Critical Challenges of Cultural Competence Professional Development

Driven by increasing inequities in health, education and social outcomes for Aboriginal people, cultural competence professional development has become more commonplace in many organizations. There are hundreds, possibly thousands, of cultural awareness, cultural sensitivity, or cultural competence professional development workshops held throughout Australia each year. However, there is an uncertainty about whether some professional development approaches improve one’s knowledge, skills and attitudes towards diverse cultures. This article presents one of the key findings of a doctoral study which explored early years educators’ understandings of cultural competence and presents several viewpoints towards professional development. This article calls for approaches to professional development that move beyond passive transmission modes of learning towards localized, participatory models that encourage engagement with local community to privilege a diversity of voices and that also inspires critical self-reflection

The Five Accomplishments: A Framework for Obtaining Customer Feedback in a Health Service Community Learning Disability Team

The usefulness of using the philosophy of normalisation and, in particular, O`Brien`s (1992) Five Accomplishments as a basis for evaluating client satisfaction with a community based health service learning disabilities team was examined. A survey of a group of people with mild learning disabilities took place using the Five Accomplishments as a framework for a semi-structured interview. Areas of client satisfaction and dissatisfaction are discussed in the context of the use of a value-based means of obtaining feedback from clients. Limitations of interviewing techniques and specifically those used in this study are reviewed

Workshop: Regulatory Gaps in Continuous Processing

1 Objectives To provide a forum for participants to discuss and share experiences relating regulatory approaches and challenges when implementing or considering ICB. Please click Additional Files below to see the full abstract

A Bayesian Approach to Dose-finding Studies for Cancer Therapies: Producing Personalised Procedures While Incorporating Information from Later Cycles of Therapy.

Bayesian model based approaches for Phase I dose-finding studies are popular procedures to implement due to the efficiency of updating information sequentially after accruing information. Traditionally dose-finding studies for cancer treatments focus on the occurrence of a patient's first dose limiting toxicity in the first cycle of therapy. This thesis develops a Bayesian decision procedure featuring an Interval-Censored Survival model to incorporate information from multiple cycles of therapy. The use of data from multiple cycles of therapy should produce more precise estimates of target doses to recommend for further investigation in later phases of drug development, in a shorter amount of time. An increasingly desired approach in dose-finding procedures is to provide personalised procedures to target therapy to individual tolerances. Features such as allowing intra-patient dose adjustments and incorporating baseline characteristics to investigate the underlying drug tolerance of population subgroups are investigated within the use of the Interval-Censored Survival Decision Procedure (ICSDP). The inclusion of time-varying covariates is also possible when using the ICSDP, which is investigated through including lower grade toxicities as a marker for tolerance. Individual target doses can be estimated, but the analysis of dose limiting toxicities alone provides a population target dose to recommend for further investigation. Results show the ICSDP as an efficient approach to use when observing a patient's first dose limiting toxicity. Target doses are estimated with good precision, comparable to or better than existing designs for dose-finding, and are generally obtained in a shorter amount of time. Multiple target doses can be produced for different subgroups of the population when baseline characteristics are used and intrapatient dose adjustments are possible between cycles. When using intra-patient adjustments based on observation of lower grade toxicities, personalised dose-escalations lead to estimates of individual target doses and a population target dose with good precision in a reduced amount of time

Simulating Surfactant Spreading: Impact of a Physically Motivated Equation of State

For more than two decades, a single model for the spreading of a surfactant-driven thin liquid film has dominated the applied mathematics literature on the subject. Recently, through the use of fluorescently-tagged lipids, it has become possible to make direct, quantitative comparisons between experiments and models. These comparisons have revealed two important discrepancies between simulations and experiments: the spatial distribution of the surfactant layer, and the timescale over which spreading occurs. In this paper, we present numerical simulations that demonstrate the impact of the particular choice of the equation of state (EoS) relating the surfactant concentration to the surface tension. Previous choices of the model EoS have been an ad-hoc decreasing function. Here, we instead propose an empirically-motivated equation of state; this provides a route to resolving some discrepancies and raises new issues to be pursued in future experiments. In addition, we test the influence of the choice of initial conditions and values for the non-dimensional groups. We demonstrate that the choice of EoS improves the agreement in surfactant distribution morphology between simulations and experiments, and impacts the dynamics of the simulations. The relevant feature of the EoS, the gradient, has distinct regions for empirically motivated choices, which suggests that future work will need to consider more than one timescale. We observe that the non-dimensional number controlling the relative importance of gravitational vs. capillary forces has a larger impact on the dynamics than the other non-dimensional groups. Finally, we observe that the experimental approach of using a ring to contain the surfactant could a affect the surfactant and fluid dynamics if it disrupts the intended initial surfactant distribution. However, the meniscus itself does not significantly affect the dynamics

Facets of mindfulness in health professionals and patient adjustment to cancer

Systematic Review: Healthcare professionals work in highly emotive environments and are considered to be at high risk of developing burnout due to the nature of their roles. There has been increased interest in applying mindfulness-based interventions for stress reduction in healthcare professionals. Previous reviews have tended to include a heterogeneous mix of patients, healthcare students and healthcare professionals. The inherent differences in these roles limits the conclusions that can be drawn regarding the effectiveness of mindfulness-based interventions for healthcare professionals. The current review aimed to address this gap in knowledge by reviewing mindfulness-based interventions specifically for healthcare professionals. Eight studies were included in the review. It was concluded that despite some methodological weaknesses there was promising evidence of the effectiveness of mindfulness-based interventions in reducing stress and improving well-being particularly when baseline levels of stress were high. The evidence in support of reducing burnout was less conclusive. Future studies employing larger samples using active controls and longitudinal designs will provide valuable information on the long-term efficacy of these interventions. Empirical Research Study: Several studies have identified psychological adjustment as one of the most important factors correlating with psychological distress and quality of life in people with cancer. Identifying ways to promote positive adjustment to cancer is an important goal in helping to alleviate distress and improve quality of life for this client group. This can be facilitated by identifying robust predictors of distress. Previous studies have identified a number of useful predictors, such as coping styles and psychological adjustment styles. The current study aimed to explore the predictive power of two newer constructs aligned to mindfulness-based processes: self-compassion and cognitive fusion - in determining adjustment to cancer. 114 adults with various cancer diagnoses completed the Mini Mental Adjustment to Cancer Scale, Brief COPE, the Self-Compassion Scale, Cognitive Fusion Questionnaire; and two outcome measures: the Hospital Anxiety and Depression Scale and the Functional Analysis of Cancer Therapy – General. Hierarchical multiple regression was used to explore relationships between predictor variables: mental adjustment, coping style, self-compassion and cognitive fusion, and outcome variables: distress and quality of life. Results showed that a known predictor, emotional avoidance coping and the newer construct, cognitive fusion were significant predictors of distress over and above other known predictors. Emotional avoidance coping was the only significant predictor of quality of life over and above known predictors and the newer constructs under examination. Self-compassion did not account for any significant incremental variance in distress or quality of life after controlling for other known predictors. The results of this study indicate that interventions focused on reducing cognitive fusion and emotional avoidance are warranted and potentially beneficial in reducing distress in this population

Technical Consultation on the Integration of Statistical and Agricultural Market Information Services

The objectives of this workshop were to share experiences on running market information systems (MIS), monitoring these systems and enhancing their performance and sustainability. The MIS case studies presented at the workshop were drawn from Ghana, Kenya, Uganda, Jamaica and the Caribbean region.The objectives of this workshop were to share experiences on running market information systems (MIS)..

The impact of COVID-19 on the physical activity and sedentary behaviour levels of pregnant women with gestational diabetes

BackgroundThe aim of this study was to understand how physical activity and sedentary behaviour levels of pregnant women with gestational diabetes in the UK have been affected by COVID-19.MethodsAn online survey exploring physical activity and sedentary behaviour levels of pregnant women with gestational diabetes during COVID-19 was distributed through social media platforms. Women who had been pregnant during the COVID-19 outbreak and had gestational diabetes, were resident in the UK, were 18 years old or over and could understand written English were invited to take part.ResultsA total of 724 women accessed the survey, 553 of these met the eligibility criteria and took part in the survey. Sedentary time increased for 79% of the women during the pandemic. Almost half of the women (47%) were meeting the physical activity guidelines pre COVID-19 during their pregnancy, this dropped to 23% during the COVID-19 pandemic. Fear of leaving the house due to COVID-19 was the most commonly reported reason for the decline. Significant associations were found between meeting the physical activity guidelines during COVID-19 and educational attainment, fitness equipment ownership and knowledge of how to exercise safely in pregnancy.Conclusions and implicationsThese results show the impact of COVID-19 on physical activity and sedentary behaviour levels and highlight the need for targeted public health initiatives as the pandemic continues and for future lockdowns. Women with gestational diabetes need to know how it is safe and beneficial to them to engage in physical activity and ways to do this from their homes if fear of leaving the house due to COVID-19 is a barrier for them. Online physical activity classes provided by certified trainers in physical activity for pregnant women may help them remain active when face-to-face appointments are reduced and limited additional resources are available