Including disabled children at school: Is it really as simple as 'a, c, d'?

This paper presents and discusses a social justice strategy that may progress inclusion in schools. The framework for this strategy is grounded in the theoretical discussions by Nancy Fraser and Trevor Gale about distributive, redistributive, and recognitive models of social justice. None of these theoretical frameworks, however, in themselves, offer a clear way forward for marginalised and misrecognised groups, such as disabled children, who need both educational resources and recognition in inclusive classrooms. The authors propose, however, that the work of Fraser and Gale combines into a social justice strategy, which consists of three elements (agency, competency, and diversity, or ‘a, c, d’) that can lead to inclusion. When disabled children are provided with the opportunity to exercise their agency, demonstrate their competence, and transform and affirm notions of diversity, then inclusion is more likely to occur in the classroom. Data from two research projects are presented using this framework to illustrate this argument, and the proposed ‘a, c, d’ social justice strategy towards inclusion.

Costs, outputs and outcomes in school PFI contracts and the significance of project size

This article examines operational Private Finance Initiative (PFI) school projects and reports the experiences of UK headteachers. It considers the impact of project size on value for money (VFM). Headteachers involved in small projects are more satisfied with costs than those involved in large projects, but headteachers involved in larger projects are more satisfied with affordability. Generally, heads are more satisfied with the buildings than with the services. The authors question the government’s recent policy changes to increase the size of PFI projects.

Developing Frameworks for School Self-Evaluation to Improve School Effectiveness for Peace in Northern Ireland

This article contributes towards redefining school improvement more broadly than conventional outcomes sometimes imply, and describes original and practical applications of school self-evaluation models. The significance of the work has been acknowledged by reviewers in the school improvement and peacebuilding and development fields. As a result of the research reported here, Smith was invited to support the work of the Department for Education Northern Ireland Schools Community Relations Panel and the Community Relations officers representing the five Education and Library Boards. The latter used the self-evaluation framework as a model for developing a regional whole-school self-evaluation document. Smith was the lead author of the paper.

Outreach and Early Warning Systems (EWS) for the prevention of intensive care admission and death of critically ill adult patients on general hospital wards

BACKGROUND: Despite the fact that outreach and early warning systems (EWS) are an integral part of a hospital wide systems approach to improve the early identification and management of deteriorating patients on general hospital wards, the widespread implementation of these interventions in practice is not based on robust research evidence. OBJECTIVES: The primary objective was to determine the impact of critical care outreach services on hospital mortality rates. Secondary objectives included determining the effect of outreach services on intensive care unit (ICU) admission patterns, length of hospital stay and adverse events. SEARCH STRATEGY: The review authors searched the following electronic databases: EPOC Specialised Register, The Cochrane Central Register of Controlled Trials (CENTRAL) and other Cochrane databases (all on The Cochrane Library 2006, Issue 3), MEDLINE (1996-June week 3 2006), EMBASE (1974-week 26 2006), CINAHL (1982-July week 5 2006), First Search (1992-2005) and CAB Health (1990-July 2006); also reference lists of relevant articles, conference abstracts, and made contact with experts and critical care organisations for further information. SELECTION CRITERIA: Randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series designs (ITS) which measured hospital mortality, unanticipated ICU admissions, ICU readmissions, length of hospital stay and adverse events following implementation of outreach and EWS in a general hospital ward to identify deteriorating adult patients versus general hospital ward setting without outreach and EWS were included in the review. DATA COLLECTION AND ANALYSIS: Three review authors independently extracted data and two review authors assessed the methodological quality of the included studies. Meta-analysis was not possible due to heterogeneity. Summary statistics and descriptive summaries of primary and secondary outcomes are presented for each study. MAIN RESULTS: Two cluster-randomised control trials were included: one randomised at hospital level (23 hospitals in Australia) and one at ward level (16 wards in the UK). The primary outcome in the Australian trial (a composite score comprising incidence of unexpected cardiac arrests, unexpected deaths and unplanned ICU admissions) showed no statistical significant difference between control and medical emergency team (MET) hospitals (adjusted P value 0.640; adjusted odds ratio (OR) 0.98; 95% confidence interval (CI) 0.83 to 1.16). The UK-based trial found that outreach reduced in-hospital mortality (adjusted OR 0.52; 95% CI 0.32 to 0.85) compared with the control group. AUTHORS' CONCLUSIONS: The evidence from this review highlights the diversity and poor methodological quality of most studies investigating outreach. The results of the two included studies showed either no evidence of the effectiveness of outreach or a reduction in overall mortality in patients receiving outreach. The lack of evidence on outreach requires further multi-site RCT's to determine potential effectiveness.