Stakeholders\u27 voices : A socio-cultural approach to describing and extending an understanding of primary education in Mauritius

This study describes and expands an understanding of primary education in one developing country, Mauritius. The need for the study was argued from a review of literature which brought to notice the lack of social action perspectives in analysis of education in and about developing countries and the necessity and importance of knowing about the reality of schooling in developing countries. The research was conceptualised as a socio-cultural approach. It gave analytical priority to the actions, experiences and perceptions of teachers, pupils, parents and educationists in order to create an account of what Mauritian education was like and meant to individuals involved in or closely associated with Mauritian primary educational processes and functionings. The research was conceptualised on the premise that, as a social construction, Mauritian primary education was to be understood in its social milieu but also was located and had to be understood in the broader context of national and global circumstances, influences and pressures. The research can be taken as an attempt to integrate micro and macro levels of analysis. Data was collected in Mauritius over a period of four months, for the most part in two primary schools and also in participants\u27 places of work and homes and methods were triangulated to ensure validity. They comprised: (a) observation to describe people and educational settings and to document school routines and processes; (b) in-depth interviews to elicit participants\u27 constructs and document the issues and priorities they brought to their understanding of Mauritian primary education and; (c) stories and drawings to elicit pupils\u27 own views. Data analysis has been emergent and inductive and the research findings were presented through diverse instrumental short case studies. The findings of the study showed that Mauritian primary education was construed by participant stakeholders as a means to an end, a credential enabling the achievement of a cultural aspiration for individual social upgrading and to succeed at an examination Certificate of Primary Education (CPE) which put pupils in competition to rank for a restricted number of \u27good\u27 secondary colleges. The findings highlighted teacher-centered instructional methods, the valuing of encyclopedic knowledge, hard work and uniformity and the practices of \u27ability privileging\u27 and \u27differential treatment\u27 of pupils as prominent characteristics of Mauritian primary education. They also revealed a polarisation between the \u27official\u27 intent of Mauritian primary education and their realisation at school level with regard to educational opportunity and the degree to which Mauritian primary education promoted and provided the appropriate attitudes, skills and knowledge for individuals and for the social and economic good of the nation. The study concluded asserting that the research exemplified a conceptual and theoretical approach that may be replicated for collecting rich micro data, useful for pursuing a quality agenda for basic education in developing countries. The study has provided an illustration of the interactions between context, educational processes and the ways in which primary education was experienced by participant stakeholders. It has also located Mauritian primary education within the framework of international educational ideals and principles. In doing so, the study has served to remind that one way of looking at education is to see it as a developmental undertaking that should serve childrens\u27 immediate as well as future interests and has brought to light foundational and detailed information about Mauritian educational processes that could be useful for educational change trying to achieve a developmental objective in Mauritius

Exploring endocrinologists’ views and experiences of psychosocial and self-management support for patients with hypothyroidism

BackgroundHypothyroidism affects between 2% and 5% of the UK population. Reports suggest that up to 15% of patients report persistent symptoms despite treatment. Recommendations exist for psychosocial and self-management support for patients to address the demands of living with their condition and to develop the skills, knowledge, and experience to manage their health. In this study, Endocrinologists were asked about the provision of support for patients with hypothyroidism in secondary care. Their views, experiences, and perceptions of the barriers and facilitators to the implementation of psychosocial and self-management models of care were explored. MethodsEighteen Consultant Endocrinologists in the UK were recruited via a snowballing sampling technique and interviewed. Interviews were analysed using reflexive thematic analysis.FindingsFour overarching themes were identified. In the first theme (‘Walk with them’) participants identified that patients with hypothyroidism have diverse needs for psychosocial and self-management support from the point of diagnosis, but that participants report varied will, skill and confidence to meet these needs. The second theme (‘Embedded is best’) encapsulates participants’ attempts to explore psychosocial issues and embed components of self-management support into their own practice. Difficulties in shifting the focus of the consultation towards self-management and subsequent challenges to professional identity as biomedical expert are reported. These were perceived to be confounded by debates about non-standard (T3) treatments for hypothyroidism and a lack of available support services for referral. The third theme (‘Incorporate and collaborate’) presents participants’ views that collaboration is required to address gaps in provision in primary and secondary care. Valuable partners include: Patients, Endocrine Nurses, Health Psychologists, Pharmacists, Exercise Physiologists, embedded Researchers, and experts in the charitable sector. The fourth theme (‘We can’t do this alone’) includes participant-identified barriers to progress and highlights a need for change. This includes increases in funding and research, and supportive environment which empowers clinicians to place patients at the centre of their care.ConclusionThe findings from this research suggest that patients with hypothyroidism have unmet needs for psychosocial and self-management support from the point of diagnosis, and that Endocrinologists may to benefit from training, collaboration and support to incorporate non-medical models of care. Patients, professional collaborators, and experts in the charitable sector are valuable assets to Endocrinology and can contribute to psychosocial and self-management programmes for patients and clinician skills training, as well as acting as agents of change to address gaps in provision in primary and secondary care. A whole-systems approach is required to improve outcomes for patients with hypothyroidism and the clinicians who manage their care

Evaluation of older people\u27s knowledge, awareness, motivation and perceptions about falls and falls prevention in residential aged care homes: A tale of two cities

Falls prevention strategies can only be effective in reducing falls amongst older people if they are adopted and enacted in their daily lives. There is limited evidence identifying what older people in residential aged care (RAC) homes understand about falls and falls prevention, or what may limit or enable their adoption of strategies. This study was conducted in two countries and explored older people’s knowledge and awareness of falls and their preferences, opportunities and motivation to undertake falls prevention strategies. A cross-sectional survey was administered to participants (N = 70) aged 65 years and over, living in six RAC homes in Perth, Australia and six RAC homes in Swansea, Wales, United Kingdom. Participants had limited knowledge about intrinsic falls risk factors and strategies to address these and frequently expressed self-blame regarding falling. Almost all (N = 67, 95.7%) participants felt highly motivated to maintain their current functional mobility and independence in everyday tasks. Key preferences for receiving falls prevention messages favoured a positive approach promoting wellness and independence (N = 41, 58.6%) via pictorial posters or brochures (N = 37, 52.9%) and small group discussions preferably with demonstrations (N = 18, 25.7%). Findings from this study may assist organisations and staff to more effectively engage with older people living in RAC about falls prevention and design targeted resources to address the motivations and preferences of this population

Issues affecting therapist workforce and service delivery in the disability sector in rural and remote New South Wales, Australia: perspectives of policymakers, managers and senior therapists

Introduction: The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. Methods: The project gathered information via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGOs) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues.Results: Five broad themes resonated across participants’ roles, locations and service settings: (1) challenges to implementing policy in rural and remote NSW; (2) the impact of geographic distribution of workforce and clients; (3) workforce issues - recruitment, support, workloads, retention; (4) equity and access issues for rural clients; and (5) the important role of the NGO sector in rural service delivery and support. Conclusions: Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to those reported in the rural health literature but rarely in the context of allied health and disability services. Relatively recent innovations such as therapy assistants, information technology, and trans-disciplinary approaches, were raised as important service delivery considerations within the region. These and other innovations were expected to extend the coverage provided by therapists. Nongovernment organisations played a significant role in service delivery and support in the region. Participants recognised the need for therapists working for different organisations, in rural areas, to collaborate both in terms of peer support and service delivery to clients

The need for new models for delivery of therapy intervention to people with a disability in rural and remote areas of Australia

Early therapy intervention by occupational therapists, physiotherapists, and speech pathologists (therapists) is recognised to yield benefits across the lifecourse (Carpenter, 2007; Law, 2002; Thomaidis, Kaderoglou, Stefou, Damianou, & Bakoula, 2000; Ziviani, Feeney, Rodger, & Watter, 2010). As a result,there have recently been increases in funding for therapy positions in disability services in New South Wales(NSW), Australia (New South Wales Government, 2006). However, research by Keane, Smith, Lincoln,and Fisher (2011), Chisholm, Russell, and Humphreys (2011), and Denham and Shaddock (2004) indicated that there is a shortage of therapists living and working in rural and remote areas of Australia

Addressing the barriers to accessing therapy services in rural and remote areas

Purpose: Throughout the world, people with a disability who live in rural and remote areas experience difficulty accessing a range of community-based services including speech-, physioand occupational therapy. This paper draws on information gathered from carers and adults with a disability living in a rural area in New South Wales (NSW), Australia to determine the extent to which people living in rural areas may receive a person-centred therapy service. Methods: As part of a larger study in rural NSW into the delivery of therapy services, focus groups and individual interviews were conducted with 78 carers and 10 adults with a disability. Data were analysed using constant comparison and thematic analysis. Results: Three related themes emerged: (i) travelling to access therapy; (ii) waiting a long time to get therapy; and (iii) limited access to therapy past early childhood. The themes overlaid the problems of recruiting and retaining sufficient therapists to work in rural areas. Conclusions: Community-based rehabilitation principles offer possibilities for increasing person-centred therapy services. We propose a person-centred and place-based approach that builds on existing service delivery models in the region and involves four inter-related strategies aimed at reducing travel and waiting times and with applicability across the life course

Integrating evidence into policy and sustainable disability services delivery in western New South Wales, Australia: the ‘wobbly hub and double spokes’ project

Background: Policy that supports rural allied health service delivery is important given the shortage of services outside of Australian metropolitan centres. The shortage of allied health professionals means that rural clinicians work long hours and have little peer or service support. Service delivery to rural and remote communities is further complicated because relatively small numbers of clients are dispersed over large geographic areas. The aim of this five-year multi-stage project is to generate evidence to confirm and develop evidence-based policies and to evaluate their implementation in procedures that allow a regional allied health workforce to more expeditiously respond to disability service need in regional New South Wales, Australia. Methods/Design: The project consists of four inter-related stages that together constitute a full policy cycle. It uses mixed quantitative and qualitative methods, guided by key policy concerns such as: access, complexity, cost, distribution of benefits, timeliness, effectiveness, equity, policy consistency, and community and political acceptability. Stage 1 adopts a policy analysis approach in which existing relevant policies and related documentation will be collected and reviewed. Policy-makers and senior managers within the region and in central offices will be interviewed about issues that influence policy development and implementation. Stage 2 uses a mixed methods approach to collecting information from allied health professionals, clients, and carers. Focus groups and interviews will explore issues related to providing and receiving allied health services. Discrete Choice Experiments will elicit staff and client/carer preferences. Stage 3 synthesises Stage 1 and 2 findings with reference to the key policy issues to develop and implement policies and procedures to establish several innovative regional workforce and service provision projects. Stage 4 uses mixed methods to monitor and evaluate the implementation and impact of new or adapted policies that arise from the preceding stages. Discussion: The project will provide policy makers with research evidence to support consideration of the complex balance between: (i) the equitable allocation of scarce resources; (ii) the intent of current eligibility and prioritisation policies; (iii) workforce constraints (and strengths); and (iv) the most effective, evidence-based clinical practice

Addressing the barriers to accessing therapy services in rural and remote areas

Purpose: Throughout the world, people with a disability who live in rural and remote areas experience difficulty accessing a range of community-based services including speech-, physioand occupational therapy. This paper draws on information gathered from carers and adults with a disability living in a rural area in New South Wales (NSW), Australia to determine the extent to which people living in rural areas may receive a person-centred therapy service. Methods: As part of a larger study in rural NSW into the delivery of therapy services, focus groups and individual interviews were conducted with 78 carers and 10 adults with a disability. Data were analysed using constant comparison and thematic analysis. Results: Three related themes emerged: (i) travelling to access therapy; (ii) waiting a long time to get therapy; and (iii) limited access to therapy past early childhood. The themes overlaid the problems of recruiting and retaining sufficient therapists to work in rural areas. Conclusions: Community-based rehabilitation principles offer possibilities for increasing person-centred therapy services. We propose a person-centred and place-based approach that builds on existing service delivery models in the region and involves four inter-related strategies aimed at reducing travel and waiting times and with applicability across the life course

Carer and service providers’ experiences of individual funding models for children with a disability in rural and remote areas

There is a global movement for people with a disability towards personcentred practices with opportunities for self-determination and choice. Person-centred approaches may involve individual funding (IF) for the purchase of required support. A shift to a person-centred model and IF should allow people with a disability and their carers greater choice in therapy access. However, individuals who live in rural and remote areas have less choice and access to therapy services than their metropolitan counterparts. Drawing on data from a larger study into therapy service delivery in a rural and remote area of New South Wales, Australia, this study describes some benefits and barriers to using IF to access therapy services in rural areas. Ten carers and 60 service providers participated in audio-recorded focus groups and individual interviews during which IF was discussed. Transcribed data were analysed using thematic analysis and constant comparison. Greater access to and choice of therapy providers were identified as benefits of IF. Four barriers were identified: (i) lack of information and advice; (ii) limited local service options and capacity; (iii) higher costs and fewer services and (iv) complexity of self-managing packages. A range of strategies is required to address the barriers to using IF in rural and remote areas. Carers indicated a need for: accessible information; a local contact person for support and guidance; adequate financial compensation to offset additional travel expenses and coordinated eligibility and accountability systems. Service providers required: coordinated cross-sector approaches; local workforce planning to address therapist shortages; certainty around service viability and growth; clear policies and procedures around implementation of IF. This study highlights the need for further discussion and research about how to overcome the barriers to the optimal use of an IF model for those living in rural and remote areas

Application of a library of near isogenic lines to understand context dependent expression of QTL for grain yield and adaptive traits in bread wheat

(a) Summary of the mixed model analysis performed for the grain number components studied comprising 553 NILs carrying the Avalon or Cadenza alleles in the introgressed region in 2013. (b) Average values for the two groups (carrying the Avalon or Cadenza alleles in the QTL region) based on the chromosome and background in 2013. Significant difference between Avalon and Cadenza alleles are highlighted in bold (spikes/m2 (S), spikelet/spike (s/S) and grains/spikelet (G/S). (PDF 111 kb