Comprehensive School Reform: A Study on the Effectiveness of the High Schools That Work Program in Texas

This mixed methods, sequential explanatory research study evaluated the effectiveness of a comprehensive school reform program titled High Schools That Work (HSTW). High schools were tasked with having students meet passing standards on high-stakes assessments or face sanctions. This study was necessary because, as Herman et al. (2008) said, “unfortunately, the research base on effective strategies for quickly turning around low-performing schools is sparse” (p. 4). Quantitative and qualitative data were collected to determine if schools improved after the HSTW program was implemented. First, Academic Excellence Indicator System reports on Texas HSTW program schools were downloaded from the Texas Education Agency’s website. At least 3 consecutive years of data from 2005–2012 was needed. Demographic and performance data were used to determine which schools to include. Second, administrator and teacher surveys were distributed online to participants. Third, a basic interpretive and descriptive qualitative study was conducted in which 5 administrators were interviewed regarding HSTW experiences. Data from all 3 sources were linked and conclusions were drawn about HSTW implementation and its impact on students’ academic performance. Results from the study yielded positive results for the HSTW program. On average, 10th grade students’ academic performance improved in the areas of English language arts (ELA) and mathematics for all students and for subpopulations in Year 5 after implementation. Limited English proficient and economically disadvantaged subpopulations’ scores improved, but the special education subpopulation demonstrated the greatest increase. 6 of 10 HSTW key components assessed from surveying administrators and teachers included guidance, keeping score, teachers working together, academic studies, program of study, work-based learning, and students actively engaged. Administrators, teachers, and parents were committed to implementing HSTW. High levels of collaboration with peers and tri-level support (school administrators, district administrators, and HSTW staff) resulted in increased buy-in. 5 administrators were interviewed and the following themes emerged: implementation, support for implementation, change culture, structure and preplanning, monitoring and feedback, and data gathering. 4 of 5 administrators had positive experiences with implementing HSTW. Responses from interviews were similar to survey responses indicating that a high level of support and collaboration was instrumental in program effectiveness. Connecting themes revealed convergent patterns that emerged from collecting multiple forms of data. Results suggested that HSTW was an effective comprehensive school reform when implemented with fidelity. HSTW was most successful in closing achievement gaps between special education students’ average assessment scores and all students’ scores. Administrators and teachers collaborated and received tri-level support creating experiences that led to commitment to the program. Relationships fostered buy-in to implementing the program, inevitably leading to program success. Replicating the current study is feasible for evaluating the effectiveness of other Comprehensive School Reform programs

A Critique of the Adverse Childhood Experiences Framework in Epidemiology and Public Health: Uses and Misuses

International audienceAdverse childhood experiences (ACEs) have emerged as a major research theme. They make reference to an array of potentially harmful exposures occurring from birth to eighteen years of age and may be involved in the construction of health inequalities over the lifecourse. As with many simplified concepts, ACEs present limitations. They include diverse types of exposures, are often considered cumulatively, can be identified using prospective and retrospective approaches, and their multidimensional nature may lead to greater measurement error. From a public health perspective, ACEs are useful for describing the need to act upon complex social environments to prevent health inequalities at a population level. As the ACEs concept becomes popular in the context of policy interventions, concerns have emerged. As a probabilistic and population-level tool, it is not adapted to diagnose individual-level vulnerabilities, an approach which could ultimately exacerbate inequalities. Here, we present a critique of the ACEs framework, discussing its strengths and limits

Post-Separation Parenting Apps in the Context of Family Violence: Harm Minimisation versus Harm Facilitation

Post-separation parenting apps are designed for separated parents to use as a dedicated space for child-related communication and organisation. Their enhanced record-keeping features often lead to recommendations for their use within the context of family law and they are likely to appeal to victim/survivors of family violence. However, concerns have also been raised about their potential misuse by perpetrating parents. Using responses to an online survey about post-separation parenting apps, this study explores the tension between the harms and benefits of app use under these circumstances. Data were examined from 33 mothers who reported experiencing family violence via parenting apps. Comparative methods were used to contrast those who endorsed beneficial outcomes from app use with those whose outcomes were detrimental (net-benefit case group [n = 24] vs net-detriment case group [n = 9], respectively). Overall, mothers in the net-benefit case group reported a shorter time since separation (M = 3 years) and fewer experiences of app misuse by the other parent. For these mothers, apps worked to minimise harmful perpetrator conduct by deterring and/or capturing abusive behaviours and affording containment and boundary setting around interactions. By contrast, those in the net-detriment case group were separated longer (M = 6.9 years) and reported a higher incidence of app misuse and fear. These participants experienced a range of app-facilitated harms centred on perpetrators’ false narratives and manipulation. These results suggests that while post-separation parenting apps may be useful harm-minimisation tools for many victim/survivors of post-separation family violence, they are not a panacea for parenting communication in all such contexts – particularly where there is entrenched coercive control

How do party leaders present themselves on social media? The race for premiership in Western Canadian elections 2011 - 2017

Voters have partisan and gendered expectations of candidates, and literature suggests that candidates will shape their campaigns to have wide appeal. It’s reasonable to expect that these decisions will extend beyond the “traditional” campaign to their social media presence, but we really do not know. I ask if candidates conform to traditional gendered stereotypes and how their self-presentation on social media is influenced by party label, sex, and electoral timeframe. I assess Twitter feeds of party leaders seeking the premiership in western Canadian elections. I analyze the use of gendered language in tweets to determine how, and in what ways, stereotypical norms impact a leaders’ self-presentation. My findings reveal that sex, party and time have an impact on tweets to varying degrees; with party label and time having the strongest overall effect. This analysis breaks down some complexities of self-presentation, furthering the dialogue around gender presentation in the political arena

Impact of interprofessional education about psychological and medical comorbidities on practitioners’ knowledge and collaborative practice: mixed method evaluation of a national program

BACKGROUND Many patients with chronic physical illnesses have co-morbid psychological illnesses, which may respond to interprofessional collaborative care. Continuing education programs frequently focus on skills and knowledge relevant for individual illnesses, and unidisciplinary care. This study evaluates the impact of “Mind the Gap”, an Australian interprofessional continuing education program about management of dual illnesses, on practitioners’ knowledge, use of psychological strategies and collaborative practice. METHODS A 6-h module addressing knowledge and skills needed for patients with physical and psychological co-morbid illnesses was delivered to 837 practitioners from mixed health professional backgrounds, through locally-facilitated workshops at 45 Australian sites. We conducted a mixed-methods evaluation, incorporating observation, surveys and network analysis using data collected, before, immediately after, and three months after training. RESULTS Six hundred forty-five participants enrolled in the evaluation (58 % GPs, 17 % nurses, 15 % mental health professionals, response rate 76 %). Participants’ knowledge and confidence to manage patients with psychological and physical illnesses improved immediately. Among the subset surveyed at three months (response rate 24 %), referral networks had increased across seven disciplines, improvements in confidence and knowledge were sustained, and doctors, but no other disciplines, reported an increase in use of motivational interviewing (85.9 % to 96.8 %) and mindfulness (58.6 % to 74 %). CONCLUSIONS Interprofessional workshops had an immediate impact on the stated knowledge and confidence of participants to manage patients with physical and psychological comorbidities, which appears to have been sustained. For some attendees, there was a sustained improvement in the size of their referral networks and their use of some psychological strategies.This project was funded by the Australian Medicare Local Alliance, through a grant from the Department of Veterans Affairs

Big Data and the Study of Social Inequalities in Health: Expectations and Issues

Understanding the construction of the social gradient in health is a major challenge in the field of social epidemiology, a branch of epidemiology that seeks to understand how society and its different forms of organization influence health at a population level. Attempting to answer these questions involves large datasets of varied heterogeneous data suggesting that Big Data approaches could be then particularly relevant to the study of social inequalities in health. Nevertheless, real challenges have to be addressed in order to make the best use of the development of Big Data in health for the benefit of all. The main purpose of this perspective is to discuss some of these challenges, in particular: (i) the perimeter and the particularity of Big Data in health, which must be broader than a vision centerd solely on care, the individual and his or her biological characteristics; (ii) the need for clarification regarding the notion of data, the validity of data and the question of causal inference for various actors involved in health, such data as researchers, health professionals and the civilian population; (iii) the need for regulation and control of data and their uses by public authorities for the common good and the fight against social inequalities in health. To face these issues, it seems essential to integrate different approaches into a close dialog, integrating methodological, societal, and ethical issues. This question cannot escape an interdisciplinary approach, including users or patients

A qualitative study identifying the key components of independent midwifery practice in mainland UK.

Independent Midwives provide relational continuity of care whilst promoting women’s autonomy. They report associated high levels of physiological birth and positive outcomes for women and babies and low levels of interventions (Milan 2004). Since the publication of the Changing Childbirth Report (Department of Health 1993) it has been government policy for these components of care to be incorporated into national maternity services to facilitate higher quality of care, although this policy has as yet to be widely implemented in the United Kingdom (UK). The Better Births report (National Maternity Review 2016) has most recently reiterated the need for the inclusion of these components into maternity care in England as a measure to improve care. In Scotland, The Best Start: five-year plan for maternity and neonatal care (Scottish Government 2017) sets out their strategy for improving maternity care based on a commitment to provide individualised continuity of care to mothers and babies. The Welsh strategic vision for maternity services (Welsh Government 2011) is less specific, broadly describing respectful care in which the mother and family are the focus. Whilst continuity of care and supporting women’s choices are commonly known attributes of independent midwifery care there is little knowledge about the full gamut of this type of practice. Aims and objectives: The overall aim of this study was to advance knowledge about the practice of Independent Midwives working in Mainland UK. The objective was to explore Independent Midwives’ perceptions and experiences of independent midwifery, through in-depth interviews, and to gain an overarching understanding of what is involved in working independently and providing care for clients. Through this exploration the intention was to identify and understand the essential components of a way of practising midwifery which reportedly work well for both mothers and midwives. Research design: This study took a qualitative approach, drawing on the principles of constructivist grounded theory methodology and used semi-structured, in-depth interviews to generate the data. With the participants’ consent each interview was digitally recorded, transcribed and then analysed using a constant comparative method. Participants: Eight Independent Midwives were recruited from across Mainland UK using purposive and then theoretical sampling techniques. Ethical approval was gained from the Bournemouth University Human Ethics Committee. Findings: Five categories were identified as being key components of the independent midwifery model of care: professional autonomy, time, mother-centred care, knowledge, evidence and practice, and midwifery philosophy. Conclusions and key recommendations: Professional autonomy is a vital component of independent midwifery practice, enabling Independent Midwives to practise in ways which best serve their clients. They are free to choose how they can best practice in particular circumstances, and importantly, how they apportion their time. Providing continuity of care through caseloading facilitates the establishment of mother-midwife relationships and results in a sustainable work-life balance for the midwives. Time is a critical factor in providing high-quality care. Independent Midwives allot substantial amounts of time to working with their clients and developing their practice, both of which are associated with safer care and better outcomes. The development of mother-midwife relationships results in individualised care and consequently safer care and better outcomes. Independent Midwives’ use of a continuum of evidence enables them to incorporate a range of information into the care they provide which caters to the individual needs of the client, resulting in safer care. The midwives’ philosophy of normality guides their practice, enabling them to promote health and physiological processes and avoid interventions. The Independent Midwives’ model of care provides mother-centred relational continuity of care in the context of the woman’s choices, through a caseloading scheme, as recommended by current government policy for maternity services. This exemplar can be used to assist service providers implement government policy recommendations for maternity care. A systems-level change is required to enable all midwives to move from providing fragmented care, to providing individualised, relational continuity of care. Midwives need to have greater professional autonomy and more time, in order to effectively provide this type of care. Maternity services need to focus on normality throughout the pregnancy continuum because it promotes health and physiological processes and reduces the use of interventions

Assessing victim risk in cases of violent crime

Purpose: There is a body of evidence that suggests a range of psychosocial characteristics demarcate certain adults to be at an elevated risk for victimisation. To this end, the aim of the current study was to examine consistency between one police force, and a corresponding victim support service based in England, in their assessment of level of risk faced by victims of violent crime. Methodology: This study explored matched data on 869 adult victims of violent crime gathered from these two key services in Preston, namely Lancashire Constabulary and Victim Support, from which a sub-group of comparable ‘domestic violence’ cases (n=211) were selected for further examination. Findings: Data analyses revealed methodological inconsistencies in the assessment of victimisation resulting in discrepancies for recorded levels of risk in domestic violence cases across these two agencies. Practical implications: These findings provide a compelling argument for developing a more uniformed approach to victim assessment and indicate a significant training need. Value: This paper highlights areas of good practice and forwards several recommendations for improved practice that emphasises the integration of empirical research conducted by psychologists to boost the validity and reliability of risk assessment approaches and tools used

Emerging Developments in Microbiome and Microglia Research: Implications for Neurodevelopmental Disorders

From immunology to neuroscience, interactions between the microbiome and host are increasingly appreciated as potent drivers of health and disease. Epidemiological studies previously identified compelling correlations between perinatal microbiome insults and neurobehavioral outcomes, the mechanistic details of which are just beginning to take shape thanks to germ-free and antibiotics-based animal models. This review summarizes parallel developments from clinical and preclinical research that suggest neuroactive roles for gut bacteria and their metabolites. We also examine the nascent field of microbiome-microglia crosstalk research, which includes pharmacological and genetic strategies to inform functional capabilities of microglia in response to microbial programming. Finally, we address an emerging hypothesis behind neurodevelopmental disorders, which implicates microbiome dysbiosis in the atypical programming of neuroimmune cells, namely microglia