What Makes an Effective Early Childhood Parenting Programme: a Systematic Review of Reviews and Meta analyses

The widely acknowledged importance of educating parents in children's early years has led to a substantial number of parenting programmes aimed at various aspects of early childhood care and education (ECEC). A vast amount of research has been conducted to evaluate the effectiveness of existing parenting programmes. By synthesising the research evidence, this study seeks to address the questions of whether early childhood parenting programmes are effective in improving parenting and enhancing children's development; and which factors of the programme design and implementation contribute to the successful outcomes of parenting programmes. A systematic search of bibliographic databases for reviews and meta-analyses of existing early childhood parenting programmes in the past ten years (2010-2020) was conducted through ProQuest, Ovid and EBSCOhost. Forty-seven review studies are eligible for inclusion. A thematic approach is adopted to synthesise the findings of reviews and meta-analyses. Overall, short-term positive effects on the various parent outcomes measured by the programmes have been reported with small to medium effect size across reviews. But the positive programme effects on parents do not guarantee improvement in children's development as mixed results are reported regarding the children's outcomes. Evidence of long-term effects has been far from conclusive due to the paucity of empirical research as well as the inconsistent results within the existing literature, suggesting more studies are needed to address this gap. Evidence of programme effectiveness is discussed with reference to theoretical frameworks, programme length/intensity, delivery modes, family-centred approach (incl., father-inclusiveness) and cultural adaptation. Based on the research evidence, a list of practical suggestions is proposed in order to improve the design, implementation and evaluation of early childhood parenting programmes

Beyond the team: understanding interprofessional work in two North American ICUs

OBJECTIVE: To examine the ways in which healthcare professionals work together in the ICU setting, through a consideration of the contextual, organizational, processual, and relational factors that impact their interprofessional collaboration. DESIGN: Data from over 350 hours of ethnographic observation and 35 semistructured interviews with clinicians in two ICUs were collected by two medical anthropologists over a period of 6 months. SETTING: Medical surgical ICUs in two urban research hospitals in Canada and the United States. MAIN RESULTS: Although the concept of teamwork is often central to interventions to improve patient safety in the ICU, our observations suggest that this concept does not fully describe how interprofessional work actually occurs in this setting. With the exception of crisis situations, most interprofessional interactions in the two ICUs we studied could be better described as forms of interprofessional work other than teamwork, which include collaboration, coordination, and networking. CONCLUSIONS: A singular notion of team is too reductive to account for the ways in which work happens in the ICU and therefore cannot be taken for granted in quality improvement initiatives or among healthcare professionals in this setting. Adapting -interventions to the complex nature of interprofessional work and each ICUs unique local context is an important and necessary step to ensure the delivery of safe and effective patient care

A sociological exploration of the tensions related to interprofessional collaboration in acute-care discharge planning

Patient discharge is a key concern in hospitals, particularly in acute care, given the multifaceted and challenging nature of patients' healthcare needs. Policies on discharge have identified the importance of interprofessional collaboration, yet research has described its limitations in this clinical context. This study aimed to extend our understanding of interprofessional interactions related to discharge in a general internal medicine setting by using sociological theories to illuminate the existence of, and interplay between, structural factors and microlevel practices. An ethnographic approach was employed to obtain an in-depth insight into healthcare providers' perspectives, behaviours, and interactions regarding discharge. Data collection involved observations, interviews, and document analysis. Approximately 65 hours of observations were undertaken, 23 interviews were conducted with healthcare providers, and government and hospital discharge documents were collected. Data were analysed using a directed content approach. The findings indicate the existence of a medically dominated division of healthcare labour in patient discharge with opportunities for some interprofessional negotiations; the role of organizational routines in facilitating and challenging interprofessional negotiations in patient discharge; and tensions in organizational priorities that impact an interprofessional approach to discharge. The findings provide insight into the various levels at which interventions can be targeted to improve interprofessional collaboration in discharge while recognizing the organizational tensions that challenge an interprofessional approach

Physical education as Olympic education

Introduction In a recent paper (Parry, 1998, p. 64), I argued that the justification of PE activities lies in their capacity to facilitate the development of certain human excellences of a valued kind. Of course, the problem now lies in specifying those ‘human excellences of a valued kind’, and (for anyone) this task leads us into the area of philosophical anthropology. I suggested that the way forward for Physical Education lies in the philosophical anthropology (and the ethical ideals) of Olympism, which provide a specification of a variety of human values and excellences which: •have been attractive to human groups over an impressive span of time and space •have contributed massively to our historically developed conceptions of ourselves •have helped to develop a range of artistic and cultural conceptions that have defined Western culture. •have produced a range of physical activities that have been found universally satisfying and challenging. Although physical activities are widely considered to be pleasurable, their likelihood of gaining wide acceptance lies rather in their intrinsic value, which transcends the simply hedonic or relative good. Their ability to furnish us with pleasurable experiences depends upon our prior recognition in them of opportunities for the development and expression of valued human excellences. They are widely considered to be such opportunities for the expression of valued human excellences because, even when as local instantiations, their object is to challenge our common human propensities and abilities. I claimed that Olympic ideals may be seen not merely as inert ‘ideals’, but living ideas which have the power to remake our notions of sport in education, seeing sport not as mere physical activity but as the cultural and developmental activity of an aspiring, achieving, well-balanced, educated and ethical individual. This paper seeks to make good that claim by trying to develop a case for Physical Education as Olympic Education. I begin by setting out various accounts and conceptions of the Olympic Idea; then I suggest a unifying and organising account of the philosophical anthropology of Olympism; and this is followed by the practical application of that account in two examples of current ethical issues. Finally, I seek to present an account of Physical Education as Olympic Education

Preventing the Selection of "Deaf Embryos" Under the Human Fertilisation and Embryology Act 2008:Problematizing Disability?

Section 14(4) of the Human Fertilisation and Embryology Act 2008 imposes – within the general licensing conditions listed in the Human Fertilisation and Embryology Act 1990 – a prohibition to prevent the selection and implantation of embryos for the purpose of creating a child who will be born with a “serious disability.” This article offers a perspective that demonstrates the problematic nature of the consultation, review, and legislative reform process surrounding s 14(4). The term “serious disability” is not defined within the legislation, but we highlight the fact that s 14(4) was passed with the case of selecting deaf children in mind. We consider some of the literature on the topic of disability and deafness, which, we think, casts some doubt on the view that deafness is a “serious disability.” The main position we advance is that the lack of serious engagement with alternative viewpoints during the legislative process was unsatisfactory. We argue that the contested nature of deafness necessitates a more robust consultation process and a clearer explanation and defence of the normative position that underpins s 14(4)

Why don't hospital staff activate the rapid response system (RRS)? How frequently is it needed and can the process be improved?

Abstract Background The rapid response system (RRS) is a process of accessing help for health professionals when a patient under their care becomes severely ill. Recent studies and meta-analyses show a reduction in cardiac arrests by a one-third in hospitals that have introduced a rapid response team, although the effect on overall hospital mortality is less clear. It has been suggested that the difficulty in establishing the benefit of the RRS has been due to implementation difficulties and a reluctance of clinical staff to call for additional help. This assertion is supported by the observation that patients continue to have poor outcomes in our institution despite an established RRS being available. In many of these cases, the patient is often unstable for many hours or days without help being sought. These poor outcomes are often discovered in an ad hoc fashion, and the real numbers of patients who may benefit from the RRS is currently unknown. This study has been designed to answer three key questions to improve the RRS: estimate the scope of the problem in terms of numbers of patients requiring activation of the RRS; determine cognitive and socio-cultural barriers to calling the Rapid Response Team; and design and implement solutions to address the effectiveness of the RRS. Methods The extent of the problem will be addressed by establishing the incidence of patients who meet abnormal physiological criteria, as determined from a point prevalence investigation conducted across four hospitals. Follow-up review will determine if these patients subsequently require intensive care unit or critical care intervention. This study will be grounded in both cognitive and socio-cultural theoretical frameworks. The cognitive model of situation awareness will be used to determine psychological barriers to RRS activation, and socio-cultural models of interprofessional practice will be triangulated to inform further investigation. A multi-modal approach will be taken using reviews of clinical notes, structured interviews, and focus groups. Interventions will be designed using a human factors analysis approach. Ongoing surveillance of adverse outcomes and surveys of the safety climate in the clinical areas piloting the interventions will occur before and after implementation