School Performance of Children in Families Receiving Public Assistance in Canada

The choice of this particular piece of research for analysis was to some extent influenced by the experiences of my field placements in a Children’s Aid Society and in Provincial Welfare. In both settings I worked with families receiving public assistance and became concerned about the generally poor performance and adjustment in school of many children in these families. Increasing emphasis is being placed on the need for education. It is important to examine the situation in order to see why these children are not successful, so that changes can be brought about to meet their educational needs. Without adequate education and training the future for these children in our present society would appear to be rather limited in terms of participating fully in the community

An observational study to identify factors associated with readmission and to evaluate the impact of pharmacist validation of discharge prescriptions on readmission rate

To identify demographic and pharmaceutical factors associated with readmission and to determine whether pharmacist validation of discharge prescriptions impacted on readmission rate in a district general hospital. • The average number of items prescribed at discharge and the average age were found to be significantly higher in patients who were readmitted than those who were not, and mandating pharmacist validation of discharge prescriptions was associated with a reduction of around one-fifth in the readmission rate. • The study provides evidence of the patient groups it may be most appropriate for pharmacists to focus on in order to reduce readmissions. Introduction Readmission is a growing problem for the National Health Service. In England the rate has increased by almost one-third over ten years, reaching 11.5% in 2011/12.1 In 2009 the Care Quality Commission reported that 81% of General Practitioners recorded discrepancies in discharge medication information “all” or “most of the time.”2 Whilst pharmacist validation of discharge prescriptions (TTOs) is routine in Calderdale and Huddersfield NHS Foundation Trust, it was previously prompted by the need for supply, and due to the successful implementation of one-stop dispensing theTTOvalidation rate was surprisingly low. The study aimed to identify factors associated with readmission, to quantify the effect of enforcing pharmacist validation of TTOs and to determine whether this impacted on the readmission rate. Methods Retrospective analysis of data from all adults discharged from Calderdale Royal Hospital’s Short Stay Unit between 30th September 2013 and 19th January 2014 (pharmacist validation of TTOs became mandatory during normal working hours from the mid-point). Data collected from TTOs included admission and discharge dates, demographics and pharmaceutical details (e.g. number of items prescribed, number of prescription changes, validation status). The primary outcome measure was 30-day readmission status; readmission interval was the secondary outcome measure. Ethical approval was not required. Results Two hundred eighty-three TTOs were completed during the baseline evaluation: 101 (35.7%) were validated by a pharmacist and 42 (14.8%) resulted in readmission. Two hundred ninety-six TTOs were completed during the intervention evaluation: 223 (75.3%) were validated by a pharmacist and 36 (12.2%) resulted in readmission. The average age of those readmitted (73.2) was seven and a half years older than those not readmitted (65.7) (p < 0.01, 95% CI for the difference 3.20–11.8); patients aged 65 or older were significantly more likely to be readmitted (17.6%, 63/357) than younger patients (6.8%, 15/222) (p < 0.01). The number of prescription changes on the TTO was not found to differ significantly between those who were readmitted and those who were not; however, those readmitted were prescribed an average of two more items at discharge (10.8) than those who were not (8.4) (p < 0.01, 95% CI for the difference 0.989–3.90). The readmission behaviour of patients prescribed seven or less items at discharge (n = 221)was found to differ significantly (p < 0.01) from patients prescribed eight or more (n = 264). Discussion The results indicate where pharmacists may have the most impact on reducing readmissions; specifically patients over 65 years of age and those taking eight or more medicines. Further work is needed to determine whether readmission can be reduced in these groups by application of pharmaceutical interventions and to establish the long term benefits of focusing limited resources. Mandating pharmacist validation ofTTOs in working hours was associated with a substantial increase in proportion validated and a notable reduction in readmission rate. It is acknowledged that the activity of the Trust’s Virtual Ward varied during the study, however there was not a pharmacist on the team at that time; further work will be carried out to determine the influence of this on the results observed

A preliminary study identifying prescription factors associated with readmission

The LACE index (1) is used by Calderdale and Huddersfield NHS Foundation Trust to refer patients to a Virtual Ward, providing post discharge support with a view to preventing readmissions. Derivation of the LACE index found the Charlson comorbidity index (CCI) predictive of readmission; conditions in the CCI are likely to be treated with medication

The Iowa Homemaker vol.11, no.4

Lemon or Cream?… By Ida M. Shilling His Majesty’s Room… By Anafred Stephenson Betty Gets a New Dress… By Margaret Bruechert What Shall I wear?…? By Margaret McDonoug

Skirmishes on the Border: How Children Experienced, Influenced and Enacted the Boundaries of Curriculum in an Early Childhood Education Centre Setting

The notion of curriculum as contested was central to this thesis. In particular, the focus was on how children (aged from 8 months to 5 years) experienced and influenced the scope of curriculum and participated in the process in defining what constituted null curriculum in one New Zealand childcare centre. Qualitative methods were used to investigate this process of setting curriculum boundaries. Participant observations over five months yielded detailed observations, and these were supplemented by conversations with children which occurred in the context of a range of research strategies; children's perspectives have been foregrounded throughout. Data generation and analysis was guided by principles of the generic inductive qualitative model. Critical pedagogy and the sociology of childhood together provided the theoretical and methodological framework for the study, and 'strategies of dislocation' were devised to assist in seeing unfamiliar aspects in a familiar context. The central source of curriculum boundaries was found to be the assumed demarcation between adults and children; not only did this wider social norm influence the teachers, but it was also found to be embedded within the physical structure and organisation of the centre. It is argued this generational division conflicted with teachers' commitment to implementing sociocultural practices. The core of curriculum for children was found to be relationships with others. However, many relationships were characterised by a dialectic tension between a desire to establish relationships and be accepted within the community, and a desire to exercise control/power. It is argued that these two concerns were significant aspects of curriculum for children. Children's focus on gender and their individual interests also influenced the scope of curriculum, although children's ability to introduce interests depended upon how conducive the physical and social environment was to their expression. Teachers' and children's interpretation of what constituted null curriculum varied. Some aspects, and particularly the body, appeared to be null curriculum for all. Children used strategies of resistance to introduce new elements into the curriculum. Findings from the thesis are aligned with those of other recent qualitative studies in similar New Zealand settings and implications for the early childhood profession are discussed, particularly in relation to scrutinising the image of the child that is implied in practices, and challenging assumptions about the roles of adults and children, as a first step towards dismantling expectations that currently limit the potential scope of curriculum

Adopting a blended approach to learning: experiences from radiography at Queen Margaret University, Edinburgh

The perspective of the radiography teaching team at Queen Margaret University (QMU) was that a transmission mode of programme delivery was sub-optimal in helping students to learn and make links between theory and practice. Programme redesign adopted a blended learning approach with both face-to-face and online learning aimed at enhancing the students’ control over their own learning. Online tasks within Web Classroom Tools (WebCT) were used as an integral part of careful programme design, which resulted in a programme enabling synthesis of the skills, knowledge and competencies acquired in the academic and clinical environments. With the move towards a more learner-centred, blended educational experience for the students the lecturers’ role shifted to that of facilitator with WebCT providing the tutor with a more transparent view of student learning. Lecturers plan learning activities that build upon the skills students have developed through learning in groups, online and in class. The explicit connections that now exist between the academic programme and the opportunities for applying knowledge in practice allow students to engage more deeply in their learning

The Iowa Homemaker vol.10, no.2

Coeds of the Naughty Ninties by Mary Morrison Beyer, page 1 Color in the Garden by Edna Rhoades, page 2 The Tragedy of Errors by Marjorie W. Smith, page 3 Where Toothbrushes Grow on Trees by Nellie Goethe, page 3 Architectural Features in Small Gardens by Margaret Jane Walker, page 4 Y. W. C. A.’s Fortieth Birthday by Ila Woodburn, page 5 4-H Club by Helen Melton, page 6 State Association by Marcia E. Turner, page 8 Child Health May Day by Anafred Stephenson, page 10 Editorial, page 11 Alumnae News by Dorothy B. Anderson, page 12 Tid Bits for Home Economics by Edith Roberts and Nellie Goethe, page 1

Interlibrary loan and document delivery in North American health sciences libraries during the early months of the COVID-19 pandemic

Objective: The study purpose was to understand how early months of the COVID-19 pandemic altered interlibrary loan (ILL) and document delivery (DD) in North American health science libraries (HSLs), specifically the decision-making and workflow adjustments associated with accessing their own collections and obtaining content not available via ILL. Methods: Researchers distributed an online 26-question survey through 24 health science library email lists from January 6-February 7, 2021. Respondents reported their library’s ILL and DD activities from March-August 2020, including ILL/DD usage and policies, collection access, decision-making, and workflow adjustments. In addition to calculating frequencies, cross-tabulation and statistical tests were performed to test a priori potential associations. Two researchers independently and thematically analyzed responses to the 2 open-ended questions and reached consensus on themes. Results: Hospital libraries represented 52% (n=226/431) of respondents, along with 42% academic (n=179) and 6% (n=26) multi-type or other special. Only 1% (n=5) closed completely with no remote services, but many, 45% (n=194), ceased ILL of print materials. More than half (n=246/423; 58%) agreed that ILL requests likely to be filled from print remained unfilled more than is typical. Open-ended questions yielded 5 themes on ILL/DD staffing, setup, and systems; 6 on impacts for libraries and library users. Conclusion: Lack of communication regarding collection availability and staffing resulted in delayed or unfilled requests. Hospital and academic libraries made similar decisions about continuing services but reported different experiences in areas such as purchasing digital content. Hybrid ILL/DD workflows may continue for managing these services