Make your move: Exploring a pedagogic toolkit for creative development and global learning in primary education

The purpose of Theatre of the Imagination® is to develop a methodology which helps creative development through design and making in primary education. Objectives supporting this aim include: the development of personal agency through metacognition; the development of creative skills and ideas through practical workshops; and engagement with global learning goals through discussion and storytelling. A series of Constructivist Learning Design workshops have generated tentative findings that suggest design and making can help students to achieve these objectives. An analysis of qualitative data arising from the process of Participatory Action Research indicates that the global citizenship agenda, in tandem with design and making, helps to nurture empathy

Life below water: How can creative practice nurture personal agency and global citizenship in primary education?

Abstract: ‘Life Below Water’ aims to establish how creative practice can provide an effective way to nurture self‐efficacy and self‐regulation in primary education. A constructionist approach was developed to help children explore UN Global Goal 14, through drawing, prototyping and storytelling as collaborative activities. Working in duets and quartets, a group of eight Key Stage 2 children were set the task of ‘inventing’ sea creatures with magical healing powers. The children evaluated their progress through pre and post‐workshop questionnaires, and through discussions with their peers, teachers and parents. Workshop outcomes illustrate how nurturing skills in making can help foster creative agency and metacognition. Co‐operating as a design team encouraged symmetrical reciprocity, self‐regulation and a ‘care‐full’ approach to environmental protection. The study provides guiding knowledge for prospective developments, based upon tentative findings. The time required to assess the impact of ‘Life Below Water’ is extended to enable future research efforts, by teachers and practitioners, to inform context‐specific interpretations through whole‐class workshops and international exchanges

Theatre of the imagination: Blueprint exchange

‘Blueprint Exchange’ is the catalyst for a nascent network of children and teachers who are interested in sharing stories and artefacts, related to the UN global goals, in order to foster critical thinking, creative skills and compassion. My research brings together Participatory Action Research and Constructivist Learning Design to help build personal agency and metacognition. Learning methods transferred from art and design education were successfully applied in primary schools through a series of practical workshops. The toolkit was adopted and successfully integrated into whole-class practice by primary school teachers in the UK and India. Children shared lived experiences by articulating tacit knowledge through modelmaking and video production across geographic space. Transition Design provides a framework for social transformation by encouraging children to construct a vision of what might be possible in future. ‘Blueprint Exchange’ workshops have produced compelling insights that suggest art and design in mainstream primary education has the potential to impact upon cognitive acceleration. Translocated Practice with India and Mexico has helped to build a creative toolkit for teachers and children across continents

Religiosity and Sexual Risk Behaviors Among African American Cocaine Users in the Rural South: Religion and Sex Risk

Racial and geographic disparities in human immunodeficency virus (HIV) are dramatic and drug use is a significant contributor to HIV risk. Within the rural South, African Americans who use drugs are at extremely high risk. Due to the importance of religion within African American and rural Southern communities, it can be a key element of culturally-targeted health promotion with these populations. Studies have examined religion’s relationship with sexual risk in adolescent populations, but few have examined specific religious behaviors and sexual risk behaviors among drug-using African American adults. This study examined the relationship between well-defined dimensions of religion and specific sexual behaviors among African Americans who use cocaine living in the rural southern United States

A randomized controlled trial of methotrexate for patients with generalized myasthenia gravis

OBJECTIVE: To determine the steroid-sparing effect of methotrexate (MTX) in patients with symptomatic generalized myasthenia gravis (MG). METHODS: We performed a 12-month multicenter, randomized, double-blind, placebo-controlled trial of MTX 20 mg orally every week vs placebo in 50 acetylcholine receptor antibody-positive patients with MG between April 2009 and August 2014. The primary outcome measure was the prednisone area under the dose-time curve (AUDTC) from months 4 to 12. Secondary outcome measures included 12-month changes of the Quantitative Myasthenia Gravis Score, the Myasthenia Gravis Composite Score, Manual Muscle Testing, the Myasthenia Gravis Quality of Life, and the Myasthenia Gravis Activities of Daily Living. RESULTS: Fifty-eight patients were screened and 50 enrolled. MTX did not reduce the month 4-12 prednisone AUDTC when compared to placebo (difference MTX - placebo: -488.0 mg, 95% confidence interval -2,443.4 to 1,467.3, p = 0.26); however, the average daily prednisone dose decreased in both groups. MTX did not improve secondary measures of MG compared to placebo over 12 months. Eight participants withdrew during the course of the study (1 MTX, 7 placebo). There were no serious MTX-related adverse events. The most common adverse event was nonspecific pain (19%). CONCLUSIONS: We found no steroid-sparing benefit of MTX in MG over 12 months of treatment, despite being well-tolerated. This study demonstrates the challenges of conducting clinical trials in MG, including difficulties with recruitment, participants improving on prednisone alone, and the need for a better understanding of outcome measure variability for future clinical trials. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for patients with generalized MG MTX does not significantly reduce the prednisone AUDTC over 12 months of therapy

Changing behaviour 'more or less'-do theories of behaviour inform strategies for implementation and de-implementation? A critical interpretive synthesis

BACKGROUND: Implementing evidence-based care requires healthcare practitioners to do less of some things (de-implementation) and more of others (implementation). Variations in effectiveness of behaviour change interventions may result from failure to consider a distinction between approaches by which behaviour increases and decreases in frequency. The distinction is not well represented in methods for designing interventions. This review aimed to identify whether there is a theoretical rationale to support this distinction. METHODS: Using Critical Interpretative Synthesis, this conceptual review included papers from a broad range of fields (biology, psychology, education, business) likely to report approaches for increasing or decreasing behaviour. Articles were identified from databases using search terms related to theory and behaviour change. Articles reporting changes in frequency of behaviour and explicit use of theory were included. Data extracted were direction of behaviour change, how theory was operationalised, and theory-based recommendations for behaviour change. Analyses of extracted data were conducted iteratively and involved inductive coding and critical exploration of ideas and purposive sampling of additional papers to explore theoretical concepts in greater detail. RESULTS: Critical analysis of 66 papers and their theoretical sources identified three key findings: (1) 9 of the 15 behavioural theories identified do not distinguish between implementation and de-implementation (5 theories were applied to only implementation or de-implementation, not both); (2) a common strategy for decreasing frequency was substituting one behaviour with another. No theoretical basis for this strategy was articulated, nor were methods proposed for selecting appropriate substitute behaviours; (3) Operant Learning Theory makes an explicit distinction between techniques for increasing and decreasing frequency. DISCUSSION: Behavioural theories provide little insight into the distinction between implementation and de-implementation. Operant Learning Theory identified different strategies for implementation and de-implementation, but these strategies may not be acceptable in health systems. Additionally, if behaviour substitution is an approach for de-implementation, further investigation may inform methods or rationale for selecting the substitute behaviour