Reassessing Grameen Bank's micro credit programme for poverty alleviation in bangladesh : a new perspective

Rural finance has been a mltior policy in alleviating poverty in developing countries. Of specific interest are the micro credit programmes that target the poorest segment of the population. Despite some successes in particular settings, the efficacy of micro credit programmes has been a mltior concern in recent years. This paper evaluates the success of the Grameen Bank, the premier micro credit provider in rural areas in Bangladesh in the context of contemporary development philosophies. Only a few studies have evaluated the performance of the Grameen Bank from a poverty alleviation perspective. Many have evaluated the efficiency of the Grameen Bank's micro credit programmes using attributes such as the repayment rate. In this paper, we add a new dimension to the literature by arguing that if poverty alleviation is the ultimate objective, then the bank's micro credit programme should be assessed from the borrowers' perspective. Rural credit should be conceptualised not as just an input to production but as a mechanism for rural transformation. Our analysis reveals that while Grameen Bank is an efficient provider of micro credit in rural Bangladesh, its programmes fall short of achieving poverty alleviation for a multitude of borrowers and reshaping the process is hence a critical imperative.

Effective mathematics learning environments : primary teachers' beliefs and practices

A first priority for changing teaching practice is to make problematic for teachers aspects of their current practice. As part of a project on improving mathematics and science teaching in the middle years of schooling, teachers were asked to rate their practice against components of effective teaching and learning and to rate each of these according to their perceived importance. Findings suggest that primary teachers endorsed the components as representing effective practice, scoring most components higher than their actual practice. Gaps were particularly evident for items relating to challenging students conceptually and higher-order thinking, with these becoming the basis for some of the action planning for change.

Family, school, peer and individual influences on early adolescent alcohol use: first-year impact of the Resilient Families programme

Introduction and Aims:  This study aimed to examine: (a) the influence of family factors relative to school, peer and individual influences on the development of adolescent alcohol use during the first year of secondary school; and (b) the feasibility of preventing adolescent alcohol use by modifying family factors. Design and Methods:  Twenty-four schools in Melbourne, Australia were randomly assigned to either the 'Resilient Families' intervention or a control condition. A baseline cohort of 2315 grade 7 students (mean age 12.3 years) were followed-up one year later (n = 2128 for longitudinal analyses). A sub-set of parents (n = 1166) also returned baseline surveys. Results: The prevalence of lifetime alcohol use in year 7 was 33% and rose to 47% by year 8. Student-reported predictors of year 8 alcohol use included baseline alcohol [Odds Ratio (OR) 3.64] and tobacco use (2.68), and school friend's alcohol (1.41) and tobacco use (1.64). After adjusting for other influences, student-reported family factors were not maintained as significant predictors of year 8 alcohol use. Parent-report predictors of student-reported alcohol use included allowing alcohol use in the home (2.55), parental alcohol use (1.88) and child hyperactivity (1.85). Protective factors included attendance at brief parent education (0.60) and parent involvement in school education (0.65). Discussion and Conclusions: The intervention appeared to benefit education-related outcomes, but no overall effect in reducing student alcohol use was found in year 8. Intervention effects on alcohol misuse may become significant in later secondary school once the entire program has been implemented. Considerable alcohol use was detected in early secondary school,   suggesting that interventions to reduce alcohol use may be usefully implemented prior to this period.

Fresh kids: the efficacy of a health promoting schools approach to increasing consumption of fruit and water in Australia

The Fresh Kids programme utilized the Health Promoting Schools (HPSs) framework to design a whole-of-school, multifaceted intervention targeting specific behaviours to promote healthy eating and reduce the risk factors associated with childhood obesity. The aim of the programme was to evaluate the effectiveness of the HPS framework to increase fruit and water consumption among primary school-aged children over a 2-year period. The study design was an interrupted time series. Four primary schools in the inner west of Melbourne, Australia, participated in the programme intervention. Baseline data were collected using a lunch box audit to assess the frequency of children with fresh fruit, water and sweet drinks, either brought from home or selected from canteen lunch orders. The lunch box audit was repeated periodically for up to 2 years following programme implementation to assess the sustainability of dietary changes. Across all participating schools, significant increases between 25 and 50% were observed in the proportion of children bringing fresh fruit. Similarly, all schools recorded increases between 15 and 60% in the proportion of students bringing filled water bottles to school and reductions between 8 and 38% in the proportion of children bringing sweet drinks. These significant changes in dietary patterns were sustained for up to 2 years following programme implementation. Targeting key nutrition behaviours and using the HPS framework is an effective and simple approach which could be readily implemented in similar childhood settings. Effective strategies include facilitating organizational change within the school; integrating curriculum activities; formalizing school policy and establishing project partnerships with local community nutrition and dietetic services.

ICT and girls: the need for a large scale intervention programme

In recent years there have been fewer students enrolling into ICT courses and subsequently there has been a significant decline in ICT graduates. The decline in participation by females has been even greater than for males resulting in a further widening of the gender imbalance in this discipline. Much of the research indicates that it is the early years that influence children's decisions regarding career choice. For many girls, although
they are initially interested and engaged with IT in their early years of schooling, this fades as they reach middle and senior secondary school. Reasons for this decline in interest include the perceptions that, among other things, IT is ‘geeky’, male dominated and generally not a people focused career. There have been many initiatives to try and redress the problem however most are localised, poorly funded and depend very much on one key individual usually in schools. This paper briefly describes the outcomes of the Young Girls ICT project designed to encourage girls to continue with computing. The paper considers what the best options might be for encouraging more girls to continue to study computing.

CHD and stroke : Scotland`s pandemics also need co-ordinated and vigorous primary prevention programmes

Further reductions in the incidence and mortality from CHD and stroke in Scotland will be largely dependent upon changes in the three major risk factors – cholesterol, blood pressure and smoking. Vigorous and co-ordinated primary prevention programmes are therefore required. This paper outlines the main elements of such a prevention programme starting in the Scottish Borders. It considers the three major risk factors and discusses local action within high risk groups and within the population at large for each. The importance of considering environmental changes and social supports for change are emphasised, and because of this, the key role of local authorities and other local partners. Suggestions for action at the national level to encourage and support the growth of such programmes across Scotland are given.

Stability of body mass index in Australian children: a prospective cohort study across the middle childhood years

Objective: To investigate the prevalence and incidence of overweight and obesity, the frequency of overweight resolution and the influence of parental adiposity during middle childhood.

Design: As part of a prospective cohort study, height and weight were measured in 1997 and 2000/2001. Children were classified as non-overweight, overweight or obese based on standard international definitions. Body mass index (BMI) was transformed into age- and gender-specific Z-scores employing the LMS method and 2000 growth chart data of the Centers for Disease Control and Prevention. Parents self-reported height and weight, and were classified as underweight, healthy weight, overweight or obese based on World Health Organization definitions.

Setting: Primary schools in Victoria, Australia.

Subjects: In total, 1438 children aged 5–10 years at baseline.

Results: The prevalence of overweight and obesity increased between baseline (15.0 and 4.3%, respectively) and follow-up (19.7 and 4.8%, respectively; P < 0.001 for increase in overweight and obesity combined). There were 140 incident cases of overweight (9.7% of the cohort) and 24 of obesity (1.7% of the cohort); only 3.8% of the cohort (19.8% of overweight/obese children) resolved to a healthy weight. The stability of child adiposity as measured by BMI category (84.8% remained in the same category) and BMI Z-score (r = 0.84; mean change = −0.05) was extremely high. Mean change in BMI Z-score decreased with age (linear trend β = 0.03, 95% confidence interval 0.01–0.05). The influence of parental adiposity largely disappeared when children's baseline BMI was adjusted for.

Conclusions: During middle childhood, the incidence of overweight/obesity exceeds the proportion of children resolving to non-overweight. However, for most children adiposity remains stable, and stability appears to increase with age. Prevention strategies targeting children in early childhood are required.

Thirty years into teaching: professional development, exhaustion and rejuvenation

Female primary school teachers are usually absent from debates about literacy theory and practice, teachers’ professional development, significant policy changes and school reform. Typically they are positioned as the silent workers who passively translate the latest and of course best theory into practice, whatever that might be and despite what years of experience might tell them. Their accumulated knowledges and critical analysis, developed across careers, remain an untapped resource for the profession. In this paper five literacy educators, three primary school teachers and two university educators, all of whom have been teaching around thirty years, reflect on what constitutes professional development. The teachers examine their experiences of professional development in their particular school contexts – the problems with top-down, mandated professional development which has a managerial rather than educative function, the frustrations of trying to implement the experts’ ideas without the resources, and the effects of devolved school management on teachers’ work and learning. In contrast, they also explore their positive experiences of professional learning through being positioned as teacher researchers in a network of early and later career teachers engaged in a three-year research project investigating unequal literacy outcomes.

Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity

OBJECTIVES: To reduce gain in body mass index (BMI) in overweight/mildly obese children in the primary care setting.
DESIGN: Randomized controlled trial (RCT) nested within a baseline cross-sectional BMI survey.
SETTING: Twenty nine general practices, Melbourne, Australia.
PARTICIPANTS: (1) BMI survey: 2112 children visiting their general practitioner (GP) April-December 2002; (2) RCT: individually randomized overweight/mildly obese (BMI z-score <3.0) children aged 5 years 0 months-9 years 11 months (82 intervention, 81 control).
INTERVENTION: Four standard GP consultations over 12 weeks, targeting change in nutrition, physical activity and sedentary behaviour, supported by purpose-designed family materials.
MAIN OUTCOME MEASURES: Primary: BMI at 9 and 15 months post-randomization. Secondary: Parent-reported child nutrition, physical activity and health status; child-reported health status, body satisfaction and appearance/self-worth.
RESULTS: Attrition was 10%. The adjusted mean difference (intervention-control) in BMI was -0.2 kg/m(2) (95% CI: -0.6 to 0.1; P=0.25) at 9 months and -0.0 kg/m(2) (95% CI: -0.5 to 0.5; P=1.00) at 15 months. There was a relative improvement in nutrition scores in the intervention arm at both 9 and 15 months. There was weak evidence of an increase in daily physical activity in the intervention arm. Health status and body image were similar in the trial arms.
CONCLUSIONS: This intervention did not result in a sustained BMI reduction, despite the improvement in parent-reported nutrition. Brief individualized solution-focused approaches may not be an effective approach to childhood overweight. Alternatively, this intervention may not have been intensive enough or the GP training may have been insufficient; however, increasing either would have significant cost and resource implications at a population level.

Television, computer use and body mass index in Australian primary school children

Objective: To investigate relationships between children's body mass index (BMI) and parent reports of children's television and video game/computer habits, controlling for other potential risk factors for paediatric obesity.

Methods: Child BMI was calculated from measured height and weight collected in 1997 as part of a large, representative, cross-sectional study of children in Victoria, Australia. Parents reported the amount of time children watched television and used video games/computers, children's eating and activity habits, parental BMI and sociodemographic details.

Results: A total of 2862 children aged 5−13 years participated. Child mean BMI z-score was significantly related to television (F = 10.2₃, P < 0.001) but not video game/computer time (F = 2.2₃, P = 0.09), but accounted for only 1 and 0.2% of total BMI variance, respectively. When parental BMI, parental education, number of siblings, food intake, organized exercise and general activity level were included, television ceased to be independently significantly related to child BMI. Using adjusted logistic regression, the odds of being overweight and obese generally increased with increasing television viewing. No relationship was found for video game/computer use.
Conclusions: A small proportion of variance in child BMI was related to television, but not video game/computer time. This was far outweighed by the influence of other variables. Causal pathways are likely to be complex and interrelated.

Renal transplantation in patients with primary immunoglobulin A nephropathy

Background. Opinions on the clinical course and outcome of renal transplantation in patients with primary immunoglobulin A nephropathy (IgAN) have been controversial.
Methods. We conducted a retrospective single-centre study on 542 kidney transplant recipients over the period 1984–2001. Long-term outcome and factors affecting recurrence in recipients with primary IgAN were analysed.
Results. Seventy-five patients (13.8%) had biopsy-proven IgAN as the cause of renal failure, and their mean duration of follow-up after transplantation was 100 ± 5.8 months. Fourteen (18.7%) of the 75 patients had biopsy-proven recurrent IgAN, diagnosed at 67.7 ± 11 months after transplantation. The risk of recurrence was not associated with HLA DR4 or B35. Graft failure occurred in five (35.7%) of the 14 patients: three due to IgAN and two due to chronic rejection. Three (4.9%) of the 61 patients without recurrent IgAN had graft failure, all due to chronic rejection. Graft survival was similar between living-related and cadaveric/living-unrelated patients (12-year graft survival, 88 and 72%, respectively, P = 0.616). Renal allograft survival within the first 12 years was better in patients with primary IgAN compared with those with other primary diseases (80 vs 51%, P = 0.001). Thereafter, IgAN patients showed an inferior graft survival (74 vs 97% in non-IgAN patients, P = 0.001).
Conclusions. Our data suggested that around one-fifth of patients with primary IgAN developed recurrence by 5 years after transplantation. Recurrent IgA nephropathy in allografts runs an indolent course with favourable outcome in the first 12 years. However, the contribution of recurrent disease to graft loss becomes more significant on long-term follow up.

The primary health professional education : current models and barriers to participation

Introduction
Continuing Education (CE) for health professionals is a life-long process which endeavours to update or enhance knowledge, refine skills, reinforce professional values and support the delivery of professional practice. It plays a pivotal role in the maintenance of professional competence and in the past decade participation in CE has become an expectation of, rather than an option for, practising health professionals. The time and resources required from organisers and participants in
CE and the need to ensure practical outcomes justifies a review of current models being used for its delivery. This entails an understanding of the purpose of CE, a consideration of how it should be delivered, and the role played by assessment in achieving the goals of CE.
Aim of Report
The overall aim of this study is to identify important considerations and subsequently make recommendations for the development of an ideal model(s) of CE for community pharmacy.
Goals of Report
1. Define CE and its role.
2. Identify and assess current CE delivery models.
3. Examine the current status of continuing education and registration requirements for pharmacists.
4. Identify barriers to participation in CE.
5. Identify components and considerations for developing a model of CE delivery.
Methods
The following methods were employed for this project:
1. Literature review
A number of electronic databases were systematically searched in order to profile current trends and concepts in CE. CE structures currently in use were investigated by directly accessing the websites of appropriate associations.
2. Stakeholder interviews
A series of semi-structured interviews were completed with stakeholders from CE delivery organisations across a range of professions including pharmacy.
3. Community pharmacy focus groups
A series of focus group teleconferences were held with groups of pharmacists thought to have distinct CE needs: experienced pharmacists (qualified more than 5 years), recently-qualified pharmacists (5 years or less), rural/remote pharmacists, and pharmacists with specialist training
needs (such as Home Medication Reviews). These focus groups asked about participants’ experiences and opinions in relation to many aspects of CE including its delivery and its assessment.

Play to learn : building literacy in the early years

Features a range of activities that will help teachers use pretend play in the classroom.

Improving pedagogy in the middle years

There has been considerable emphasis over the last decade on effective teaching and learning in the middle years of schooling, associated with the particular responses to schooling of adolescent students in a period of their lives when issues of identity, commitment, and independence are central to their experience and concern. Extensive research and development has generated considerable reform in Years 5 to 9. Improved understandings of students' different learning styles and needs has led to more diverse and strategic selection of teaching methods. However, there is still considerable scope for improving the quality of contemporary approaches to the education and development of adolescents. A number of major research projects have been conducted by the Victorian Department of Education and Training (DE&T) middle years strategy team since 1998, including the Middle Years Research and Development (MYRAD) project, the Middle Years Literacy, and Middle Years Numeracy Research projects. Currently, the focus has shifted to a more explicit framing of a Middle Years pedagogical framework. The Middle Years Pedagogy Research and Development (MYPRAD) project has developed an explicit pedagogical framework that is grounded in research findings from previous projects and from the literature more generally.

Investigation of the factors responsible for the superior performance of male students in standardised testing at one primary school

The project set out to investigate one primary school where, for four years or more, boys have outperformed girls in standardized Year 3 and 5 Basic Skills Tests in literacy and numeracy, which contradicts general findings on male and female performance in standardized literacy and numeracy testing. The school placed a heavy emphasis on literacy programs, which appear to be making a difference to the boys. Over time, there has been a slight improvement in boys’ literacy performance but the greatest area of growth is generally boys’ numeracy, rather than boys’ literacy.

Further aims of the study were to isolate school-based factors, which are potentially responsible for this phenomenon, from community-based factors and to explore the possibility that, rather than boys being advantaged, girls were actually being disadvantaged by practices at the school. The approach adopted by the research team employed intensive case-study methods and ethnographic approaches, including interviews, document analysis, and structured and unstructured observation of a range of school activities.

This paper describes how the school has transformed itself, the effects that this has had upon the teaching and learning environment and the results that have been achieved in the key areas of numeracy and literacy.