Evaluating health visitors’ existing knowledge of Down syndrome and the effect of a training workshop

© 2018 The Authors. Journal of Policy and Practice in Intellectual Disabilities published by International Association for the Scientific Study of Intellectual and Developmental Disabilities and Wiley Periodicals, Inc.Children with Down syndrome are at an increased risk of health and development issues in early childhood, therefore monitoring their development and identifying health conditions as early as possible is critical. Health professionals may not always have the training and knowledge to effectively support families of children with disabilities, including Down syndrome. In the UK, health visitors conduct health and development reviews for children under 5 years, therefore they have a key role to play in monitoring and identifying health issues in young children with Down syndrome. However there has been no research on health visitors' knowledge and training needs regarding Down syndrome. This study aimed to assess health visitors' existing knowledge of Down syndrome and evaluate a pilot Down syndrome training session for health visitors. Twenty-six health visitors from two NHS Trusts in England participated in 1 of 5 group training workshops. Pretraining and posttraining questionnaires assessed knowledge about Down syndrome, and feedback on the training session. Knowledge about Down syndrome was low prior to the training and increased significantly following the training session. Health visitors rated the training workshop very highly and would recommend it to a colleague. Health visitors identified a need for training to enable them to increase their knowledge about Down syndrome and better support families. In summary, a pilot training session about Down syndrome received positive feedback from health visitors, and led to improvements in knowledge and understanding about Down syndrome. This has the potential to improve health outcomes for children with Down syndrome.Peer reviewe

Health research policy: a case study of policy change in Aboriginal and Torres Strait Islander health research

The need for research to better address health disparities in Indigenous people has been widely recognised. This paper examines past policies and outlines issues for Indigenous health policy in the future. There is considerate potential for health research to contribute to better health services and programs and improved health outcomes; the policies of health research funding agencies are critical to achieving health gains from research. This paper (i) describes the policy changes by NHMRC from 1997 to 2002 to improve funding of Aboriginal health research (ii) examines the catalysts for the policy changes (iii) describes the extent to which this has resulted in new models of research and (iv) outlines issues for Indigenous health policy in the future. &nbsp

Psychological distress in carers of aboriginal children in urban New South Wales: Findings from search (phase one)

OBJECTIVE: To examine the factors associated with psychological distress in parents and carers of Aboriginal children living in urban communities in New South Wales. DESIGN: Cross-sectional survey (phase one of the Study of Environment on Aboriginal Resilience and Child Health [SEARCH], November 2007 - December 2011). SETTING AND PARTICIPANTS: Primary care; 589 parents and carers of Aboriginal children were recruited when attending one of the four Aboriginal Community Controlled Health Services (ACCHSs) in urban NSW that participated in SEARCH. MAIN OUTCOME MEASURE: Kessler Psychological Distress Scale (K10) scores; a score of 22 or higher was deemed to indicate high levels of psychological distress. RESULTS: High levels of psychological distress were identified in 18% of our sample. The factors most strongly associated with this distress were functional limitations (v those with K10 scores under 22: adjusted odds ratio [aOR], 4.2; 95% CI, 1.3-13.5), previous hospitalisation (aOR, 5.5; 95% CI, 1.5-19.4) or other treatment for social and emotional wellbeing (aOR, 3.3; 95% CI, 1.3-8.4), low satisfaction with feeling part of the community (aOR, 0.83; 95% CI, 0.70-0.98) and low involvement in clubs and groups (aOR, 2.9; 95% CI, 1.2-7.3). CONCLUSIONS: Clinicians should note that those with functional limitations or a history of treatment for mental health problems are at higher risk of psychological distress and may require additional support. Increased funding that allows ACCHSs to provide mental health services, and funding and promoting programs and activities that increase social connectedness should remain focuses for ACCHSs and policy makers

Science teacher educator partnerships with schools (STEPS): developing an interpretive framework for primary science teacher education

The STEPS Project responds to international concern about primary teachers’ lack of science knowledge and confidence to teach science, and recent questioning of the effectiveness of traditional approaches to teacher education. The project reviews and builds on established, innovative and successful practices at five universities, to develop and promote a framework supporting school‐based approaches to pre‐service teacher education. This paper will outline the processes involved in developing an Interpretive Framework, which will be a key outcome of the project. The Interpretive Framework identifies key elements to assist teacher educators in planning, implementing and sustaining school-based approaches to teacher education

Developing effective school and university partnerships for teacher education

The use of school-university partnerships to address the theory-practice divide in teacher education has recently come to attention in international teacher education studies (e.g. Darling-Hammond, 2005; Jones & Ryan, in press). School-university partnerships are particularly important in primary science teacher education as a means to overcome limited opportunities primary pre-service teachers have to observe and practice science teaching during their Practicum. Their opportunities are limited due to a lack of practising teachers who include science in their classroom teaching or who do not feel sufficiently competent to act as science mentors. This is generally attributable to low teacher confidence and knowledge of how to teach science (Jones & Carter, 2007).This workshop will report on a study which is exploring existing approaches to school-university partnerships in science teacher education at 5 Australian universities. Utilising a multiple case study methodology (Yin, 2009), the project has examined the experiences of establishing, maintaining and developing these partnership and explored the benefits of the partnerships for pre-service teachers, practising teachers and schools. A key outcome of the project is the development of an “Interpretive Framework” in which partnership practices were exemplified, contextualized and summarized, documenting key phases in the development of partnership arrangements. The Framework is currently undergoing validation with Australian universities. In this paper, the authors present the Framework to an braoder audience for comment and seek to explore its relevance and transferability to school-university partnerships in an international context

Respect is central: a critical review of implementation frameworks for continuous quality improvement in Aboriginal and Torres Strait Islander primary health care services

Background: Primary health care (PHC) services are complex systems, shaped by an interplay of factors at individual, organisational and broader system levels. For Aboriginal and Torres Strait Islander PHC services, closer relationships with the people they serve, local knowledge of community, and cultural awareness are critical. Continuous quality improvement (CQI) has proven to be an effective process for identification of priority issues in health care delivery and for instigating the design, implementation and evaluation of improvement interventions in these settings. However, wide-scale variation in care quality persists partly due to the mismatch between CQI interventions and context. Methods: This critical review of implementation frameworks for CQI in Aboriginal and Torres Strait Islander primary health care was conducted in two phases: (1) a review of primary published implementation frameworks used in PHC contexts, and (2) a comparison of key features of these frameworks with quality concepts identified by high-improving Aboriginal and Torres Strait Islander PHC services in remote Australia. Results: We found nine primary implementation frameworks previously used in PHC contexts guiding interventions within and between macro (broader contextual) level; meso (health service) level; and micro (community and inter-personal) level systems. There was commonality between these frameworks and key quality concepts in Aboriginal and Torres Strait Islander PHC. However, none of the frameworks covered all concepts with rare consideration of communities driving health improvement, two-way learning (integrating cultural knowledge into healthcare provision), and caring staff—engendering trusting relationships with community enacted through respect. Conclusion: Respect, as a secret essence, privileges the importance of culture, and is an essential element of CQI implementation frameworks for positive change in Aboriginal and Torres Strait Islander PHC services. It is essential to work with communities to design workforce models that grow a caring stable workforce to ensure improvements in quality of care that are effective for their context

A qualitative exploration of priorities for quality improvement amongst Aboriginal and Torres Strait Islander primary health care services

Background: Achieving quality improvement in primary care is a challenge worldwide, with substantial gaps between best practice and actual practice. Within the context of Australia, Aboriginal and Torres Strait Primary Health Care (PHC) services have great variation across settings, structures and context. Research has highlighted how these contextual differences can critically influence the success of Quality Improvement (QI) interventions and outcomes. Less understood is the interaction between local context and other factors, which may impact the implementation of QI interventions. This paper aims to explore the strengths and challenges in QI for Aboriginal and Torres Strait Islander PHC services and their priorities for improvement. Methods: A multiple case study design was adopted, working with eight Aboriginal and Torres Strait Islander PHC services in Northern Territory, Queensland and Western Australia. Data were collected via a health service survey, semi-structured interviews with health service staff and service users and researcher observations, to explore QI and perceptions of care quality at the service level. Data reported here were analysed using an iterative thematic technique, within-case and across-case. Results: A total of 135 interviews were conducted with health service staff, service users and community members. Participants emphasised the centrality of resilient community, committed workforce and valued Aboriginal and Torres Strait Islander team members in delivering care. A shared purpose around improving the health of community was a significant driver. Key challenges included staff turnover and shortages, a complex and overwhelming acute and chronic care workload, building relationships and trust between health services and the community. Service-suggested priority areas for improvement were categorised into five themes: i) cultural safety (community driving health and planning for culturally safe services); ii) community engagement (through clinical activities in the community); iii) shared ownership and a team approach around QI; iv) strengthening systems and consistent ways of doing things in the health service; and v) strengthening local workforce (and resources for a culturally safe workforce). Conclusions: These findings advance understandings of relational, community and cultural factors which are identified priorities for the delivery of quality care in Aboriginal and Torres Strait Islander PHC services across varied contexts

An Ecosystem Framework for use in Recovery and Management of the Puget Sound Ecosystem: Linking Assessments of Ecosystem Condition to Threats and Management Strategies

The ongoing influx of people to the Puget Sound basin has placed pressure on the ecosystem and contributed to a decline in ecosystem health. The Puget Sound Partnership (Partnership), formed in July 2007, is leading an effort to restore the health of Puget Sound. The Partnership is taking an ecosystem-based approach to management that will, over time, address policy questions associated with multiple interacting ecosystem goals. As a foundation of this approach, indicators of ecosystem condition are used to describe a healthy Puget Sound, to evaluate progress towards meeting the recovery goals, to evaluate and adapt management strategies, and as the basis for reporting back to the public. A portfolio of high-level ecological and human health indicators, “vital signs,” was developed and adopted in 2011. Since then, the indicators have received external review by the WA State Academy of Sciences, scientists, planners, decision-makers, and other stakeholders. In response, the Partnership is evolving its portfolio of indicators in order to provide a broader set of indicators to track progress toward threat reductions and ecosystem recovery. To guide the indicator evolution process, we developed an overall organizing ecosystem framework that is an amalgamation of three frameworks: (1) a generalized “causal chain/network framework” that is used to link drivers and pressures of ecosystem health with (2) a framework for assessment of the condition of Puget Sound’s biophysical system, and (3) a framework for the condition of human well-being (HWB). Assessing a complete array of condition and driver/pressure indicators can aid the analysis of the causal mechanisms underlying compromised ecosystem condition. Moreover, in this framework, HWB is recognized as an outcome of biophysical condition as well as a driver of biophysical condition, and that its many components are differentially affected by and can affect conservation outcomes. This paper will present examples of how the Partnership, working with the Puget Sound Ecosystem Monitoring Program, is using this ecosystem framework to identify key ecosystem attributes and associated indicators for major ecosystem components. These biophysical condition indicators, along with indicators of key pressures on the system and indicators of HWB, can be used adaptively to track the recovery of Puget Sound

Monitoring Guidance for Underwater Noise in European Seas- Part II: Monitoring Guidance Specifications

This document has been prepared by the Technical Subgroup on Underwater Noise and other forms of Energy (TSG Noise), established in 2010 by the Marine Directors, i.e. the representatives of directorates or units in European Union Member States, Acceding Countries, Candidate Countries and EFTA Member States dealing with or responsible for marine issues. In December 2011, the Marine Directors requested the TSG Noise to provide monitoring guidance that could be used by Member States in establishing monitoring schemes to meet the needs of the Marine Strategy Framework Directive indicators for underwater noise in their marine waters. This document presents the recommendations and information needed to commence the monitoring required for underwater noise.JRC.H.1-Water Resource

Monitoring Guidance for Underwater Noise in European Seas - Part I: Executive Summary

This document has been prepared by the Technical Subgroup on Underwater Noise and other forms of Energy (TSG Noise), established in 2010 by the Marine Directors, i.e. the representatives of directorates or units in European Union Member States, Acceding Countries, Candidate Countries and EFTA Member States dealing with or responsible for marine issues. In December 2011, the Marine Directors requested the TSG Noise to provide monitoring guidance that could be used by Member States in establishing monitoring schemes to meet the needs of the Marine Strategy Framework Directive indicators for underwater noise in their marine waters. This document presents the key conclusions and recommendations that support the implementation of the practical guidance to commence the monitoring required for underwater noise.JRC.H.1-Water Resource