Christianity, John M. Hull and notions of ability, disability and education

We are delighted to welcome Simon Hayhoe as the guest editor for this Special Issue on Disability, Christianity and Education. Simon is Senior Lecturer in the Faculty of Education at Canterbury Christ Church University, UK and is a distinguished scholar in this field, having undertaken extensive research in arts education of both blind adults and school children and published widely in disability and education. He is also a Research Associate in the Centre for the Philosophy of Natural and Social Science at the London School of Economics, where he is researching the epistemology of disability and ability, with special reference to education, inclusion, technology and the arts. Simon has also worked as a research officer at Birkbeck College and the Institute of Education, both in the University of London, and at the University of Toronto (Canada). In his editorial Simon reflects on the significance of the work of Professor John Hull, who is a giant amongst academics working in the theology of disability. John was my main supervisor for my doctoral studies when I was working on developing an evangelical theology of religious education for British schools. He was a remarkable tutor with whom I enjoyed the most stimulating debates. I disagreed with his basic position and critiqued that in my thesis, but was heavily influenced by his ideas and the challenges he presented me with. His book, What Prevents Christian Adults from Learning? first published in 1985, is still, in my opinion, one of the most important books that I have read on Christian learning. However, as Simon too acknowledges, it was John’s personal qualities that had the most impact. I started as his doctoral student not long after he finally lost his sight in 1983 in the middle years of a distinguished academic career. Such a happening would cause many to give up. Not John. Up to the moment of his death in the early hours of 28th July 2015, he was still producing ground-breaking work. It is fitting that this special issue is dedicated to him. --Trevor Coolin

Evaluation of a collaborative photography workshop using the iPad 2 as an accessible technology for participants who are blind, visually impaired and sighted working collaboratively

A workshop using iPads to train photographers who are blind, visually impaired and sighted is evaluated using a model of inclusive technical capital. It was hypothesized that all participants would find iPad apps accessible. It was found that iPads were good introductory devices, but experienced participants who are blind and sighted still preferred specialized cameras

Evaluation of a collaborative photography workshop using the iPad 2 as an accessible technology for participants who are blind, visually impaired and sighted working collaboratively

A workshop using iPads to train photographers who are blind, visually impaired and sighted is evaluated using a model of inclusive technical capital. It was hypothesized that all participants would find iPad apps accessible. It was found that iPads were good introductory devices, but experienced participants who are blind and sighted still preferred specialized cameras

Improving multidisciplinary team working to support integrated care for people with frailty amidst the COVID-19 pandemic

Multidisciplinary team (MDT) working is essential to optimise and integrate services for people who are frail. MDTs require collaboration. Many health and social care professionals have not received formal training in collaborative working. This study investigated MDT training designed to help participants deliver integrated care for frail individuals during the Covid-19 pandemic. Researchers utilised a semi-structured analytical framework to support observations of the training sessions and analyse the results of two surveys designed to assess the training process and its impact on participants knowledge and skills. 115 participants from 5 Primary Care Networks in London attended the training. Trainers utilised a video of a patient pathway, encouraged discussion of it, and demonstrated the use of evidence-based tools for patient needs assessment and care planning. Participants were encouraged to critique the patient pathway, reflect on their own experiences of planning and providing patient care. 38% of participants completed a pre-training survey, 47% a post-training survey. Significant improvement in knowledge and skills were reported including understanding roles in contributing to MDT working, confidence to speak in MDT meetings, using a range of evidence-based clinical tools for comprehensive assessment and care planning. Greater levels of autonomy, resilience, and support for MDT working were reported. Training proved effective; it could be scaled up and adopted to other settings

Age-related decline in antibiotic prescribing for uncomplicated respiratory tract infections in primary care in England following the introduction of a national financial incentive (the Quality Premium) for health commissioners to reduce use of antibiotics in the community: an interrupted time series analysis

Objectives: To assess the impact of the 2015/16 NHS England Quality Premium (which provided a financial incentive for Clinical Commissioning Groups to reduce antibiotic prescribing in primary care) on antibiotic prescribing by General Practitioners (GPs) for respiratory tract infections (RTIs). Method: Interrupted time series analysis using monthly patient-level consultation and prescribing data obtained from the Clinical Practice Research Datalink (CPRD), between April 2011 and March 2017. The study population comprised patients consulting a GP who were diagnosed with an RTI. We assessed the rate of antibiotic prescribing in patients (both aggregate and stratified by age) with a recorded diagnosis of uncomplicated RTI, before and after the implementation of the Quality Premium. Results: Prescribing rates decreased over the six year study period, with evident seasonality. Notably, there was a 3% drop in the rate of antibiotic prescribing (equating to 14.65 prescriptions per 1,000 RTI consultations) (p<0.05) in April 2015, coinciding with the introduction of the Quality Premium. This reduction was sustained, such that after two years there was a 3% decrease in prescribing relative to that expected had the pre-intervention trend continued. There was also a concurrent 2% relative reduction in the rate of broad-spectrum antibiotic prescribing. Antibiotic prescribing for RTIs diagnosed in children showed the greatest decline with a 6% relative change two years after the intervention. Of the RTI indications studied, the greatest reductions in antibiotic prescribing were seen for patients with sore throats. Conclusions: Community prescribing of antibiotics for RTIs significantly decreased following the introduction of the Quality Premium, with the greatest reduction seen in younger patients

Patient-initiated second medical consultations: patient characteristics and motivating factors, impact on care and satisfaction: A systematic review

Objectives: To review the characteristics and motivations of patients seeking second opinions, and the impact of such opinions on patient management, satisfaction, and cost-effectiveness. Data sources: Embase, Medline, PsycINFO and HMIC databases. Study design: A systematic literature search was performed for terms related to second opinion and patient characteristics. Study quality was assessed using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data collection / Extraction methods: We included articles focused on patient-initiated second opinions, which provided quantitative data on their impact on diagnosis, treatment, prognosis or patient satisfaction, described the characteristics or motivating factors of patients who initiated a second opinion, or the cost-effectiveness of patient-initiated second opinions. Principal findings: Thirty-one articles were included in the review. 27 studies considered patient characteristics, 18 patient motivating factors, 10 patient satisfaction, and 17 clinical agreement between the first and second opinion. Seeking a second opinion was more common in women, middle age patients, more educated patients; and in people having a chronic condition, with higher income or socioeconomic status or living in central urban areas. Patients seeking a second opinion sought to gain more information or reassurance about their diagnosis or treatment. While many second opinions confirm the original diagnosis or treatment, discrepancies in opinions had a potential major impact on patient outcomes in up to 58% of cases. No studies reporting on the cost-effectiveness of patient initiated second opinions. Conclusions: Seeking a second opinion was more common in women, middle-age patients, and more educated patients, and in people having a chronic condition, with higher income or socioeconomic status or living in central urban areas. Patients seeking a second opinion sought to gain more information or reassurance about their diagnosis or treatment

The climate sensitivity of carbon, timber, and species richness covaries with forest age in boreal–temperate North America

Climate change threatens the provisioning of forest ecosystem services and biodiversity (ESB). The climate sensitivity of ESB may vary with forest development from young to old-growth conditions as structure and composition shift over time and space. This study addresses knowledge gaps hindering implementation of adaptive forest management strategies to sustain ESB. We focused on a number of ESB indicators to (a) analyze associations among carbon storage, timber growth rate, and species richness along a forest development gradient; (b) test the sensitivity of these associations to climatic changes; and (c) identify hotspots of climate sensitivity across the boreal–temperate forests of eastern North America. From pre-existing databases and literature, we compiled a unique dataset of 18,507 forest plots. We used a full Bayesian framework to quantify responses of nine ESB indicators. The Bayesian models were used to assess the sensitivity of these indicators and their associations to projected increases in temperature and precipitation. We found the strongest association among the investigated ESB indicators in old forests (\u3e170 years). These forests simultaneously support high levels of carbon storage, timber growth, and species richness. Older forests also exhibit low climate sensitivity of associations among ESB indicators as compared to younger forests. While regions with a currently low combined ESB performance benefitted from climate change, regions with a high ESB performance were particularly vulnerable to climate change. In particular, climate sensitivity was highest east and southeast of the Great Lakes, signaling potential priority areas for adaptive management. Our findings suggest that strategies aimed at enhancing the representation of older forest conditions at landscape scales will help sustain ESB in a changing world