The intentional teaching of science in early childhood settings

The introduction of the new “Early Years Learning Framework” (DEEWR, 2009) has shifted the focus in Early Childhood Centres (ECC) from incidental learning through play, to planning curriculum with play as the vehicle to achieve learning in science. Using student research, we identified instances of educator practice that fitted with the new framework, and videoed practitioners’ sessions to select vignettes to use as part of an Early Childhood Science Education Unit. This presentation will discuss the varied practitioners’ approaches we saw and students’ and teachers’ interpretations of forms of ‘intentional teaching, with particular reference to science. We formulated an ‘Intentional Teaching Spectrum’ for the purpose of locating along it early childhood educator practice that differed in the opportunities that practice provided for creative and innovative children’s activity. As this work is not yet complete, full analysis of the video material is yet to be completed, so descriptive aspects only will be discussed.

Providing quality mental health nursing in primary health care settings in Kenya : A discussion paper.

Kenya, a country of 38 million people in East Africa has about 75 Psychiatrists and 500 Psychiatric Nurses, the majority work in the private sector and mainly in urban areas. Mental illness is common in Kenya, however, specialist services are sparse and primary care struggles to cope, and this has been worsened by general health programs which have been slow to appreciate the significance of mental health. The World Health Organisation recommends that provision of good quality mental health care does not only involve increasing the number of health workers but changing the skill mix and developing new competencies among existing workers. Successful implementation of mental, neurological and substance abuse disorder services in Kenya will depend on nurses, who constitute majority of the workforce located in provinces, districts and community clinics.

This discussion paper will address s key workforce issues affecting the up-scaling of mental health services, and the delivery of quality mental health nursing care in primary health care settings in Kenya. Strategies to develop skills and competencies of new and existing personnel will be discussed.

Screening and intervention for mental health problems in alcohol and other drug settings: Can training change practitioner behaviour?

Aims: The comorbidity of substance use and mental health problems poses a significant challenge for alcohol and other drug (AOD) treatment services. In many cases, AOD practitioners do not have experience or training in identifying or managing mental health conditions. Methods: This project examined the implementation of screening and intervention practices for mental health disorders among AOD clients. Training and supervision was provided to 20 AOD practitioners across five sites in four agencies with a focus on enhancing skills in detection of, and intervention for, mental health conditions among their clients. A package developed for this purpose, known as PsyCheck, was used. A random file audit was undertaken to examine changes in detection of mental health conditions. Findings: There were significant improvements in detection after training and supervision, with detection rates almost doubling in this time. Conclusions: Training and supervision using the PsyCheck package appears to have the potential to improve mental health detection and intervention in AOD services. This study shows promise for the implementation of mental health intervention in AOD services.

Prison substance misuse programs and offender rehabilitation

This article considers the nature of the association between substance misuse and criminal behaviour and how this might inform the development of prison-based substance misuse treatment programs. The literature on what is known about the effectiveness of prison-based treatment is reviewed and the implications for correctional practice considered. It is concluded that prison-based substance misuse treatment should be considered a critical component of rehabilitation programming and that justice outcomes are likely to be improved when a number of program features are incorporated.

Teachers' perceptions of their abilities to be educational leaders in Victorian childcare settings

In the context of new national regulatory requirements for designated educational leaders in early childhood settings, 11 Victorian teachers participated in semi-structured interviews exploring their perceptions of their ability to act as educational leaders in their childcare centres. Analysis of these interviews showed that, while teachers successfully made changes within their rooms, only those with a formal title or authority expressed confidence in their ability to lead change across their centres. Barriers to leadership included lack of time and a perception that their teacher qualifications 'did not buy authority'. A hierarchical model of leadership appeared dominant within the centres. The findings suggest both time allowance and formal role designation as strategies to support the new leadership roles, but also raise questions about the most effective models for supporting teacher leadership in childcare contexts.

A study protocol to investigate the management of depression and challenging behaviors associated with dementia in aged care settings

Background: 

Economic evaluation of adult rehabilitation: a systematic review and meta-analysis of randomized controlled trials in a variety of settings

Objectives:
To report if there is a difference in costs from a societal perspective between adults receiving rehabilitation in an inpatient rehabilitation setting versus an alternative setting. If there are cost differences, to report whether opting for the least expensive program setting adversely affects patient outcomes.

Data Sources:
Electronic databases from the earliest possible date until May 2011. All languages were included.

Study Selection
Multiple reviewers identified randomized controlled trials with a full economic evaluation that compared adult inpatient rehabilitation with an alternative. There were 29 included trials with 6746 participants.

Data Extraction
Multiple observers extracted data independently. Trial appraisal included a risk of bias assessment and a checklist to report the strength of the economic evaluation.

Data Synthesis:
Results were synthesized using standardized mean differences (SMDs) and meta-analyses for the primary outcome of cost. The Grading of Recommendations Assessment, Development, and Evaluation was applied to assess for risk of bias across studies for meta-analyses. There was high-quality evidence that cost was significantly reduced for rehabilitation in the home versus inpatient rehabilitation in a meta-analysis of 732 patients poststroke (pooled SMD [δ]=−.28; 95% confidence interval [CI], −.47 to −.09), without compromise to patient outcomes. Results of individual trials in other patient groups (orthopedic, rheumatoid arthritis, and geriatric) receiving rehabilitation in the home or community were generally consistent with the meta-analysis. There was moderate quality evidence that cost was significantly reduced for inpatient rehabilitation (stroke unit) versus general acute care in a meta-analysis of 463 patients poststroke (δ=.31; 95% CI, .15–.48), with improvement to patient outcomes. These results were not replicated in 2 individual trials with a geriatric and a mixed cohort, where costs did not differ between general acute care and inpatient rehabilitation. Three of the 4 individual trials, inclusive of a stroke or orthopedic population, reported less cost for an intensive inpatient rehabilitation program compared with usual inpatient rehabilitation. Sensitivity analysis included a health service perspective and varied inflation rates with no change to the significant findings of the meta-analyses.

Conclusions:
Based on this systematic review and meta-analyses, a single rehabilitation service may not provide health economic benefits for all patient groups and situations. For some patients, inpatient rehabilitation may be the most cost-effective method of providing rehabilitation; yet, for other patients, rehabilitation in the home or community may be the most cost-effective model of care. To achieve cost-effective outcomes, the ideal combination of rehabilitation services and patient inclusion criteria, as well as further data for nonstroke populations, warrants further research.