Professional Learning Communities in the Expanded Learning Field

This white paper uses twelve evaluation reports of the Professional Learning Community (PLC) initiatives, as well as interviews with PLC participants and facilitators, to better understand how the PLC model is used in the Expanded Learning field, to demonstrate the benefits to participating staff and expanded learning programs, and to share best practices for youth-serving organizations interested in using PLCs

An Emerging Model of Knowledge for Youth Development Professionals

A model of knowledge for youth development professionals that is comprised of five knowledge domains: 1) Foundational Knowledge of Positive Youth Development; 2) Knowledge of Youth; 3) Knowledge of Group Facilitation; 4) Knowledge of Contexts and Organizational Systems and; 5) Specialized Youth Development Knowledge is proposed in this paper. The model is intended for use in youth development programs, which have been associated with better outcomes for participants when compared to other types of youth programs. The development of the knowledge base is framed by seminal research on teacher knowledge and informed by practice-oriented research in the out-of-school time field and literature on the quality of youth development programs

A Comparative Analysis of Competency Frameworks for Youth Workers in the Out-of-School Time Field

Research suggests that the quality of out-of-school time (OST) programs is related to positive youth outcomes and skilled staff are a critical component of high quality programming. This descriptive case study of competency frameworks for youth workers in the OST field demonstrates how experts and practitioners characterize a skilled youth worker. A comparative analysis of 11 competency frameworks is conducted to identify a set of common core competencies. A set of 12 competency areas that are shared by existing frameworks used in the OST field are identified. The age of youth being served, descriptions of mastery for each competency area, an emphasis on developing mid-level managers, and incorporating research emerge as factors that should be addressed in future competency frameworks

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Creating a Rising Tide: Improving Social and Emotional Learning Across California

Given the recent emphasis on social and emotional development, many professionals who manage, develop, or influence expanded learning systems are beginning to ask, "How do we better prepare staff to promote social and emotional development?" California has adopted a statewide professional development strategy for publicly-funded expanded learning programs that is designed to raise awareness of the importance of social and emotional learning (SEL) among practitioners and build tools for the field to support implementation. The strategy -- led by a partnership among a state agency, expanded learning intermediaries, and funders -- combines leadership development, field-building initiatives, and program-level supports. It also complements the current expanded learning system. In this article, we describe the statewide strategy and discuss how it addresses workforce challenges, the core levers that California used to develop the strategy, and why and how the state-level leadership prioritized social and emotional learning. We conclude the article with lessons learned about collaboration, implementation, and assessing impact

Costs of a Smoking Cessation Counseling Intervention for Pregnant Women: Comparison of Three Settings

OBJECTIVE: Although the rate of smoking among women giving birth in the United States has declined steadily from 19.5% in 1989 to 11.4% in 2002, it still far exceeds the Healthy People 2010 goal of 1%. The objective of this study was to estimate the costs of a recommended five-step smoking cessation counseling intervention for pregnant women. METHODS: Costs were compared across three settings: a clinical trial, a quit line, and a rural managed care organization. Cost data were collected from August 2002 to September 2003. Intervention costs were compared with potential neonatal cost savings from averted adverse outcomes using data from the Centers for Disease Control and Prevention's Maternal and Child Health Smoking-Attributable Mortality, Morbidity, and Economics Costs software. RESULTS: The costs of implementing the intervention ranged from $24 to$34 per pregnant smoker counseled across the three settings. Potential neonatal cost savings that could be accrued from women who quit smoking during pregnancy were estimated at $881 per maternal smoker. Assuming a 30$8 million within the range of costs per pregnant smoker. CONCLUSIONS: Costs may vary depending on the intensity and nature of the intervention; however, this analysis found a surprisingly narrow range across three disparate settings. Cost estimates presented here are shown to be low compared with potential cost savings that could be accrued across the quit rates that could be achieved through use of the 5A's smoking cessation counseling intervention