Time for Reading Instruction: How Much Time Should Schools and Teachers Devote to Reading Instruction in Grades K-2?

Although research has indicated that time allotted for instruction in reading is associated with reading achievement, no studies have examined what is the appropriate or optimal time that should be given to reading instruction in the primary grades (grades K-2). Given the understanding that it is the teachers themselves who would have the best sense of the appropriate time for reading instruction and its various components. Results of the survey indicate that teachers feel that 178-198 minutes be devoted to the general literacy curriculum, while 62-71 minutes be devoted to the core reading curriculum per day. We note that the allocation of time to the major components of reading instruction (word study, fluency, and comprehension) varied considerably. In follow-up survey inquiries, a significant number of teachers manifest difficulties in actually meeting their own recommendations for time appropriation for reading instruction. Among the factors that keep teachers from meeting their recommendations for instructional time are special events that disrupt and disturb the time given for instruction. Recommendations for making time for literacy instruction for effective and efficient are considered

Behavioural intervention to promote the uptake of planned care in urgent dental care attenders:study protocol for the RETURN randomised controlled trial

This is the final version. Available on open access from BMC via the DOI in this recordAvailability of data and materials: As per the data controller agreement, the following organisations which have access to the final dataset are The University of Liverpool and the University of Leeds.BACKGROUND: People with disadvantaged backgrounds are less likely to visit the dentist for planned care, even though they have disproportionately poorer oral health. They are correspondingly more likely to experience dental problems and use urgent dental care, general practices and Accident and Emergency departments, which not only makes meeting their needs expensive, but, since these services often rely on prescriptions rather than addressing the clinical cause, can contribute to antimicrobial resistance. METHODS: The RETURN intervention has been developed with substantial community co-production, to be delivered opportunistically in urgent dental care settings. This brief intervention is delivered by dental nurses and involves material relevant to the 'in-group' targeted. The material includes booklets relating to barriers to planned dental visiting with corresponding short video clips featuring local people and including a modelling element. Dental nurses are trained to have supportive and non-judgemental conversations, assisting patients to set personal goals and action plans, which are reinforced in a follow-up text within a few weeks. A randomised controlled trial will be undertaken in 3 types of sites: dental practices delivering urgent care (a) within working hours, (b) out of hours, and (c) in a Dental Hospital. The trial will recruit 1180 adult urgent dental care users over 12 months, who have not visited a dentist for a planned care appointment for 2 years or more and do not have a dentist who they visit for routine care. It aims to investigate the effectiveness and cost-effectiveness of the intervention and to explore whether the intervention has different effects across the socio-economic gradient. Participants will be followed up at 6, 12 and 18 months after randomisation. Co-primary outcomes are attendance at a dental practice for planned care within 12 months and self-reported oral health-related quality of life at 12 months. DISCUSSION: This is a pragmatic trial, evaluating the effectiveness of the intervention under the usual condition in which it might be applied. Since dental practices work as independent contractors to the NHS, this brings implementation and fidelity challenges which will be explored and described in embedded qualitative work. TRIAL REGISTRATION: ISRCTN registry identifier ISRCTN84666712. Registered 12/04/2021.National Institute for Health Research (NIHR

Comparing how patients value and respond to information on risk given in three different forms during dental check-ups: the PREFER randomised controlled trial

Background: This study aims to compare patient preference for, and subsequent change in, oral health behaviour for three forms of risk information given at dental check-ups (verbal advice compared to verbal advice accompanied by a traffic light (TL) risk card; or compared to verbal advice with a quantitative light fluorescence (QLF) photograph of the patient's mouth). Methods: A multi-centre, parallel-group, patient-randomised clinical trial was undertaken between August 2015 and September 2016. Computer-generated random numbers using block stratification allocated patients to three arms. The setting was four English NHS dental practices. Participants were 412 dentate adults at medium/high risk of poor oral health. Patients rated preference and willingness to pay (WTP) for the three types of information. The primary outcome was WTP. After receiving their check-up, patients received the type of information according to their group allocation. Follow-up was by telephone/e-mail at 6 and 12 months. Mean and median WTP for the three arms were compared using Wilcoxon signed-rank tests. Tobit regression models were used to investigate factors affecting WTP and preference for information type. Secondary outcomes included self-rated oral health and change in oral health behaviours (tooth-brushing, sugar consumption and smoking) and were investigated using multivariate generalised linear mixed models. Results: A total of 412 patients were randomised (138 to verbal, 134 to TL and 140 to QLF); 391 revisited their WTP scores after the check-up (23 withdrew). Follow-up data were obtained for 185 (46%) participants at 6 months and 153 (38%) participants at 12 months. Verbal advice was the first preference for 51% (209 participants), QLF for 35% (145 participants) and TL for 14% (58 participants). TL information was valued lower than either verbal or QLF information (p Conclusions: Although a new NHS dental contract based on TL risk stratification is being tested, patients prefer the usual verbal advice. There was also a practice effect which will needs to be considered for successful implementation of this government policy

Applying Definitions of “Asbestos” to Environmental and “Low-Dose” Exposure Levels and Health Effects, Particularly Malignant Mesothelioma

Although asbestos research has been ongoing for decades, this increased knowledge has not led to consensus in many areas of the field. Two such areas of controversy include the specific definitions of asbestos, and limitations in understanding exposure-response relationships for various asbestos types and exposure levels and disease. This document reviews the current regulatory and mineralogical definitions and how variability in these definitions has led to difficulties in the discussion and comparison of both experimental laboratory and human epidemiological studies for asbestos. This review also examines the issues of exposure measurement in both animal and human studies, and discusses the impact of these issues on determination of cause for asbestos-related diseases. Limitations include the lack of detailed characterization and limited quantification of the fibers in most studies. Associated data gaps and research needs are also enumerated in this review

Does information form matter when giving tailored risk information to patients in clinical settings? A review of patients’ preferences and responses

Rebecca Harris, Claire Noble, Victoria Lowers Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK Abstract: Neoliberal emphasis on “responsibility” has colonized many aspects of public life, including how health care is provided. Clinical risk assessment of patients based on a range of data concerned with lifestyle, behavior, and health status has assumed a growing importance in many health systems. It is a mechanism whereby responsibility for self (preventive) care can be shifted to patients, provided that risk assessment data is communicated to patients in a way which is engaging and motivates change. This study aimed to look at whether the form in which tailored risk information was presented in a clinical setting (for example, using photographs, online data, diagrams etc.), was associated with differences in patients’ responses and preferences to the material presented. We undertook a systematic review using electronic searching of nine databases, along with handsearching specialist journals and backward and forward citation searching. We identified eleven studies (eight with a randomized controlled trial design). Seven studies involved the use of computerized health risk assessments in primary care. Beneficial effects were relatively modest, even in studies merely aiming to enhance patient–clinician communication or to modify patients’ risk perceptions. In our paper, we discuss the apparent importance of the accompanying discourse between patient and clinician, which appears to be necessary in order to impart meaning to information on “risk,” irrespective of whether the material is personalized, or even presented in a vivid way. Thus, while expanding computer technologies might be able to generate a highly personalized account of patients’ risk in a time efficient way, the need for face-to-face interactions to impart meaning to the data means that these new technologies cannot fully address the resource issues attendant with this type of approach. Keywords: risk, patient communication, personalisation, information, behavior change, health educatio