New skills for a new century? Challenging the orthodoxy: the role of citizenship and enterprise education in promoting effective learning

Citizenship and enterprise education are now compulsory in the English school curriculum; both offer challenges and opportunities for the development of effective learning. There is a long-standing problem of definition with enterprise education. One sees enterprise as teaching entrepreneurship, another sees it as more generic project development, and a final conceptualisation is the development of personal ‘enterprising’ dispositions, such as creativity, problem solving, and flexibility. These definitions have drastically different implications for teaching and the organisation of the curriculum. If the purpose of enterprise education is to prepare students to start businesses then enterprise education ought to develop the knowledge, understanding and skills that are relevant for running a company. In that case the link between enterprise education and business studies is close. However, if the purpose of enterprise education is to develop students’ capacity to take the initiative in any situation, this could arguably be created in any part of the curriculum. Citizenship has more in common with the third definition of enterprise. While offering a body of knowledge, it also aims to develop skills and attitudes which can influence not only the individual student but the culture of the schools thus enhancing student's experiences and possibly attainment

Increasing understanding and uptake of advance decisions in Wales

An ‘Advance Decision’ is a legally binding record (given statutory force by the Mental Capacity Act 2005) of the treatments that someone wishes to refuse if they lose capacity to make such decisions for themselves in future. The Mental Capacity Act 2005 refers to them as ‘Advance Decisions’ (s. 24(1)): given widespread confusion about the terminology associated with end-of-life planning tools, we have often opted in this report to use the term ‘Advance Decisions to Refuse Treatment’ (ADRTs), Barriers to uptake of ADRTs include misunderstanding about what is involved; scepticism about whether they will be respected; and the mistaken belief that an ADRT is unnecessary if people have already informed family members or healthcare professionals of their wishes. There is widespread misunderstanding about the power of family members to give or withhold consent for adult relatives, and misinformation and confusion about the distinctive legal status of ADRTs (compared with other advance planning tools). This report examines the legal position and identifies ways of increasing awareness and uptake of ADRTs in Wales. It suggests that the Welsh Government has a key role to play, alongside partner organisations such as charities, in promoting better understanding of ADRTs and ensuring that people’s right to refuse treatment is respected through: - Public education, media engagement and cultural events to encourage people to plan for potential future loss of capacity; - De-bunking the myth that ‘next of kin’ have decision-making powers and correcting official forms that may mislead people about the legal status of their own or a relative’s expressed wishes; - Facilitating access to well designed ADRT forms/guidance and skilled support, both for the general population and for particular groups; - Normalising ADRTs (e.g. offering registration when patients sign up with a GP); - Training relevant practitioners to ensure that they understand what ADRTs are (and when they are valid and applicable), are able to provide appropriate guidance or referral, and can act in accordance with the law concerning them; - Creating an All-Wales national repository – flagging key emergency decisions and ensuring accessibility of full ADRT documentation

Increasing understanding and uptake of advance decisions in Wales

An ‘Advance Decision’ is a legally binding record (given statutory force by the Mental Capacity Act 2005) of the treatments that someone wishes to refuse if they lose capacity to make such decisions for themselves in future. The Mental Capacity Act 2005 refers to them as ‘Advance Decisions’ (s. 24(1)): given widespread confusion about the terminology associated with end-of-life planning tools, we have often opted in this report to use the term ‘Advance Decisions to Refuse Treatment’ (ADRTs), Barriers to uptake of ADRTs include misunderstanding about what is involved; scepticism about whether they will be respected; and the mistaken belief that an ADRT is unnecessary if people have already informed family members or healthcare professionals of their wishes. There is widespread misunderstanding about the power of family members to give or withhold consent for adult relatives, and misinformation and confusion about the distinctive legal status of ADRTs (compared with other advance planning tools). This report examines the legal position and identifies ways of increasing awareness and uptake of ADRTs in Wales. It suggests that the Welsh Government has a key role to play, alongside partner organisations such as charities, in promoting better understanding of ADRTs and ensuring that people’s right to refuse treatment is respected through: - Public education, media engagement and cultural events to encourage people to plan for potential future loss of capacity; - De-bunking the myth that ‘next of kin’ have decision-making powers and correcting official forms that may mislead people about the legal status of their own or a relative’s expressed wishes; - Facilitating access to well designed ADRT forms/guidance and skilled support, both for the general population and for particular groups; - Normalising ADRTs (e.g. offering registration when patients sign up with a GP); - Training relevant practitioners to ensure that they understand what ADRTs are (and when they are valid and applicable), are able to provide appropriate guidance or referral, and can act in accordance with the law concerning them; - Creating an All-Wales national repository – flagging key emergency decisions and ensuring accessibility of full ADRT documentation

Task-evoked pupillometry provides a window into the development of short-term memory capacity

The capacity to keep multiple items in short-term memory (STM) improves over childhood and provides the foundation for the development of multiple cognitive abilities. The goal of this study was to measure the extent to which age differences in STM capacity are related to differences in task engagement during encoding. Children (n = 69, mean age = 10.6 years) and adults (n = 54, mean age = 27.5 years) performed two STM tasks: the forward digit span test from the Wechsler Intelligence Scale for Children (WISC) and a novel eyetracking digit span task designed to overload STM capacity. Building on prior research showing that task-evoked pupil dilation can be used as a real-time index of task engagement, we measured changes in pupil dilation while participants encoded long sequences of digits for subsequent recall. As expected, adults outperformed children on both STM tasks. We found similar patterns of pupil dilation while children and adults listened to the first six digits on our STM overload task, after which the adults' pupils continued to dilate and the children's began to constrict, suggesting that the children had reached their cognitive limits and that they had begun to disengage from the task. Indeed, the point at which pupil dilation peaked at encoding was a significant predictor of WISC forward span, and this relationship held even after partialing out recall performance on the STM overload task. These findings indicate that sustained task engagement at encoding is an important component of the development of STM

Housing policy in the UK: the importance of spatial nuance

The UK has been engaged in an ongoing process of constitutional reform since the late 1990s, when devolved administrations were established in Northern Ireland, Scotland and Wales. As devolution has evolved there has been a greater trend towards divergence in housing policy, which calls into question any notion of a ‘UK experience’. Whilst the 2014 Scottish independence referendum again returned constitutional reform high onto the political agenda, there still remain tensions between devolved governments and the UK Government in Westminster, with England increasingly becoming the outlier in policy terms. Informed by ideas of social constructionism, which emphasises the politics of housing, this paper draws on an analysis of policy narratives to highlight the need for greater geographical sensitivity. This requires not only more spatial nuance, but also a recognition that these differences are underpinned by divergent political narratives in different parts of the UK. This emphasis on the politics underpinning policy has relevance internationally in other geographical contexts

The effectiveness of an intervention in increasing community health clinician provision of preventive care: a study protocol of a non-randomised, multiple-baseline trial

<p>Abstract</p> <p>Background</p> <p>The primary behavioural risks for the most common causes of mortality and morbidity in developed countries are tobacco smoking, poor nutrition, risky alcohol use, and physical inactivity. Evidence, guidelines and policies support routine clinician delivery of care to prevent these risks within primary care settings. Despite the potential afforded by community health services for the delivery of such preventive care, the limited evidence available suggests it is provided at suboptimal levels. This study aims to assess the effectiveness of a multi-strategic practice change intervention in increasing clinician's routine provision of preventive care across a network of community health services.</p> <p>Methods/Design</p> <p>A multiple baseline study will be conducted involving all 56 community health facilities in a single health district in New South Wales, Australia. The facilities will be allocated to one of three administratively-defined groups. A 12 month practice change intervention will be implemented in all facilities in each group to facilitate clinician risk assessment of eligible clients, and clinician provision of brief advice and referral to those identified as being 'at risk'. The intervention will be implemented in a non-random sequence across the three facility groups. Repeated, cross-sectional measurement of clinician provision of preventive care for four individual risks (smoking, poor nutrition, risky alcohol use, and physical inactivity) will occur continuously for all three facility groups for 54 months via telephone interviews. The interviews will be conducted with randomly selected clients who have visited a community health facility in the last two weeks. Data collection will commence 12 months prior to the implementation of the intervention in the first group, and continue for six months following the completion of the intervention in the last group. As a secondary source of data, telephone interviews will be undertaken prior to and following the intervention with randomly selected samples of clinicians from each facility group to assess the reported provision of preventive care, and the acceptability of the practice change intervention and implementation.</p> <p>Discussion</p> <p>The study will provide novel evidence regarding the ability to increase clinician's routine provision of preventive care across a network of community health facilities.</p> <p>Trial registration</p> <p>Australian Clinical Trials Registry <a href="http://www.anzctr.org.au/ACTRN12611001284954.aspx">ACTRN12611001284954</a></p> <p>Universal Trial Number (UTN)</p> <p>U1111-1126-3465</p

A randomised controlled trial linking mental health inpatients to community smoking cessation supports: A study protocol

<p>Abstract</p> <p>Background</p> <p>Mental health inpatients smoke at higher rates than the general population and are disproportionately affected by tobacco dependence. Despite the advent of smoke free policies within mental health hospitals, limited systems are in place to support a cessation attempt post hospitalisation, and international evidence suggests that most smokers return to pre-admission smoking levels following discharge. This protocol describes a randomised controlled trial that will test the feasibility, acceptability and efficacy of linking inpatient smoking care with ongoing community cessation support for smokers with a mental illness.</p> <p>Methods/Design</p> <p>This study will be conducted as a randomised controlled trial. 200 smokers with an acute mental illness will be recruited from a large inpatient mental health facility. Participants will complete a baseline survey and will be randomised to either a multimodal smoking cessation intervention or provided with hospital smoking care only. Randomisation will be stratified by diagnosis (psychotic, non-psychotic). Intervention participants will be provided with a brief motivational interview in the inpatient setting and options of ongoing smoking cessation support post discharge: nicotine replacement therapy (NRT); referral to Quitline; smoking cessation groups; and fortnightly telephone support. Outcome data, including cigarettes smoked per day, quit attempts, and self-reported 7-day point prevalence abstinence (validated by exhaled carbon monoxide), will be collected via blind interview at one week, two months, four months and six months post discharge. Process information will also be collected, including the use of cessation supports and cost of the intervention.</p> <p>Discussion</p> <p>This study will provide comprehensive data on the potential of an integrated, multimodal smoking cessation intervention for persons with an acute mental illness, linking inpatient with community cessation support.</p> <p>Trial Registration</p> <p>Australian and New Zealand Clinical Trials Registry ANZTCN: <a href="http://www.anzctr.org.au/ACTRN12609000465257.aspx">ACTRN12609000465257</a></p

A school-based resilience intervention to decrease tobacco, alcohol and marijuana use in high school students

<p>Abstract</p> <p>Background</p> <p>Despite schools theoretically being an ideal setting for accessing adolescents and preventing initiation of substance use, there is limited evidence of effective interventions in this setting. Resilience theory provides one approach to achieving such an outcome through improving adolescent mental well-being and resilience. A study was undertaken to examine the potential effectiveness of such an intervention approach in improving adolescent resilience and protective factor scores; and reducing the prevalence of adolescent tobacco, alcohol and marijuana use in three high schools.</p> <p>Methods</p> <p>A non-controlled before and after study was undertaken. Data regarding student resilience and protective factors, and measures of tobacco, alcohol and marijuana use were collected from grade 7 to 10 students at baseline (n = 1449) and one year following a three year intervention (n = 1205).</p> <p>Results</p> <p>Significantly higher resilience and protective factors scores, and significantly lower prevalence of substance use were evident at follow up.</p> <p>Conclusions</p> <p>The results suggest that the intervention has the potential to increase resilience and protective factors, and to decrease the use of tobacco, alcohol and marijuana by adolescents. Further more rigorous research is required to confirm this potential.</p