Exploration of implementation variables impacting trauma informed practices in schools: A narrative review

Current literature suggests that by using trauma- informed practices (TIP) in our schools and classrooms, positive short and long-term outcomes can be achieved for both children and their communities. However, there is little research identifying what helps or hinders the implementation of trauma-informed practice in schools or the development of a practitioner’s trauma-informed pedagogy. As part of this narrative review, 25 trauma- informed practice implementation variables were identified from 34 peer-reviewed works of current (2015-2020) literature using a process of thematic analysis. This review utilised an ecological model as an overlay to present these variables in a useable format. The results of this research may be utilised to identify unaddressed implementation variables that support practice change and TIP in schools. The literature and this review support the idea that, if given the right input, conditions and setting events, an effective trauma-informed practice or pedagogy can be developed. Furthermore, by helping practitioners fill the gaps in their knowledge and assisting them to develop their trauma-informed pedagogy, they are able to create an environment where students who have experienced complex trauma may be healthy, safe, engaged, and supported

Exploration of implementation variables impacting trauma informed practices in schools: A narrative review

Current literature suggests that by using trauma- informed practices (TIP) in our schools and classrooms, positive short and long-term outcomes can be achieved for both children and their communities. However, there is little research identifying what helps or hinders the implementation of trauma-informed practice in schools or the development of a practitioner’s trauma-informed pedagogy. As part of this narrative review, 25 trauma- informed practice implementation variables were identified from 34 peer-reviewed works of current (2015-2020) literature using a process of thematic analysis. This review utilised an ecological model as an overlay to present these variables in a useable format. The results of this research may be utilised to identify unaddressed implementation variables that support practice change and TIP in schools. The literature and this review support the idea that, if given the right input, conditions and setting events, an effective trauma-informed practice or pedagogy can be developed. Furthermore, by helping practitioners fill the gaps in their knowledge and assisting them to develop their trauma-informed pedagogy, they are able to create an environment where students who have experienced complex trauma may be healthy, safe, engaged, and supported

An fMRI investigation of moral cognition in healthcare decision making

This study used fMRI to investigate the neural substrates of moral cognition in health resource allocation decision problems. In particular, it investigated the cognitive and emotional processes that underpin utilitarian approaches to health care rationing such as Quality Adjusted Life Years (QALYs). Participants viewed hypothetical medical and nonmedical resource allocation scenarios which described equal or unequal allocation of resources to different groups. In addition, participants were assigned to 1 of 2 treatments in which they either did or did not receive advanced instructions about the principles of utilitarianism. In all cases, participants were asked to judged the proposed allocations as “fair” or “unfair.” More brain activity was observed within the superior parietal lobe, angular gyrus, middle temporal gyrus, and bilateral caudate nucleus when participants viewed scenarios depicting equal divisions of resources. Conversely, unequal resource divisions were associated with more activity in the inferior frontal gyrus and insula cortex. Furthermore, instructions about the principles of utilitarianism led to significant activation differences within the inferior frontal gyrus and the middle frontal gyrus. Significant differences in activity were also found within the inferior frontal cortex and anterior insula between medical and nonmedical scenarios. The implications for cognitive control mechanisms and the cognitive and neural bases of utilitarian ethical judgment are discussed

Steps towards evidence-based foot-care for children:behaviour and opinions of health professionals

Allied health professionals (AHPs) working with children need the appropriate knowledge, skills and experiences to provide high-quality care. This includes using research to drive improvements in care and ensuring that knowledge and practices are consistent and build upon the best available evidence. The aim of this work was to understand more about the shared behaviours and opinions of health professionals supporting children's foot health care; how they find information that is both relevant to their clinical practice as well as informing the advice they share. A qualitative design using semi-structured, one-to-one, telephone interviews with AHPs was adopted. Thematic analysis was used to generate meaning, identify patterns and develop themes from the data. Eight interviews were conducted with physiotherapists, podiatrists and orthotists. Five themes were identified relating to health professionals: (a) Engaging with research; (b) Power of experience; (c) Influence of children's footwear companies; (d). Dr Google - the new expert and (e) Referral pathways for children's foot care. The findings indicate that the AHPs adopted a number of strategies to develop and inform their own professional knowledge and clinical practice. There could be barriers to accessing information, particularly in areas where there is limited understanding or gaps in research. The availability of online foot health information was inconsistent and could impact on how AHPs were able to engage with parents during consultations. [Abstract copyright: © 2020 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.