The Knowledge They Possess: Elementary Teachers\u27 Expertise and Where It Becomes Usable Knowledge in the MA Education System

ABSTRACT The Knowledge They Possess: Elementary Teachers’ Expertise and Where It Becomes Usable Knowledge in the Massachusetts Education System February 15, 2018 By Helen-Ann Ireland BA University of New Hampshire MEd Antioch University EdD University of Massachusetts Amherst (pending) Dr. Sharon Rallis, Dissertation Chair Elementary teachers are facing a dilemma. They are expected to uphold the Massachusetts (MA) state mandate and deliver Common Core State Standards (CCSS), use the programs their school has adopted aligned with CCSS and meet the various cognitive and behavioral needs of their students. Sometimes the teachers experience competing commitments between meeting standards, using programs, pacing, scripted curricula, and meeting the immediate needs of their students. How they navigate this dilemma when it occurs and where the classroom teacher’s knowledge become usable knowledge in the MA education system are the two foci of this study. Using Senge’s model of learning organizations and applying it to the MA education system will shed some light on how five elementary teachers use their professional knowledge and autonomy in their classrooms

Professionalism in the pre-registration pharmacist placement: an exploratory stakeholder study

Interest in professionalism within UK healthcare has increased following reports highlighting poor patient care. This, combined with the development of new patient-facing roles for pharmacists, has led to questions about how pharmacists develop professionalism. The pre-registration placement is a key component of the education and training of pharmacists. This is when pre-registration trainees spend 52 weeks in an approved training site under the supervision of an experienced tutor. This study explored how professionalism is understood, developed and assessed during the pre-registration placement from the perspectives of the professional regulator, which is the General Pharmaceutical Council, service users, pre-registration trainees and pre-registration tutors. An interpretative paradigm was adopted, involving a semi-structured interview, focus groups and qualitative e-questionnaire. An active thematic interpretative analysis was used to identify and evaluate patterns and meaning across all data sets. Stakeholders understood professionalism in ways that were dynamic and subjective; a shared definition was elusive. Trainees and tutors provided insights into a series of transformative moments which potentiated professionalism development. The first moment being the issuing of the title pre-registration trainee. All groups reported that emotional connections with patients throughout the placement aided professionalism maturation from a self-centred student to becoming an outwardly looking and responsible professional. Tutors indicated the rate of professionalism development may vary across sectors of pharmacy practice, with community pharmacy facilitating faster professionalism maturation due to increased trainee autonomy. Although no tutors reported that patients formally assessed trainees’ professionalism, service users expected to be involved. This study proposes the existence of transformative moments and maturation periods during in pre-registration training and suggests both are essential to becoming a professional. The study suggests careful planning of training placements to optimise professionalism development across different sectors of practice. Formal and consistent involvement of patients in assessments of trainee’s achievement of professionalism is recommended

Quality in the e-landscape: a collegial and developmental approach

Since the appearance of e-learning in the tertiary education sector a range of approaches have been used to enhance the quality of online learning environments. Building on these approaches, at the University of Western Sydney our approach is one of developing quality e-learning sites in a collegial and developmental manner, as a central part of overall good teaching practice. Our view is that, in order for the process to be truly collegial and developmental, it needs to be supported across all levels of the academic environment and, importantly, it should be adopted by academics rather than being imposed upon them. A central aspect of the collegial and developmental approach is that academics should be provided with the skills and support to be the drivers of quality in the e-landscape. This paper introduces a project that applies this developmental and collegial philosophy to building quality in our online learning environments in a whole of enterprise context

Midwives' competence : is it affected by working in a rural location?

Introduction: Rising health care costs and the need to consolidate expertise in tertiary services have led to the centralisation of services. In the UK, the result has been that many rural maternity units have become midwife-led. A key consideration is that midwives have the skills to competently and confidently provide maternity services in rural areas, which may be geographically isolated and where the midwife may only see a small number of pregnant women each year. Our objective was to compare the views of midwives in rural and urban settings, regarding their competence and confidence with respect to ‘competencies’ identified as being those which all professionals should have in order to provide effective and safe care for low-risk women. Method: This was a comparative questionnaire survey involving a stratified sample of remote and rural maternity units and an ad hoc comparison group of three urban maternity units in Scotland. Questionnaires were sent to 82 midwives working in remote and rural areas and 107 midwives working in urban hospitals with midwife-led units. Results: The response rate from midwives in rural settings was considerably higher (85%) than from midwives in the urban areas (60%). Although the proportion of midwives who reported that they were competent was broadly similar in the two groups, there were some significant differences regarding specific competencies. Midwives in the rural group were more likely to report competence for breech delivery (p = 0.001), while more urban midwives reported competence in skills such as intravenous fluid replacement (p <0.001) and initial and discharge examination of the newborn (p <0.001). Both groups reported facing barriers to continuing professional development; however, more of the rural group had attended an educational event within the last month (p <0.001). Lack of time was a greater barrier for urban midwives (p = 0.02), whereas distance to training was greater for rural midwives (p = 0.009). Lack of motivation or interest was significantly higher in urban units (p = 0.006). Conclusion: It is often assumed that midwives in rural areas where there are fewer deliveries, will be less competent and confident in their practice. Our exploratory study suggests that the issue of competence is far more complex and deserves further attention.NHS Education Scotlan

Microbiological assessment of aerosol generated during debond of fixed orthodontic appliances

Introduction The aims of this study were to describe bacterial load and diversity of the aerosol created during enamel cleanup after the removal of fixed orthodontic appliances and to assess the effect of a preprocedural mouth rinse. Methods The study involved the sampling of ambient air adjacent to the patient's mouth during adhesive removal using a slow-speed handpiece and a spiral fluted tungsten carbide bur without water irrigation. Sampling was carried out during enamel cleanup with or without a preprocedural mouth rinse of either sterile water or chlorhexidine. Airborne particles were collected using a viable inertial impactor simulating the human respiratory tree. The bacteria collected were analyzed using both culture and molecular techniques. Results Bacteria produced during debond and enamel cleanup can reach all levels of the respiratory tree. The use of a preprocedural mouth rinse, either sterile water or chlorhexidine, increased the numbers and diversity of the bacteria in the air. Conclusions When using a slow-speed handpiece and a spiral fluted tungsten carbide bur for enamel cleanup after orthodontic treatment, the bacterial load and diversity of the aerosol produced are lower when a preprocedural mouth rinse is not used.</p

Sustainable Maternity Service Provision in Remote and Rural Areas of Scotland: The scoping of core multidisciplinary skills and exploration of best practice in the development and maintenance of skills - Executive Summary

First paragraph: Health care provision in remote and rural areas of Scotland is a current cause for concern. With respect to maternity services, there are particular issues around falling fertility rates and medical workforce capacity, accompanied by a policy climate that is encouraging further centralisation of acute services. There are important implications for the sustainability of safe, local maternity care if the reduction in geographical access to acute consultant-led obstetric and neonatal services continues

Engaging Gypsy, Roma, and Traveller Communities in research: Maximizing opportunities and overcoming challenges

Gypsy, Roma, and Traveller people are marginalized worldwide and experience severe health inequalities, even in comparison to other ethnic minority groups. While diverse and hard to categorize, these communities are highly cohesive and members have a strong sense of identity as a group apart from the majority population. Researchers commonly experience challenges in accessing, recruiting, and retaining research participants from these communities, linked to their outsider status, insular nature, and history of discrimination. In this article, the challenges and the opportunities of engaging Gypsies, Roma, and Travellers in a multicenter qualitative research project are discussed. The management of public involvement and community engagement in this U.K.-based project provides insights into conducting research effectively with ethnically and linguistically diverse communities, often considered to be “hard to reach.”

An integrated computational-experimental approach reveals Yersinia pestis genes essential across a narrow or a broad range of environmental conditions

Background The World Health Organization has categorized plague as a re-emerging disease and the potential for Yersinia pestis to also be used as a bioweapon makes the identification of new drug targets against this pathogen a priority. Environmental temperature is a key signal which regulates virulence of the bacterium. The bacterium normally grows outside the human host at 28 °C. Therefore, understanding the mechanisms that the bacterium used to adapt to a mammalian host at 37 °C is central to the development of vaccines or drugs for the prevention or treatment of human disease. Results Using a library of over 1 million Y. pestis CO92 random mutants and transposon-directed insertion site sequencing, we identified 530 essential genes when the bacteria were cultured at 28 °C. When the library of mutants was subsequently cultured at 37 °C we identified 19 genes that were essential at 37 °C but not at 28 °C, including genes which encode proteins that play a role in enabling functioning of the type III secretion and in DNA replication and maintenance. Using genome-scale metabolic network reconstruction we showed that growth conditions profoundly influence the physiology of the bacterium, and by combining computational and experimental approaches we were able to identify 54 genes that are essential under a broad range of conditions. Conclusions Using an integrated computational-experimental approach we identify genes which are required for growth at 37 °C and under a broad range of environments may be the best targets for the development of new interventions to prevent or treat plague in humans

Microbiological assessment of aerosol generated during debond of fixed orthodontic appliances

Introduction The aims of this study were to describe bacterial load and diversity of the aerosol created during enamel cleanup after the removal of fixed orthodontic appliances and to assess the effect of a preprocedural mouth rinse. Methods The study involved the sampling of ambient air adjacent to the patient's mouth during adhesive removal using a slow-speed handpiece and a spiral fluted tungsten carbide bur without water irrigation. Sampling was carried out during enamel cleanup with or without a preprocedural mouth rinse of either sterile water or chlorhexidine. Airborne particles were collected using a viable inertial impactor simulating the human respiratory tree. The bacteria collected were analyzed using both culture and molecular techniques. Results Bacteria produced during debond and enamel cleanup can reach all levels of the respiratory tree. The use of a preprocedural mouth rinse, either sterile water or chlorhexidine, increased the numbers and diversity of the bacteria in the air. Conclusions When using a slow-speed handpiece and a spiral fluted tungsten carbide bur for enamel cleanup after orthodontic treatment, the bacterial load and diversity of the aerosol produced are lower when a preprocedural mouth rinse is not used.</p

Identifying interventions with Gypsies, Roma and Travellers to promote immunisation uptake: methodological approach and findings

Background: In the UK, Gypsy, Roma and Traveller (GRT) communities are generally considered to be at risk of low or variable immunisation uptake. Many strategies to increase uptake for the general population are relevant for GRT communities, however additional approaches may also be required, and importantly one cannot assume that “one size fits all”. Robust methods are needed to identify content and methods of delivery that are likely to be acceptable, feasible, effective and cost effective. In this paper, we describe the approach taken to identify potential interventions to increase uptake of immunisations in six GRT communities in four UK cities; and present the list of prioritised interventions that emerged.Methods: This work was conducted in three stages: (1) a modified intervention mapping process to identify ideas for potential interventions; (2) a two-step prioritisation activity at workshops with 51 GRTs and 25 Service Providers to agree a prioritised list of potentially feasible and acceptable interventions for each community; (3) crosscommunity synthesis to produce a final list of interventions. The theoretical framework underpinning the study was the Social Ecological Model.Results: Five priority interventions were agreed across communities and Service Providers to improve the uptake of immunisation amongst GRTs who are housed or settled on an authorised site. These interventions are all at the Institutional (e.g. cultural competence training) and Policy (e.g. protected funding) levels of the Social Ecological Model.Conclusions: The “upstream” nature of the five interventions reinforces the key role of GP practices, frontline workers and wider NHS systems on improving immunisation uptake. All five interventions have potentially broader applicability than GRTs. We believe that their impact would be enhanced if delivered as a combined package. The robust intervention development and co production methods described could usefully be applied to other communities where poor uptake of immunisation is a concern