The roles of specialist provision for children with specific speech and language difficulties in England and Wales: a model for inclusion?

Children with specific speech and language difficulties pose a challenge to the education and health systems. In addition to their language difficulties they are also at risk of literacy and social, emotional and behavioural difficulties. The main support for children with more severe difficulties has been enhanced provision in mainstream schools (language units or integrated resources) and special schools. The move to an inclusive education system challenges this tradition. The present paper reports the results of interviews with heads of language units/integrated resources and headteachers of special schools (n=57) as part of a larger study within England and Wales. Their views are considered with reference to criteria for entry to specialist provision, the development of collaborative practice between teachers, teaching assistants and speech and language therapists, and the implications for inclusive education

Defining and assessing spiritual health : a comparative study among 13- to 15-year-old pupils attending secular schools, Anglican schools, and private Christian schools in England and Wales

This article argues that the nation's commitment to young people involves proper concern for their physical health, their psychological health, and their spiritual health. In this context the notion of spiritual health is clarified by a critique of John Fisher's model of spiritual health. Fisher developed a relational model of spiritual health, which defines good spiritual health in terms of an individual's relationship to four domains: the personal, the communal, the environmental, and the transcendental. In the present analysis, we make comparisons between pupils educated in three types of schools: publicly funded schools without religious foundation, publicly funded schools with an Anglican foundation, and new independent Christian schools (not publicly funded). Our findings draw attention to significant differences in the levels of spiritual health experienced by pupils within these three types of schools

Access to healthy foods: Part I. Barriers to accessing healthy foods: Differentials by gender, social class, income and mode of transport

This paper examines the issues of access to food and the influences people face when shopping for a healthy food basket. It uses data from the Health Edu cation Authority's 1993 Health and Lifestyles Survey to examine the barriers people face in accessing a healthy diet. The main findings are that access to food is primarily determined by income, and this is in turn closely related to physical resources available to access healthy food. There is an associated class bias over access to sources of healthy food. The poor have less access to a car, find it harder to get to out-of-town shopping centres and thus are less able to carry and transport food in bulk. The majority of people shop in supermarkets as they report that local shops do not provide the services people demand and that food choice and quality are limited. In tackling food poverty and pro moting healthy eating, health promotion practice needs to address these struc tural issues as opposed to relying on psycho-social models of education based on the provision of information and choice

Emergency and critical care services in Tanzania: a survey of ten hospitals.

While there is a need for good quality care for patients with serious reversible disease in all countries in the world, Emergency and Critical Care tends to be one of the weakest parts of health systems in low-income countries. We assessed the structure and availability of resources for Emergency and Critical Care in Tanzania in order to identify the priorities for improving care in this neglected specialty. Ten hospitals in four regions of Tanzania were assessed using a structured data collection tool. Quality was evaluated with standards developed from the literature and expert opinion. Important deficits were identified in infrastructure, routines and training. Only 30% of the hospitals had an emergency room for adult and paediatric patients. None of the seven district and regional hospitals had a triage area or intensive care unit for adults. Only 40% of the hospitals had formal systems for adult triage and in less than one third were critically ill patients seen by clinicians more than once daily. In 80% of the hospitals there were no staff trained in adult triage or critical care. In contrast, a majority of equipment and drugs necessary for emergency and critical care were available in the hospitals (median 90% and 100% respectively. The referral/private hospitals tended to have a greater overall availability of resources (median 89.7%) than district/regional hospitals (median 70.6). Many of the structures necessary for Emergency and Critical Care are lacking in hospitals in Tanzania. Particular weaknesses are infrastructure, routines and training, whereas the availability of drugs and equipment is generally good. Policies to improve hospital systems for the care of emergency and critically ill patients should be prioritised

Language and cultural capital in school experience of Polish children in Scotland

This article addresses the complex relationship between migration and education in the context of recent intra-European labour mobility. It considers how this mobility impacts the education and life chances of migrant students attending schools in Scotland, UK. By examining the experiences of Polish migrant children and youth at schools in Scotland, the article engages with the issues of language, cultural capital transferability and social positioning. Drawing on qualitative data from 65 in-depth interviews with school children aged 5–17 years, their parents and teachers, as well as observations in the contexts of school and home, the article points to a range of factors affecting the transition of migrant pupils to new schools and social environments

Why don't many obese pregnant and post-natal women engage with a weight management service?

Objective: This study investigated the views and experiences of obese pregnant and post-natal women who had declined or disengaged from an evidence-based weight management service, and their reasons for doing so. Background: Despite significant risks of maternal obesity to both mother and baby, the majority of obese women offered tailored weight management support during or after pregnancy declined to use it, and many women who accepted the service disengaged soon after. Methods: Semi-structured interviews regarding women’s views and experiences were conducted with obese pregnant and post-natal women who declined the service (N = 7) and women who disengaged from the service (N = 11) and analysed thematically. Results: Four main themes were identified. ‘First contact counts’ related to inadequate explanation of the service by the referrer, being offended by the referral, and negative expectations of the service. ‘Missed opportunities for support’ describes what support declining women identified as desirable, such as regular weight monitoring. ‘No need for help’, and ‘Service not meeting needs’ related to personal choices regarding weight management, including not wanting support and preferring group-based services. Conclusions: While some obese pregnant and post-natal women did not want any type of weight management support, many did but failed to engage with the service on offer due to a variety of barriers. A more sensitive and transparent referral process and further tailoring of the service to meet individual needs may increase uptake and continued use of this service. The inclusion of non-participants and non-completers formed a valuable element of service evaluation

Football fans in training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits

<p>Background: The prevalence of obesity in men is rising, but they are less likely than women to engage in existing weight management programmes. The potential of professional sports club settings to engage men in health promotion activities is being increasingly recognised. This paper describes the development and optimization of the Football Fans in Training (FFIT) programme, which aims to help overweight men (many of them football supporters) lose weight through becoming more active and adopting healthier eating habits.</p> <p>Methods: The MRC Framework for the design and evaluation of complex interventions was used to guide programme development in two phases. In Phase 1, a multidisciplinary working group developed the pilot programme (p-FFIT) and used a scoping review to summarize previous research and identify the target population. Phase 2 involved a process evaluation of p-FFIT in 11 Scottish Premier League (SPL) clubs. Participant and coach feedback, focus group discussions and interviews explored the utility/acceptability of programme components and suggestions for changes. Programme session observations identified examples of good practice and problems/issues with delivery. Together, these findings informed redevelopment of the optimized programme (FFIT), whose components were mapped onto specific behaviour change techniques using an evidence-based taxonomy.</p> <p>Results: p-FFIT comprised 12, weekly, gender-sensitised, group-based weight management classroom and ‘pitch-side’ physical activity sessions. These in-stadia sessions were complemented by an incremental, pedometer-based walking programme. p-FFIT was targeted at men aged 35-65 years with body mass index ≥ 27 kg/m2. Phase 2 demonstrated that participants in p-FFIT were enthusiastic about both the classroom and physical activity components, and valued the camaraderie and peer-support offered by the programme. Coaches appreciated the simplicity of the key healthy eating and physical activity messages. Suggestions for improvements that were incorporated into the optimized FFIT programme included: more varied in-stadia physical activity with football-related components; post-programme weight management support (emails and a reunion session); and additional training for coaches in SMART goal setting and the pedometer-based walking programme.</p> <p>Conclusions: The Football Fans in Training programme is highly acceptable to participants and SPL coaches, and is appropriate for evaluation in a randomised controlled trial.</p&gt