Do schools promote social inclusion? The experiences of intercountry adoptees in Australia

Intercountry adoption programs have brought children from racially and culturally diverse backgrounds to live as Australians, including 30 children from Rangsit Children’s Home who arrived in South Australia in the late 1980s and early 1990s. As part of a project which explored the life experiences of 12 adults who had arrived as children aged between 4 and 9 from Rangsit, this paper explores the role of schools in facilitating their inclusion into life in Australia. The school experience was often critical in learning English and was pre-requisite for acceptance in the school yard but also a place in which most of these Thai-born intercountry adoptees experienced racism. More than half of the participants did not complete secondary school but all had employment. However, many of these jobs were low-paying and this precluded them from participating in opportunities to return to Thailand to learn more about their Thai origins or participating as adoptive parents in intercountry adoption programs. Hence, while schools can play an important role in facilitating social inclusion, the school system alone may be unable to address the multiple dimensions of exclusion experienced by intercountry adoptees

Identifying obstacles and opportunities for inclusion in the school curriculum for children adopted from overseas: developmental and social constructionist perspectives

In Australia, teachers are expected to teach a diverse range of students, including children adopted from overseas who have experienced attachment disruption and complex trauma early in life. International research identifies the potential vulnerability of this minority group at school. However, teachers’ backgrounds, knowledge and experience, as well as curriculum policies and school practices, may influence how teachers respond to the diverse needs of these children. Drawing on examples from a qualitative study which used focus group interviews and a multi-case study of 10 adoptive families, this article applies developmental and social constructionist perspectives to analyse the potential impact some common curriculum units may have on these children’s experiences of school. This paper reports on the way in which various units in the Australian Curriculum may provide obstacles and opportunities for inclusion, with particular examples provided from the English and History Curriculum. Findings show there is a need for greater awareness, understanding and sensitivity in teaching approach, as well as flexibility in teachers’ professional agency and discretion in the selection of resources when responding to the educational needs of intercountry adoptees

Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism.

BACKGROUND: Whether the oral factor Xa inhibitor edoxaban can be an alternative to warfarin in patients with venous thromboembolism is unclear. METHODS: In a randomized, double-blind, noninferiority study, we randomly assigned patients with acute venous thromboembolism, who had initially received heparin, to receive edoxaban at a dose of 60 mg once daily, or 30 mg once daily (e.g., in the case of patients with creatinine clearance of 30 to 50 ml per minute or a body weight below 60 kg), or to receive warfarin. Patients received the study drug for 3 to 12 months. The primary efficacy outcome was recurrent symptomatic venous thromboembolism. The principal safety outcome was major or clinically relevant nonmajor bleeding. RESULTS: A total of 4921 patients presented with deep-vein thrombosis, and 3319 with a pulmonary embolism. Among patients receiving warfarin, the time in the therapeutic range was 63.5%. Edoxaban was noninferior to warfarin with respect to the primary efficacy outcome, which occurred in 130 patients in the edoxaban group (3.2%) and 146 patients in the warfarin group (3.5%) (hazard ratio, 0.89; 95% confidence interval [CI], 0.70 to 1.13; P<0.001 for noninferiority). The safety outcome occurred in 349 patients (8.5%) in the edoxaban group and 423 patients (10.3%) in the warfarin group (hazard ratio, 0.81; 95% CI, 0.71 to 0.94; P=0.004 for superiority). The rates of other adverse events were similar in the two groups. A total of 938 patients with pulmonary embolism had right ventricular dysfunction, as assessed by measurement of N-terminal pro-brain natriuretic peptide levels; the rate of recurrent venous thromboembolism in this subgroup was 3.3% in the edoxaban group and 6.2% in the warfarin group (hazard ratio, 0.52; 95% CI, 0.28 to 0.98). CONCLUSIONS: Edoxaban administered once daily after initial treatment with heparin was noninferior to high-quality standard therapy and caused significantly less bleeding in a broad spectrum of patients with venous thromboembolism, including those with severe pulmonary embolism. (Funded by Daiichi-Sankyo; Hokusai-VTE ClinicalTrials.gov number, NCT00986154.)