Contrasting explicit with implicit measures of children’s representations: The case of segmental phonology

Current theories of phonological development make contrasting predictions about the role of vocabulary growth and orthographic knowledge on the emergence of segmental phonological representation. Testing these predictions in children is made difficult by the metacognitive nature of tasks commonly used to assess phonological representations. The current study uses novel tasks which measure children’s sensitivity to phonological segments, without requiring them to have any explicit awareness of the sounds in words. These measures of segmental sensitivity were contrasted with measures requiring explicit segmental analysis of word forms (N=88, age: 3;2 to 5;7). Results show that while explicit segmental analysis is related to letter-sound knowledge, tasks measuring implicit segmental sensitivity provide evidence of segmental phonology which is related to vocabulary growth and is not mediated by orthography. This study thus shows the importance of tapping into the structure of children’s phonological representations using tasks that minimise the requirement for explicit awareness

Holy lemons : learning from children's uses of the Internet in out-of-school contexts

The Internet offers new possibilities for engaging with information and is associated with a wide range of literacy practices. National guidance in the United Kingdom on ‘reading the web’, however, has focused largely on the different skills children may need to learn in school to navigate web-based texts successfully. Here it is argued that much can be learned both about the potential of the web and of the kinds of reading associated with it by examining children's use of the Internet outside school. This article therefore begins with an overview of particular features of on-screen reading and the different practices and orientations towards knowledge associated with this. It then reports on the use of the Internet out of school by a group of Year 6 children. It explores the purposes for which these children access the Internet, the attitudes and orientations they demonstrate in their approach to web-based texts, and their own perceptions of what has enabled them to develop as Internet users. This exploration highlights the way that children may experiment and innovate in their use of the Internet out of school, and in doing so demonstrate considerable autonomy. These findings are used to make suggestions for framing and supporting children's Internet use in school

Identification of patients with potential palliative care needs: A systematic review of screening tools in primary care

Background: Despite increasing evidence of the benefits of early access to palliative care, many patients do not receive palliative care in a timely manner. A systematic approach in primary care can facilitate earlier identification of patients with potential palliative care needs and prompt further assessment. Aim: To identify existing screening tools for identification of patients with advanced progressive diseases who are likely to have palliative care needs in primary healthcare and evaluate their accuracy. Design: Systematic review (PROSPERO registration number CRD42019111568). Data sources: Cochrane, MEDLINE, Embase and CINAHL were searched from inception to March 2019 Results: From 4,127 unique articles screened, 25 reported the use or development of 10 screening tools. Most tools use prediction of death and/or deterioration as a proxy for the identification of people with potential palliative care needs. The tools are based on a wide range of general and disease-specific indicators. The accuracy of five tools was assessed in eight studies; these tools differed significantly in their ability to identify patients with potential palliative care needs with sensitivity ranging from 3% to 94% and specificity ranging from 26% to 99%. Conclusion: The ability of current screening tools to identify patients with advanced progressive diseases who are likely to have palliative care needs in primary care is limited. Further research is needed to identify standardised screening processes that are based not only on predicting mortality and deterioration but also on anticipating the palliative care needs and predicting the rate and course of functional decline. This would prompt a comprehensive assessment to identify and meet their needs on time

Primary health care organizations - through a conceptual and a political lens

Background: Governments around the world are looking at means to improve health care services and health outcomes for their communities within a sustainable expenditure framework. There is a general agreement that strengthening primary health care is the way for the future. Primary health care organizations (PHCOs) are seen as a means to achieving more effective and efficient health care. Results and conclusions: This paper proposes a complex adaptive framework for PHCOs, taking account of health and illness being subjective experiences, health care being ‘whole person’-focused, and PHCOs focusing on all of a community’s health determinants and community-based health care needs. Such approach would foster building healthy local communities as much as seamless integration of health services for all. However, despite the expressed intensions towards patient-centred health care reform the bureaucratic mindset of Australian health policy makers risks true reform by imposing highly structured – rather than ‘simple’ – policy and operational rules