Curriculum as colour and curves: a synthesis of Black theory, design and creativity realised as critical curriculum writing

This article looks to three inspirational Black women, bell hooks, Stacey McBride-Irby and Patricia Williams, in the pursuit of radical curriculum. While today curriculum is critiqued as racialised, gendered, sexualised and classed, the formats of curriculum documents such as text books, units of work and lesson plans have changed little. These documents are often conceived as linear sequences of steps leading to outcomes, and their voices are distanced and ‘neutral’. Drawing on a doctoral study of curriculum design in Australia, this article embraces a different approach by opening up a unit of work on girls’ popular culture to hooks’ invocations to teach to transgress, so that curriculum might be experienced as colour and curves, rather than a monochrome route to a pre-determined end point. Through this, along with hooks, I invite teachers to live pedagogy, rather than to deliver it.

Collaboration and co-production of knowledge in healthcare: opportunities and challenges

Over time there has been a shift, at least in the rhetoric, from a pipeline conceptualisation of knowledge implementation, to one that recognises the potential of more collaboration, co-productive approaches to knowledge production and use. In this editorial, which is grounded in our research and collective experience, we highlight both the potential and challenge with collaboration and co-production. This includes issues about stakeholder engagement, governance arrangements, and capacity and capability for working in a co-productive way. Finally, we reflect on the fact that this approach is not a panacea, but is accompanied by some philosophical and practical challenges.

Maternal creatine supplementation during pregnancy prevents acute and long-term deficits in skeletal muscle after birth asphyxia: a study of structure and function of hind limb muscle in the spiny mouse

BACKGROUND: Maternal antenatal creatine supplementation protects the brain, kidney, and diaphragm against the effects of birth asphyxia in the spiny mouse. In this study, we examined creatine's potential to prevent damage to axial skeletal muscles.

METHODS: Pregnant spiny mice were fed a control or creatine-supplemented diet from mid-pregnancy, and 1 d before term (39 d), fetuses were delivered by c-section with or without 7.5 min of birth asphyxia. At 24 h or 33 ± 2 d after birth, gastrocnemius muscles were obtained for ex-vivo study of twitch-tension, muscle fatigue, and structural and histochemical analysis.

RESULTS: Birth asphyxia significantly reduced cross-sectional area of all muscle fiber types (P < 0.05), and increased fatigue caused by repeated tetanic contractions at 24 h of age (P < 0.05). There were fewer (P < 0.05) Type I and IIa fibers and more (P < 0.05) Type IIb fibers in male gastrocnemius at 33 d of age. Muscle oxidative capacity was reduced (P < 0.05) in males at 24 h and 33 d and in females at 24 h only. Maternal creatine treatment prevented all asphyxia-induced changes in the gastrocnemius, improved motor performance.

CONCLUSION: This study demonstrates that creatine loading before birth protects the muscle from asphyxia-induced damage at birth.

Curriculum as colour and curves: a synthesis of black theory, design and creativity realised as critical curriculum writing

This article looks to three inspirational Black women, bell hooks, Stacey McBride-Irby and Patricia Williams, in the pursuit of radical curriculum. While today curriculum is critiqued as racialized, gendered, sexualised and classed, the formats of curriculum documents such as text books, units of work and lesson plans have changed little. These documents are often conceived as linear sequences of steps leading to outcomes, and their voices are distanced and “neutral”. Drawing on a doctoral study of curriculum design in Australia, this article embraces a different approach by opening up a unit of work on girls’ popular culture to hooks’ invocations to teach to transgress, so that curriculum might be experienced as colour and curves, rather than a monochrome route to a pre-determined end point. Through this, along with hooks, I invite teachers to live pedagogy, rather than to deliver it.

Patient satisfaction with treatment for alcohol use disorders: comparing patients with and without severe mental health symptoms

BACKGROUND: Previous studies suggest patients with co-occurring alcohol use disorders (AUDs) and severe mental health symptoms (SMHS) are less satisfied with standard AUD treatment when compared to patients with an AUD alone. This study compared patient satisfaction with standard AUD treatment among patients with and without SMHS and explored how standard treatment might be improved to better address the needs of these patients.

METHODS: Eighty-nine patients receiving treatment for an AUD either at an inpatient hospital, outpatient clinic, inpatient detoxification, or residential/therapeutic community services were surveyed. Patient satisfaction with treatment was assessed using the Treatment Perception Questionnaire (range: 0-40). Patients were stratified according to their score on the Depression Anxiety Stress Scale. Forty patients scored in the extremely severe range of depression (score >14) and/or anxiety (score >10) (indicating SMHS) and 49 patients did not. An inductive content analysis was also conducted on qualitative data relating to areas of service improvement.

RESULTS: Patients with SMHS were found to be equally satisfied with treatment (mean =25.10, standard deviation =8.12) as patients with an AUD alone (mean =25.43, standard deviation =6.91). Analysis revealed that being an inpatient in hospital was associated with reduced treatment satisfaction. Patients with SMHS were found to be significantly less satisfied with staffs' understanding of the type of help they wanted in treatment, when compared to patients with AUDs alone. Five areas for service improvement were identified, including staff qualities, informed care, treatment access and continuity, issues relating to inpatient stay, and addressing patients' mental health needs.

CONCLUSION: While findings suggest that AUD treatment services adequately meet the needs of patients with SMHS in treatment, patients with SMHS do feel that staff lack understanding of their treatment needs. Findings have important implications as to how current health care practice might be improved according to the patient's perspective of care.

'I'm a sick person, not a bad person': patient experiences of treatments for alcohol use disorders

BACKGROUND: Emerging research indicates that standard treatments for alcohol use disorders may not fully meet the needs of patients with co-occurring severe mental health symptoms. Investigating health quality indicators may provide insight into how current treatment might be improved.

OBJECTIVE: To better understand the experiences of patients receiving treatment for alcohol use disorders and compare the experiences of patients with and without co-occurring severe mental health symptoms.

DESIGN: Cross-sectional qualitative research design using semi-structured interviews methods and framework analysis approach.

SETTING: Inpatient hospital, outpatient service, inpatient detoxification clinic and a residential/ therapeutic community.

PARTICIPANT'S: Thirty-four patients receiving treatment for an alcohol use disorder.

MAIN VARIABLES STUDIED: Themes relating to patients' experiences of continuity of care, treatment need and satisfaction with treatment were studied. The qualitative data were divided into two groups: patients with (n = 15) and without (n = 19) severe mental health symptoms.

RESULTS: Five themes relating to patient satisfaction with treatment were identified, including: perceived effectiveness of treatment, supportive relationships, specialized but holistic care, patient autonomy and continuity of care. A diverse range of patient treatment needs, staff and service continuity and stigma were also identified as major themes. Five basic themes were identified as more critical to the experiences of patients with severe mental health symptoms.

DISCUSSION AND CONCLUSIONS: Findings suggest that patients look for supportive relationships with others, to be involved in treatment decisions, effective specialized and holistic approaches to care and a non-judgemental treatment environment.

Continuity of care in dual diagnosis treatment: definitions, applications, and implications.

OBJECTIVE: The goal of this work is to review the current literature on continuity of care in the treatment of people with dual diagnosis. In particular, this review set out to clarify how continuity of care has been defined, applied, and assessed in treatment and to enhance its application in both research and clinical practice. METHODS: To identify articles for review, the term "continuity" and combinations of "substance" and "treatment" were searched in electronic databases. The search was restricted to quantitative articles published in English after 1980. Papers were required to discuss "continuity" in treatment samples that included a proportion of patients with a dual diagnosis. RESULTS: A total of 18 non-randomized studies met the inclusion criteria. Analysis revealed six core types of continuity in this treatment context: continuity of relationship with provider(s), continuity across services, continuity through transfer, continuity as regularity and intensity of care, continuity as responsive to changing patient need, and successful linkage of the patient. Patient age, ethnicity, medical status, living status, and the type of mental health and/or substance use disorder influenced the continuity of care experienced in treatment. Some evidence suggested that achieving continuity of care was associated with positive patient and treatment-related outcomes. CONCLUSIONS: This review summarizes how continuity of care has been understood, applied, and assessed in the literature to date. Findings provide a platform for future researchers and service providers to implement and evaluate continuity of care in a consistent manner and to determine its significance in the treatment of people with a dual diagnosis.

Pilot CBT trial for anxiety in alcohol use disorders treatment

Purpose – The purpose of this paper is to test the effectiveness of a self-directed cognitive behavioural therapy (CBT) booklet allowing immediate access to treatment for anxiety during alcohol use disorder (AUD) interventions. Design/methodology/approach – Parallel pilot randomised controlled trial: 69 individuals in AUD treatment, continued to receive treatment alone (control: n=29) or in addition, a self-directed, four week CBT booklet to manage anxiety (intervention: n=40). Primary outcome measures were changes in state (SAnx) and trait anxiety (TAnx) at four weeks. Secondary outcome measures were changes in adaptive (ACop), maladaptive (MCop) coping and quality of life (QoL, physical (PHQoL), psychological (PSQoL), social (SQoL), environment (EQoL)) at four weeks. Findings – Participants had significantly higher SAnx (p<0.01) and TAnx (p<0.01) baseline scores compared to the general population. There were no statistically significant group changes in SAnx or TAnx (p>0.05). Control group allocation predicted improvement in ACop (p<0.01), MCop (p<0.05), PHQoL (p<0.01), PSQoL (p<0.05) and SQoL (p<0.01); CBT group allocation predicted improvement in EQoL (p=0.05). All effect sizes were small to moderate (Cohen’s d<0.50). Percentage of book completion did not determine changes in anxiety, coping or quality of life. Originality/value – A four week self-directed CBT booklet did not significantly reduce anxiety during AUD treatment. Larger sample sizes will determine the most suitable treatment delivery mode for this type of CBT.

A novel treatment resource for co-occurring symptoms

This paper describes the development of a novel integrative self-directed treatment tool which uses cognitive behavioural therapy techniques to reduce anxiety symptoms in patients presenting to treatment for alcohol-related problems. More specifically, the purpose of this paper is to explore patient and health practitioner perceptions of the booklet, in order to determine its suitability and utility in the context of existing alcohol treatment services. The extent of cross-informant agreement between patient and health practitioner responses is also examined. – This research utilises a cross-sectional qualitative research design using semi-structured interview methods with patients presenting to hospital for alcohol-related diseases/illnesses/accidents/injuries (n=15) and practitioners (n=10) working at inpatient, outpatient and residential substance treatment facilities. – The present study found that the majority of patients (80 per cent) and practitioners (90 per cent) expressed a motivation to utilise the proposed booklet, agreeing that the booklet was a practical, achievable and educational resource for patients suffering from co-occurring anxiety symptoms in substance abuse facilities. Participants outlined limitations of the resource, suggesting that the booklet would be most suitable for patients with moderate to high cognitive ability, who also exhibit a motivation to change alcohol consumption and have access to additional support. – Findings from the present study suggest that the booklet may be most effective in improving treatment accessibility and patient treatment seeking behaviours; rather than reducing practitioner-patient contact. – This paper focuses on the development and utility of a novel resource suitable for substance abuse treatment facilities. The findings and feedback produced from the present study can assist with modifications of the intervention and in improving the effectiveness of future trials.

Assessing the relationship between seagrass health and habitat quality with wasting disease prevalence in the Florida Keys

Marine pathogens of the genus Labyrinthula have been identified as the cause of wasting disease in seagrass systems in both temperate and subtropical regions. An understanding of the association between environmental factors and the prevalence of wasting disease in seagrass meadows is important for elucidating plant-pathogen interactions in coastal environments. We conducted a survey of 7 turtle grass-dominated beds within the Florida Keys National Marine Sanctuary to assess the relationship between environmental and biological parameters on seagrass health. All sites contained Labyrinthula spp.; the most pathogenic strain was obtained from an anthropogenically impacted site. Leaf and total biomass, in addition to root/rhizome carbon content, canopy light and % light transmitted, all displayed strong negative correlations with a wasting index (WI). It was noted that many of the same environmental measurements that showed negative correlations with WI also displayed strong positive correlations with canopy light levels. These data suggest that light availability may be an important factor that has previously been understated in the seagrass disease literature yet warrants more attention with respect to turtle grass susceptibility to infection. Studies such as this are important because they identify gaps in our understanding of plant-pathogen interactions in subtropical marine ecosystems. Furthermore, the relationships identified in this study may offer insight into which factors are most useful in identifying "at-risk" meadows prior to the onset of larger scale die-off events.