary less over ocean than land. The accuracy as derived here is also likely a lower bound as it does not account for possible systematic biases between the regions used in this analysis

Does patient self-management education of primary care professionals improve patient outcomes : a systematic review

Background: Patient self-management support is recognised as a key component of chronic care. Education and training for health professionals has been shown in the literature to be associated with better uptake, implementation and effectiveness of self-management programs, however, there is no clear evidence regarding whether this training results in improved health outcomes for patients with chronic conditions. Methods: A systematic review was undertaken using the PRISMA guidelines using the Cochrane Library, PubMEd, ERIC, EMBASE, CINAHL, PsycINFO, Web searches, Hand searches and Bibliographies. Articles published from inception to September 1st, 2013 were included. Systematic reviews, Meta-analysis, Randomized controlled trials (RCTs), Controlled clinical trials, Interrupted time series and Controlled before and after studies, which reported on primary care health professionals' continuing education or evidence-based medicine/education on patient self-management for any chronic condition, were included. A minimum of two reviewers participated independently at each stage of review. Results: From 7533 abstracts found, only two papers provided evidence on the effectiveness of self-management education for primary healthcare professionals in terms of measured outcomes in patients. These two articles show improvement in patient outcomes for chronic back pain and diabetes based on RCTs. The educational interventions with health professionals spanned a range of techniques and modalities but both RCTs included a motivational interviewing component. Conclusions: Before and up to 2 years after the incorporation of patient empowerment for self-management into the WONCA Europe definition of general practice, there was a scarcity of high quality evidence showing improved outcomes for patients as a result of educating health professionals in patient self-management of chronic conditions.Peer reviewe

‘None of Us Sets Out To Hurt People’: The Ethical Geographer and Geography Curricula in Higher Education

This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Geography in Higher Education on 22nd January 2008, available online: https://doi.org/10.1080/03098260701731462This paper examines ethics in learning and teaching geography in higher education. It proposes a pathway towards curriculum and pedagogy that better incorporates ethics in university geography education. By focusing on the central but problematic relationships between (i) teaching and learning on the one hand and research on the other, and (ii) ethics and geography curricula, the authors’ reflections illustrate how ethics may be better recognized within those curricula. They discuss issues affecting teaching and learning about ethics in geography, and through identification of a range of examples identify ways to enhance the integration of ethical issues into university geography curricula

The science threshold learning outcomes: a ‘student-friendly’ version

BACKGROUND The Science Threshold Learning Outcomes (TLOs) are a nationally agreed set of learning outcomes for graduates of bachelor level degrees in science that are increasingly being used in curriculum review, design and bench-marking at Australian universities. The Science TLOs were published in the Science Standards Statement (Jones, Yates & Kelder 2011) together with notes on their interpretation and application: this is necessarily a formal document, aimed primarily at teaching academics and those with relevant quality assurance responsibilities. Talking with students during the development of the Science TLOs indicated that students were unlikely to engage with the TLOs as thus expressed. Therefore, if the Science TLOs are to be an effective means of informing students about the learning achieved through studying science at university, a modified version was required. AIM This project aimed to develop a ‘student-friendly’ version of the Science TLOs directed at potential and current students, their parents, future employers, teachers and career advisors. APPROACH The development was carried out in collaboration with The Bookend Trust (http://www.bookendtrust.com/), a not-for-profit organisation dedicated to inspiring students to undertake positive careers in environmental science. In particular, Bookend links media and journalism students with professional scientists or science students, thus fostering effective communication about contemporary science. STAGE 1 As a scoping exercise, a Bookend scholarship student investigated students’ attitudes to the formally expressed Science TLOs. She presented four college (Year 11/12) science classes with a short survey that explored their conceptions of studying science at university and potential career paths in science. She also sought their opinions on a DL card- sized flier of the Science TLOs, and asked how the same information could be presented in a way that students would find relevant and attractive. The survey showed that a ‘student-friendly’ flier would need pictures, catchy words, bright colours, and common-use language. The students were enthusiastic about adding a QR scan code linking to a website, saying that would increase the likelihood of their picking up such a flier. The survey results informed Stage 2 of this project, particularly the design approach. STAGE 2 To embed the Science TLOs into a concrete context, Bookend summer scholarship students interviewed employers using standard questions designed to elicit responses illustrating how the Science TLOs are directly relevant to working in science. The interviews were professionally recorded on video, and the footage was edited to create short clips that were loaded onto a website. THE FINAL PRODUCT We have produced a two-sided coloured flier that provides a ‘student-friendly’ version of the Science TLOs (re-phrased as questions) and a QR code linking to a website where the employer interviews can be viewed. The ‘Student-Friendly TLOs flier’ is now freely available as a downloadable pdf from the Office for Learning and Teaching (OLT) Resource Library (http://www.olt.gov.au/resource-library) and other relevant sites. We thank the OLT for funding this project

Gradual Ordering in Red Abalone Nacre

Red abalone (Haliotis rufescens) nacre is a layered composite biomineral that contains crystalline aragonite tablets confined by organic layers. Nacre is intensely studied because its biologically controlled microarchitecture gives rise to remarkable strength and toughness, but the mechanisms leading to its formation are not well understood. Here we present synchrotron spectromicroscopy experiments revealing that stacks of aragonite tablet crystals in nacre are misoriented with respect to each other. Quantitative measurements of crystal orientation, tablet size, and tablet stacking direction show that orientational ordering occurs not abruptly but gradually over a distance of 50 {micro}m. Several lines of evidence indicate that different crystal orientations imply different tablet growth rates during nacre formation. A theoretical model based on kinetic and gradual selection of the fastest growth rates produces results in qualitative and quantitative agreement with the experimental data and therefore demonstrates that ordering in nacre is a result of crystal growth kinetics and competition either in addition or to the exclusion of templation by acidic proteins as previously assumed. As in other natural evolving kinetic systems, selection of the fastest-growing stacks of tablets occurs gradually in space and time. These results suggest that the self-ordering of the mineral phase, which may occur completely independently of biological or organic-molecule control, is fundamental in nacre formation

Exploring severe mental illness and diabetes : protocol for a longitudinal observational and qualitative mixed methods study

Background: The average life expectancy for people with a severe mental illness (SMI) such as schizophrenia or bipolar disorder is 15-20 years less than for the population as a whole. Diabetes contributes significantly to this inequality, being 2-3 times more prevalent in people with SMI. Various risk factors have been implicated, including side effects of antipsychotic medication and unhealthy lifestyles, which often occur in the context of socio-economic disadvantage and healthcare inequality. However, little is known about how these factors interact to influence the risk of developing diabetes and poor diabetic outcomes, or how the organisation and provision of healthcare may contribute. Objective: The study aims to identify the determinants of diabetes and to explore variation in diabetes outcomes for people with SMI. Methods: This study will employ a concurrent mixed methods design combining the interrogation of electronic primary care health records from the Clinical Practice Research Datalink (CPRD GOLD) with qualitative interviews with adults with SMI and diabetes, their relatives/friends, and healthcare staff. The study has been funded for two years, from September 2017 to September 2019 and data collection has recently ended. Results: CPRD and linked health data will be used to explore the association of socio-demographic, illness and healthcarerelated factors with both the development and outcomes of Type 2 diabetes in people with SMI. Experiences of managing the comorbidity and accessing healthcare will be explored through qualitative interviews using topic guides informed by evidence synthesis and expert consultation. Findings from both datasets will be merged to develop a more comprehensive understanding of diabetes risks, interventions and outcomes for people with SMI. Findings will be translated into recommendations for interventions and services using co-design workshops. Conclusions: Improving diabetes outcomes for people with SMI is a high priority area nationally and globally. Understanding how risk factors combine to generate high prevalence of diabetes and poor diabetic outcomes for this population is a necessary first step in developing healthcare interventions to improve outcomes for people with diabetes and SMI

Healthcare resource use and costs for people with type 2 diabetes mellitus with and without severe mental illness in England : longitudinal matched cohort study using the Clinical Practice Research Datalink

BACKGROUND: Approximately 60 000 people in England have coexisting type 2 diabetes mellitus (T2DM) and severe mental illness (SMI). They are more likely to have poorer health outcomes and require more complex care pathways compared with those with T2DM alone. Despite increasing prevalence, little is known about the healthcare resource use and costs for people with both conditions. AIMS: To assess the impact of SMI on healthcare resource use and service costs for adults with T2DM, and explore the predictors of healthcare costs and lifetime costs for people with both conditions. METHOD: This was a matched-cohort study using data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics for 1620 people with comorbid SMI and T2DM and 4763 people with T2DM alone. Generalised linear models and the Bang and Tsiatis method were used to explore cost predictors and mean lifetime costs respectively. RESULTS: There were higher average annual costs for people with T2DM and SMI (£1930 higher) than people with T2DM alone, driven primarily by mental health and non-mental health-related hospital admissions. Key predictors of higher total costs were older age, comorbid hypertension, use of antidepressants, use of first-generation antipsychotics, and increased duration of living with both conditions. Expected lifetime costs were approximately £35 000 per person with both SMI and T2DM. Extrapolating nationally, this would generate total annual costs to the National Health Service of around £250 m per year. CONCLUSIONS: Our estimates of resource use and costs for people with both T2DM and SMI will aid policymakers and commissioners in service planning and resource allocation