The ideal healthcare: priorities of people with chronic conditions and their carers

Background It is well established that health consumer opinions should be considered in the design, delivery, and evaluation of health services. However, the opinions of people with chronic conditions and their carers and what they actually consider as ideal healthcare is limited. The aim of this study is to investigate the healthcare priorities of consumers with chronic conditions and their carers, if there are differences between these two groups, and if priorities differ depending on geographical location. Methods The nominal group technique was used as a method to identify what is currently important to, or valued by, participants. This method was also particularly suited to learning about healthcare problems and generating important solutions, thereby helping to bridge the gap between research and policy. Recruitment was carried out via purposive sampling, with the assistance of community pharmacies, general practices, various health agencies, government and non-government organisations. A total of 11 nominal groups were conducted; five groups consisted predominantly of consumers (n = 33 participants), two groups consisted predominantly of carers (n = 12 participants) and four were mixed groups, i.e. consumers, carers, and both (n = 26 participants). Results The findings suggested that to create a model of ideal healthcare for people with chronic conditions and their carers, appropriate and timely healthcare access was of paramount importance. Continuity and coordinated care, patient-centred care and affordability were equally the second most important healthcare priorities for all groups. When compared with other groups, access was discussed more frequently among participants residing in the rural area of Mount Isa. Compared to consumers, carers also discussed priorities that were more reminiscent with their caring roles, such as increased access and continuity and coordinated care. Conclusions Access to healthcare is the most important priority for people with chronic conditions and their carers. In the event of inappropriate access for certain groups, all other efforts to increase the quality of healthcare delivery, e.g. patient-centred care, may be pointless. However, health professionals alone may be limited in their ability to address the concerns related to healthcare access; structural changes by health policy makers may be needed

Anatomy of the online dating romance scam

The Online Dating Romance Scam is a relatively new form of online fraud. This article draws from three qualitative studies: an analysis of posts from a public online support group, in-depth interviews with victims of this crime and an interview with a Serious Organised Crime Agency officer to outline the anatomy of this scam. It is argued here that there are five distinct stages of this crime. In Stage 1, the criminal creates an attractive profile to draw in the victim; in Stage 2, the criminal grooms the victim, priming them to send money; in Stage 3, the criminal begins to request funds from the victim (there a four potential trajectories at this stage); in Stage 4, which only a few went through, the victim is sexually abused via cybersex; and finally Stage 5 is the revelation. Understanding the anatomy of this scam is important for prevention as well as psychological treatment

Internet self-efficacy does not predict student use of Internet-mediated educational technology

Two studies tested the hypothesis that use of learning technologies among undergraduate psychology students was associated with higher Internet self-efficacy (ISE). In Study 1, the ISE scores of 86 students were found not to be associated with either attitudes towards, or measured use of, blogs and wikis as part of an IT skills course. ISE was associated with time spent online, and positive attitudes to wikis were associated with higher use. Study 2 measured 163 students’ ISE scores at the beginning and end of the same course. ISE was again not correlated with attitudes towards, or actual measured use of, learning technologies used in the course. However, ISE was shown to increase during the course. Positive attitudes towards wikis and discussion boards were associated with higher use of each. Overall, ISE scores did not influence measured use of a Virtual Learning Environment (VLE, including blogs, wikis and a discussion board), or attitudes towards those technologies. This implies that while ISE is linked to aspects of online behaviour (time spent online) and can be modified by online activity or training, it does not predict student use of educational Internet technologies

On the making and taking of professionalism in the further education workplace

This paper examines the changing nature of professional practice in English further education. At a time when neo-liberal reform has significantly impacted on this under-researched and over-market-tested sector, little is known about who its practitioners are and how they construct meaning in their work. Sociological interest in the field has tended to focus on further education practitioners as either the subjects of market and managerial reform or as creative agents operating within the contradictions of audit and inspection cultures. In challenging such dualism, which is reflective of wider sociological thinking, the paper examines the ways in which agency and structure combine to produce a more transformative conception of the further education professional. The approach contrasts with a prevailing policy discourse that seeks to re-professionalise and modernise further education practice without interrogating either the terms of its professionalism or the neo-liberal practices in which it resides

A Systematic Review Comparing the Acceptability, Validity and Concordance of Discrete Choice Experiments and Best–Worst Scaling for Eliciting Preferences in Healthcare

Objective: The aim of this study was to compare the acceptability, validity and concordance of discrete choice experiment (DCE) and best–worst scaling (BWS) stated preference approaches in health. Methods: A systematic search of EMBASE, Medline, AMED, PubMed, CINAHL, Cochrane Library and EconLit databases was undertaken in October to December 2016 without date restriction. Studies were included if they were published in English, presented empirical data related to the administration or findings of traditional format DCE and object-, profile- or multiprofile-case BWS, and were related to health. Study quality was assessed using the PREFS checklist. Results: Fourteen articles describing 12 studies were included, comparing DCE with profile-case BWS (9 studies), DCE and multiprofile-case BWS (1 study), and profile- and multiprofile-case BWS (2 studies). Although limited and inconsistent, the balance of evidence suggests that preferences derived from DCE and profile-case BWS may not be concordant, regardless of the decision context. Preferences estimated from DCE and multiprofile-case BWS may be concordant (single study). Profile- and multiprofile-case BWS appear more statistically efficient than DCE, but no evidence is available to suggest they have a greater response efficiency. Little evidence suggests superior validity for one format over another. Participant acceptability may favour DCE, which had a lower self-reported task difficulty and was preferred over profile-case BWS in a priority setting but not necessarily in other decision contexts. Conclusion: DCE and profile-case BWS may be of equal validity but give different preference estimates regardless of the health context; thus, they may be measuring different constructs. Therefore, choice between methods is likely to be based on normative considerations related to coherence with theoretical frameworks and on pragmatic considerations related to ease of data collection

Diluting education? An ethnographic study of change in an Australian Ministry of Education

This ethnographic study captures the processes that led to change in an Australian public education system. The changes were driven by strong neo-liberal discourses which resulted in a shift from a shared understanding about leading educational change in schools by knowledge transfer to managing educational change as a process, in other words, allowing the schools to decide how to change. Inside an Australian state education bureaucracy at a time when the organisation was restructured and services decentralised, this study helps show some of the disturbing trends resulting from the further entrenchment of neo-liberal strategies. Although control was re-centralised by legitimising performance mechanisms, in the form of national testing, there are indications that the focus on national tests may have alarming consequences for the content and context of education. I argue that the complexities of learning and fundamental pedagogies are being lost in preference for an over reliance on data systems that are based on a shallow and narrow set of standardised measures

To what extent is behaviour a problem in English schools?:Exploring the scale and prevalence of deficits in classroom climate

The working atmosphere in the classroom is an important variable in the process of education in schools, with several studies suggesting that classroom climate is an important influence on pupil attainment. There are wide differences in the extent to which classroom climate is considered to be a problem in English schools. Some ‘official’ reports suggest that behaviour in schools is ‘satisfactory or better’ in the vast majority of schools; other sources have pointed to behaviour being a serious and widespread problem. The paper details four studies conducted over the past decade which aimed to explore these disparities. The aim of the research was to gain a more accurate insight into the extent to which deficits in classroom climate limit educational attainment and equality of educational opportunity in English schools. The findings question the suggestion that behaviour is satisfactory or better in 99.7% of English schools and the concluding section suggests ways in which deficits in classroom climate might be addressed. Although the study is limited to classrooms in England, OECD studies suggest that deficits in the working atmosphere in classrooms occur in many countries. The study therefore has potential relevance for education systems in other countries

Spatial and Temporal Variations in SO2 and PM2.5 Levels from 2007-2018 K¯ılauea Volcano, Hawai‘i Liu E, Schmidt A, Roberts T, Pfeffer M, Brooks B, Mather T, et al. Frontiers in Earth Science

Among the hazards posed by volcanoes are the emissions of gases and particles that can affect air quality and damage agriculture and infrastructure. A recent intense episode of volcanic degassing associated with severe impacts on air quality accompanied the 2018 Lower East Rift Zone (LERZ) eruption of K¯ılauea volcano, Hawai‘i. This resulted in a major increase in gas emission rates with respect to usual emission values for this volcano, along with a shift in the source of the dominant plume to a populated area in the lower flank of the volcano. This led to reduced air quality in downwind communities. We analyse open-access data from the permanent air quality monitoring networks operated by the Hawai‘i Department of Health (HDOH) and National Park Service (NPS), and report on measurements of atmospheric sulfur dioxide (SO2) between 2007 - 2018 and PM2.5 (aerosol particulate matter with diameter <2.5 μm) between 2010 - 2018. Additional air quality data were collected through a community-operated network of low-cost PM2.5 sensors during the 2018 LERZ eruption. From 2007 - 2018 the two most significant escalations in K¯ılauea’s volcanic emissions were: the summit eruption that began in 2008 (K¯ılauea emissions averaged 5 - 6 kt/day SO2 from 2008 until summit activity decreased in May 2018) and the LERZ eruption in 2018 when SO2 emission rates reached a monthly average of 200 kt/day during June. In this paper we focus on characterising the airborne pollutants arising from the 2018 LERZ eruption and the spatial distribution and severity of volcanic air pollution events across the Island of Hawai‘i. The LERZ eruption caused the most frequent and severe exceedances of the Environmental Protection Agency (EPA) PM2.5 air quality threshold (35 μg/m3 as a daily average) in Hawai‘i in the period 2010 - 2018. In Kona, for example, the maximum 24-hour-mean mass concentration of PM2.5 was recorded as 59 μg/m3 on the twenty-ninth of May 2018, which was one of eight recorded exceedances of the EPA air quality threshold during the 2018 LERZ eruption, where there had been no exceedances in the previous eight years as measured by the HDOH and NPS networks. SO2 air pollution during the LERZ eruption was most severe in communities in the south and west of the island, as measured by selected HDOH 28 and NPS stations in this study, with a maximum 24-hour-mean mass concentration of 728 μg/m3 recorded in Ocean View (100 km west of the LERZ emission source) in May 2018. Data from the low-cost sensor network correlated well with data from the HDOH PM2.5 instruments, confirming that these low-cost sensors provide a robust means to augment reference-grade instrument networks

Developing diversity through specialisation in secondary education: comparing approaches in New Zealand and England

The paper compares approaches to curriculum specialisation in secondary education in New Zealand and England. In both countries there have been movements towards increased specialisation, though these have been quite different in form and scope. In both countries specialisation cannot be divorced from broader education policies designed to increase devolution and choice and the paper discusses these contexts before analysing the different approaches to specialisation and attempting an explanation. The authors of the paper draw on findings from research undertaken in New Zealand schools. The paper identifies three dimensions that have played a part in influencing curriculum specialisation in both countries. These are opportunity, source of impetus and support. It is argued that while local initiative is possible in New Zealand, central planning and guidance is inadequate. In England while central planning is strong and support is available, it is far from clear that real specialisation is encouraged by existing curriculum and assessment frameworks. In these circumstances in both countries it seems likely that vertical, rather than horizontal, diversity will continue to hold sway