Problematising policies for workforce reform in early childhood education: A rhetorical analysis of England's Early Years Teacher Status

This paper examines workforce reform in early childhood education in England, specifically the policy trajectory that led to implementation of the Early Years Teacher Status (EYTS) qualification in 2014. Taking a critical perspective on policy analysis, the paper uses rhetorical analysis to make sense of the how EYTS is understood within workforce reform. From an assemblage of salient policy documents, we report our critical analysis of two key texts: Foundations for Quality and More Great Childcare. Both documents identify policy levers and drivers for reform, but from markedly different perspectives and with contrasting recommendations. By using rhetorical analysis to examine how these policy texts construct not only problems but also preferred solutions, we illustrate the paradoxical nature of early childhood policy in England as it relates to aspirations to raise the status of the sector and improve quality through the implementation of EYTS

Quality of Care and Outcomes of Heart Failure Among Patients With Schizophrenia in Denmark

Research on the association between schizophrenia and the quality of care and clinical outcomes of heart failure (HF) remains sparse. This nationwide study compared the quality of care and clinical outcomes of HF among Danish patients with and without schizophrenia. In a population-based cohort study, we identified 36,718 patients with incident HF with hospital contacts, including 108 with schizophrenia, using Danish registries between 2004 and 2013. High quality of HF care was defined as receiving ≥ 80% guideline-recommended process-performance measures of care. Potential predictors of HF care among patients with schizophrenia included patient-specific factors (age, gender, Global Assessment of Functioning [GAF] score, alcohol or drug abuse, duration of schizophrenia); provider-specific factors (quality of schizophrenia care); and system-specific factors (patient-volume defined as hospital departments and clinics yearly average patient-volume of patients with incident HF). Clinical outcomes included 4-week all-cause readmission and 1-year all-cause mortality after a first-time hospital contact with incident HF. Results showed that compared with patients with incident HF who have no schizophrenia, patients with incident HF who have schizophrenia had a lower chance of receiving high-quality HF care (relative risk 0.66, 95% confidence interval 0.48 to 0.91). A high GAF score was associated with a higher chance of receiving high-quality HF care among patients with incident HF who have schizophrenia. Patients with incident HF who have schizophrenia had a higher risk of 1-year mortality (adjusted hazard ratio 2.83, 95% confidence interval 1.59 to 5.04), but not a higher risk of readmission than patients with incident HF who have no schizophrenia. In conclusion, efforts are warranted to reduce the high mortality among patients with incident HF who have schizophrenia.</p

The co-operative reform process in Tanzania and Sri Lanka

This article reports on findings from a three year study of co-operatives in Sri Lanka and Tanzania. The article asks three questions: why do co-operative sectors need reforming; what is the co-operative reform process; and why has reform succeeded in some countries but not others? It provides a short history of co-operatives in three phases: the colonial period, the post-colonial nationalist period and the period of market liberalisation. It shows that the control exercised by colonial governments was deepened under nationalist governments, with co-operatives becoming parastatals. Liberalisation brought a sustained attempt by international agencies to reassert the distinctive nature of co-operatives as member-owned businesses. However, co-ops were ill-prepared to adjust to a competitive market and the lifting of government regulation; many failed, some were corrupted, while a few became truly member-controlled. The article draws on documentary analysis and key informant interviews to provide accounts of the reform process in Tanzania and Sri Lanka. It finds that the process is incomplete and often contested