Educational and psychosocial programmes for adolescents with diabetes: approaches, outcomes and cost-effectiveness

Diabetes incurs heavy personal and health system costs. Self-management is required if complications are to be avoided. Adolescents face particular challenges as they learn to take responsibility for their diabetes. A systematic review of educational and psychosocial programmes for adolescents with diabetes was undertaken. This aimed to: identify and categorise the types of programmes that have been evaluated; assess the cost-effectiveness of interventions; identify areas where further research is required. Sixty-two papers were identified and Subjected to a narrative review. Generic programmes focus on knowledge/skills, psychosocial issues, and behaviour/self-management. They result in modest improvements across a range of outcomes but improvements are often not sustained, suggesting a need for continuous support, possibly integrated into normal care. In-hospital education at diagnosis confers few advantages over home treatment. The greatest returns may be obtained by targeting poorly controlled individuals. Few studies addressed resourcing issues and robust cost-effectiveness appraisals are required to identify interventions that generate the greatest returns on expenditure. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

Educational participation post-16: a longitudinal analysis of intentions and outcomes

The issue of levels of participation in post-compulsory education has been emphasised by the current policy initiatives to increase the age to which some form of participation is compulsory. One of the acknowledged weaknesses of research in the field of children's intentions with regard to participation is the lack of longitudinal data. This paper offers a longitudinal analysis using the Youth Survey from the British Household Panel Survey. The results show that most children can express intentions with regard to future participation very early in their secondary school careers and that these intentions are good predictors of actual behaviour five years later. Intentions to stay on are more consistent than intentions to leave and most children who finally leave at 16 have at some point said they want to remain in education post-16. The strongest association with participation levels is attainment at GCSE. However, there are also influences of gender and parental background and these remain, even after attainment is held constant. The results show the value of focusing on intentions for participation at a very early stage of children's school careers and also the importance of current attempts to reform curriculum and assessment for the 14-19 age group.

Re-engaging with Education

The paper reports a study of alternative pre- 16 provision in a college of further education for young people who were disaffected and/or non-attenders at secondary school. The data are derived from interviews with 26 of these young people who were 'success stories' for the programme in that they had continued attendance up to the end of Year 11 and, in a few cases, beyond. The interviews showed that, for the most part, school placements had broken down for these young people because of difficulties in personal relationships, in particular relationships with teachers. However, for a minority a perceived irrelevance of the school curriculum was also a factor. The young people were almost all positive about their experience at college and the vocational courses they were taking. A good atmosphere, good personal relationships and being treated as adults were the key features of their positive experience at college although their positive feelings about the particular course was related to its vocational relevance. Most of the young people said that education and training was important to them and that they planned further study. The paper tentatively concludes that it is poor personal relationships that are mainly responsible for the premature exit from school and that good personal relationships have enabled them to remain in education. However, their continued involvement in college and intentions for further study are strongly influenced by vocational factors. The positive tone on the results reflects the perceptions of the young people at the point of interview and the paper does not deal with the disadvantaged situation many of them may be in. Further research will focus on longer term outcomes for employment and training.

Uses of mobile phones in higher education

This brief paper explores the current and potential usage of mobile phones within higher education. It reports on the outcomes of a brain storming session regarding this subject undertaken with a cohort of final year Computer Science students undertaking a Social, Legal and Ethical Aspects of Information Technology course at The University of Reading. Subsequent analysis was undertaken as a result of online discussion using a Managed Learning Environment and a web based survey completed by over 250 undergraduates from around the UK.

What next for children's services? Can policy at a local or national level have any significant impact on the outcomes for children and their families?

In England at both strategic and operational levels, policy-makers in the public sector have undertaken considerable work on implementing the findings of the Every Child Matters report and subsequently through the Children's Act 2004. Legislation has resulted in many local authorities seeking to implement more holistic approaches to the delivery of children's services. At a strategic level this is demonstrated by the creation of integrated directorate structures providing for a range of services, from education to children's social care. Such services were generally under the management of the Director of Children's Services, holding statutory responsibilities for the delivery of services formally divided into the three sectors of education, health and social services. At a national level, more fundamental policy developments have sought to establish a framework through which policy-makers can address the underlying causes of deprivation, vulnerability and inequality. The Child Poverty Act, 2010, which gained Royal Assent in 2010, provides for a clear intention to reduce the number of children in poverty, acknowledging that ‘the best way to eradicate child poverty is to address the causes of poverty, rather than only treat the symptoms’. However, whilst the policy objectives of both pieces of legislation hold positive aspirations for children and young people, a change of policy direction through a change of government in May 2010 seems to be in direct contrast to the intended focus of these aims. This paper explores the impact of new government policy on the future direction of children's services both at the national and local levels. At the national level, we question the ability of the government to deliver the aspirations of the Child Poverty Act, 2010, given the broad range of influences and factors that can determine the circumstances in which a child may experience poverty. We argue that poverty is not simply an issue of the pressure of financial deprivation, but that economic recession and cuts in government spending will further increase the number of children living in poverty.