Patient costs during tuberculosis treatment in Bangladesh and Tanzania: the potential of shorter regimens

OBJECTIVE: To estimate the costs incurred by patients during the intensive and continuation phases of the current 6-month tuberculosis (TB) regimen in Bangladesh and Tanzania, and thus identify potential benefits to patients of a shorter, 4-month treatment regimen. DESIGN: The validated Stop TB patient cost questionnaire was adapted and used in interviews with 190 patients in the continuation phase of treatment with current regimens. RESULTS: In both countries, overall patient costs were lower during 2 months of the continuation phase (US$74 in Tanzania and US$56 in Bangladesh) than during the 2 months of the intensive phase of treatment (US$150 and US$111, respectively). However, continuation phase patient costs still represented 89% and 77% of the 2-month average national income in the respective countries. Direct travel costs in some settings were kept low by local delivery system features such as community treatment observation. Lost productivity and costs for supplementary foods remained significant. CONCLUSIONS: Although it is not a straightforward exercise to determine the exact magnitude of likely savings, a shorter regimen would reduce out-of-pocket expenses incurred by patients in the most recent 2 months of the continuation phase and allow an earlier return to productive activities. © 2014 The Union.

Managing student diversity in business education: Incorporating campus diversity into the curriculum to foster inclusion and academic success of international students

ABSTRACT
The past three decades have witnessed significant growth of culturally and linguistically diverse international students in Organization for Economic Co-operation and Development countries. International students now constitute an important component of the student body at many universities, especially in their business schools. The increased presence of international students has generated new demands and challenges for these business schools, and a number of issues related to international students have been identified in the literature. However, the increased presence of international students has not led universities and business schools to develop adequate responses to the issues and make subsequent changes in the curriculum. Diversity on campus continues to be managed in roughly the same way as in business organizations. Drawing on the notion that diversity should be defined and understood in terms of context, this conceptual paper redefines diversity on campus, identifies limitations of current diversity education in the higher education context, and develops a competency-oriented approach to improve inclusion and academic performance of international students.

Researching early career teachers and gender differences: ramifications for rural education

Recent research into the lives of early career teachers’ in Victoria and Queensland suggest that gender remains a significant factor in shaping the careers of those teaching in rural and regional schools. The cohort of nearly 5,000 teachers involved in the ARC-funded research project, ‘Studying the Effectiveness of Teacher Education’ (SETE) has a high proportion of females (78%). This composition is consistent with other large-scale datasets and across four rounds of SETE surveys between 2010-2014, and reflected in Case Studies of a selection of Victorian rural and regional schools. Continued perceptions of teaching as an ‘appropriate’ career for women remains - that is, it is reasonably well paid, with holidays and hours that allow a combination of responsibilities in work and family contexts (Acker, 1994). Yet, the analysis of SETE career progression data shows that employment and career chances of female and male graduate teachers diverge. Male graduates were more likely to be employed in full time positions and saw themselves in a leadership role in three years’ time, while female graduates were more likely to be employed in part-time positions and saw themselves teaching or in other education related occupations in the future. Interestingly, there was also significant difference in the perceptions of preparedness and effectiveness scores for males and females, with female teachers consistently reporting higher scores for both scales. In this paper, we examine the research data with regards to gender differences in rural and regional primary schools and ask the question: thirty years after the first Affirmative Action Plan for Women in the Victorian Teaching Service (1986), why do these gender differences in teaching careers still hold true—and does it matter in rural education?

Understanding a transitional teacher education in globalized and neoliberal contexts

Many early career teachers commence their transition into the teaching profession in rural and remote schools. Separated from existing interpersonal/professional networks of support, early career teachers rely on new colleagues and school leaders in more complex ways than their peers teaching closer to home. Crucially, their emerging identities, resilience and motivations are therefore influenced and reinforced
through professional interactions. This paper explores the critical turning points and narratives of two early career rural teachers. The narratives were collected through reflect.goingok.com, a digital tool created by one of the authors; that enabled the teachers to engage in regular reflections about their transition from university to the classroom. In conclusion some of the implications of the co-narration of teacher identity, and how this informs a systemic approach that supports early career teachers in rural teaching practice is discussed.

Digital technology policies in Canada and Australia: an analysis of new rules for ‘new tech'

As mobile touch screen digital devices (MTSD) have moved into a more prominent position in classrooms and schools, the development of new policies to address these devices have also emerged at a rapid pace. While policy documents aimed at MTSD usage in schools are evident at range of levels, from school-based to education ministries and departments, there is relatively little research that examines such documents or their impact on teaching and learning. This paper reports on initial analyses of educational digital media and MSTD policies in education departments and schools in Victoria, Australia and Alberta, Canada. We examined these policy documents in relation to implications for resourcing, usage and teaching practice, as a part of a large-scale Canadian-funded comparative research project studying digital tools and practices. Schools must mediate and negotiate complex entangled environments that are all at once enabling and dis-abling of innovation, in relation to digital technologies. These complex environments are made visible through a closer reading of artifacts such as policy documents guiding technology use in schools and classrooms. Our paper will interrogate such documents, across both countries (Canada and Australia) and regions (Victoria and Alberta), in relation to several emergent themes: private vs. school funded ownership, attitudes towards ‘bring your own device' (BYOD) initiatives and "co-contributions", equity and access, and surveillance and control. As well, we will address how hopes and fears and understandings of digital literacy are represented, described and enacted through such policies. Our analyses will also contextualize our data in terms of the broader cultural, political and educational considerations that framing and undergirding policies in both countries, and, finally, we will address the different (and similar) assumptions that are communicated within the digital policy documents.

Sustainable schools as pedagogical tools for environmental education

There has been extensive research about the association between school physical environment and children’s educational performance. However, the relationship between the sustainability of school physical environments and children’s environmental awareness via education has been rarely addressed in the literature. This paper evaluates the possible differences between the environmental attitudes and behaviours of children in schools designed for sustainability and conventional schools in Victoria, Australia. The New Environmental Paradigm (NEP) and General Ecological Behaviours (GEB) scales were employed to measure the environmental awareness of 275 grade 4-6 children in seven primary schools. Quantitative analysis was conducted to look for significant differences between the environmental attitudes and behaviours of two groups: children attending conventional schools and children attending schools assessed as being designed or refurbished with sustainability in mind. The results of the analysis indicated that there was a statistically significant difference between the two groups. Factor analysis revealed the NEP and GEB to be multidimensional scales. Considering the relationship between school design and the identified behaviour and attitude factors showed the presence of sustainability features had the greatest impact on the factor Children’s Attitudes via ESD (Environmentally Sustainable Design) at School. This result invites professionals in the built environment design disciplines to re-think the pedagogic importance of environmentally sustainable design in schools.

The population cost-effectiveness of delivering universal and indicated school-based interventions to prevent the onset of major depression among youth in Australia

AIMS: School-based psychological interventions encompass: universal interventions targeting youth in the general population; and indicated interventions targeting youth with subthreshold depression. This study aimed to: (1) examine the population cost-effectiveness of delivering universal and indicated prevention interventions to youth in the population aged 11-17 years via primary and secondary schools in Australia; and (2) compare the comparative cost-effectiveness of delivering these interventions using face-to-face and internet-based delivery mechanisms. METHODS: We reviewed literature on the prevention of depression to identify all interventions targeting youth that would be suitable for implementation in Australia and had evidence of efficacy to support analysis. From this, we found evidence of effectiveness for the following intervention types: universal prevention involving group-based psychological interventions delivered to all participating school students; and indicated prevention involving group-based psychological interventions delivered to students with subthreshold depression. We constructed a Markov model to assess the cost-effectiveness of delivering universal and indicated interventions in the population relative to a 'no intervention' comparator over a 10-year time horizon. A disease model was used to simulate epidemiological transitions between three health states (i.e., healthy, diseased and dead). Intervention effect sizes were based on meta-analyses of randomised control trial data identified in the aforementioned review; while health benefits were measured as Disability-adjusted Life Years (DALYs) averted attributable to reductions in depression incidence. Net costs of delivering interventions were calculated using relevant Australian data. Uncertainty and sensitivity analyses were conducted to test model assumptions. Incremental cost-effectiveness ratios (ICERs) were measured in 2013 Australian dollars per DALY averted; with costs and benefits discounted at 3%. RESULTS: Universal and indicated psychological interventions delivered through face-to-face modalities had ICERs below a threshold of $50 000 per DALY averted. That is, $7350 per DALY averted (95% uncertainty interval (UI): dominates - 23 070) for universal prevention, and $19 550 per DALY averted (95% UI: 3081-56 713) for indicated prevention. Baseline ICERs were generally robust to changes in model assumptions. We conducted a sensitivity analysis which found that internet-delivered prevention interventions were highly cost-effective when assuming intervention effect sizes of 100 and 50% relative to effect sizes observed for face-to-face delivered interventions. These results should, however, be interpreted with caution due to the paucity of data. CONCLUSIONS: School-based psychological interventions appear to be cost-effective. However, realising efficiency gains in the population is ultimately dependent on ensuring successful system-level implementation.

The cross-sectional association between diet quality and depressive symptomology amongst Fijian adolescents

OBJECTIVE: To examine the relationship between diet quality and depressive symptomology amongst a community-based sample of Fijian adolescents.

METHODS: Participants included 7,237 adolescents (52.6% girls; mean age 15.6 years) at baseline (2005) and 2,948 (56% girls; mean age 17.4 years) at follow-up (2007/2008), from the Pacific Obesity Prevention in Communities Project. Intervention schools (n = 7) were selected from Nasinu, near Suva on the main Fijian island Viti Levu, and comparison schools (n = 11) were chosen from towns on the opposite, west side of the island. A dietary questionnaire was used to measure diet quality. Factor analysis clustered dietary variables into two unique and independent factors, referred to as healthy diet quality and unhealthy diet quality. Depressive symptomology was assessed via the emotional subscale of the Paediatric Quality of Life Inventory. Both measures were self-reported and self-administered. Multiple linear regression was used to test cross-sectional associations (at baseline and follow-up) between diet quality and depressive symptomology. Variables controlled for included gender, age, ethnicity, study condition, BMI-z scores, and physical activity.

FINDINGS: Strong, positive dose-response associations between healthy diet and high emotional scores (lower depressive symptomology) were found in cross-sectional analyses at baseline and follow-up, among boys and girls. No association was found between emotional health and unhealthy diet.

CONCLUSIONS: This study suggests that cross-sectional relationships exist between a high quality diet during adolescence and less depressive symptoms, however more evidence is required to determine if these two variables are linked causally. Trial population health strategies that use dietary interventions as a mechanism for mental health promotion provide an opportunity to further test these associations. If this is indeed a true relationship, these forms of interventions have the potential to be inexpensive and have substantial reach, especially in Low and Middle Income Countries. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12608000345381.

School autonomy as ‘the way of the future’: Issues of equity, public purpose and moral leadership

This paper presents interview data from research conducted in two public high schools in the state of Queensland, Australia. The research was concerned with exploring issues of equity and diversity. Both schools had recently converted to ‘independent’ status within a new state policy reform – the Independent Public Schools initiative. This reform was seen as having a significant effect on matters of equity and diversity and so became an important focus of the research. Within current accountability parameters, there were concerns expressed by key personnel at the schools about how converting to an Independent Public Schools was both enabling and constraining student equity in terms of resource distribution and school access, and undermining schools’ focus on their public purpose in relation to imposing an excessive focus on narrow external accountability measures. These concerns bring to light the significance of moral leadership within autonomous schooling environments – shaped as they are by regimes of accountability and competition that can clearly compromise student equity and delimit schooling purposes.

Three dimensional printing as a way to create an engaging and meaningful context for learning

Three-dimensional (3D) printers are now commonplace in both primary and secondary schools within Australia. As with most new technologies they present a range of challenges to users in terms of technical problems and support, and how to integrate their use into the curriculum in a meaningful way. This research reports on data from a small number of Victorian primary schools from urban and regional areas. A case study methodology has been used to examine how each setting has approached the use of these printers and includes a review of the literature concerning the uptake of new technologies by non-experts. Data include interview transcripts from teachers, principals and technicians and photographic artefacts of 3D printed objects. Teachers reflected on their reasoning behind lesson plans and their aspirations for future use of 3D printers in the classroom. Some of the issues identified were teacher confidence, time to ‘play’ with and become familiar with 3D printers; and technical challenges that arose such as the time taken to print an object and clogging of printer extruders (heads). Recommendations are made concerning possible ways forward.

Playing the game: critical literacy, gender justice and issues of masculinity

This paper explores issues of critical literacy, gender justice and masculinity through ‘Mr A’s’ story. Mr A is head of English at ‘Grange College’ – an all boys’ school in a large urban centre in Queensland (Australia). The paper highlights how the privileging of rationality, control and ‘the masculine’ within Mr A’s ‘teaching‐as‐usual’ discourse constrains his efforts to pursue gender justice through critical literacy. While Mr A scaffolds his students’ critical analysis of gender and power in texts, his investments in teacher/student binary relations draw rigid boundaries between himself and his students in ways that delegitimise the terrain beyond the rational and ignore a theorising of the self. Drawing on Mr A’s story within Davies’ theorising about the possibilities of critical literacy, this paper adds to key work in arguing the importance of teachers’ interrogating their classrooms as lived texts where the relations of domination and power that derail the social justice possibilities of critical literacy can be made both recognisable and revisable. Such interrogation is foregrounded here as particularly urgent within the current moment where rationalist discourses within and beyond schools are increasingly working to circumscribe and constrain teacher practice in ways that stifle transformative social agendas.

School innovation in science : change, culture, complexity

The School Innovation in Science (SIS) initiative has developed and evaluated a model to improve science teaching and learning across a school system. The model involves a framework for describing effective teaching and learning, and a strategy that allows schools flexibility to develop their practice to suit local conditions and to maintain ownership of the change process. SIS has proved successful in improving science teaching and learning in primary and secondary schools. Evidence of variations in the nature and extent of the change is used to argue that the process is essentially cultural in nature, and that change occurs at different levels within a school. Processes supporting change thus need to be flexible and responsive.

Tonic Sol-fa in contemporary choral music practice : a South African case study

The Tonic Sol-fa method of teaching choral singing was propagated throughout Britain during the nineteenth century with the dual objectives of enhancing Christian worship and achieving social reform. It was then imported to South Africa where it was introduced to indigenous people principally through Christian missionary activity and government schools. Although entirely of foreign origin, Tonic Sol-fa was so fully assimilated into African culture that it became effectively 'indigenised'. Due to its widespread use, it became the mainstay of community choral singing and may now be said to represent a significant exogenous aspect of present-day South African musical identity. However, there is little documentation regarding the type and extent of its use in contemporary choral music practice.

This paper will report on the use of Tonic Sol-fa in representative present-day choral music settings. Interview data collected from choir directors, trainers and teachers in Cape Town indicate that there is far from unanimous agreement on several aspects - in particular, the future of Tonic Sol-fa as a pedagogy and notational system. Improving educational opportunities for indigenous South Africans to undertake professional training in music are now threatening the traditional dominance of Tonic Sol-fa in indigenous culture. Nevertheless this research represents a useful case study of the continuing relevance of Tonic Sol-fa to an indigenous population who have 'made it their own' and developed a vibrant choral tradition which continues to both enrich and sustain their lives.

Teaching values

Teaching Values has been designed to support teachers to introduce the Nine Values for Australian Schooling (Australian Government 2005) to their students and to build on the work that they and their schools do in the name of values education. It does not set out to be the definitive text rather it contributes to the current and historical discourse in this area by providing a unique approach to this complex area of the school curriculum. Using a range of texts sourced from collections held by the National Museum of Australia the book uses textual analysis as an approach to teaching values.

Umpire participation: is abuse really the issue?

Umpires (or referees) are essential for the ongoing production of organised sport. It has been widely argued that abuse of umpires by players, coaches, and spectators is ubiquitous and aversive, therefore engendering attrition. Cognitive behavioural theory specifies that attrition and continuation are best understood by identifying the ways that stimuli are interpreted. In this study, 22 umpires of professional and semi-professional Australian Rules football were interviewed to determine what they think of abusive behaviour, and what they find to be rewarding about umpiring. Findings showed that umpires routinely reframe abuse, considering it to be a normal part of their role. Abuse was not deemed to be particularly aversive, and there was no evidence that it contributes to attrition. On the other hand, umpires enjoyed the social world they share with other umpires, and identified social interactions among umpires as a key reason for continuing to umpire. This study highlights the important role that socialisation into the social world of umpiring plays in helping umpires to reframe abuse, and the importance of socialising with other umpires in maintaining their commitment to umpiring. It is suggested that the social rewards of umpiring should be stressed in umpire recruitment, and that the social world of umpiring should be incorporated into umpire training and retention.