Making prevention matter : a survey of child sexual abuse prevention programs in Australia

Throughout Australia, there is considerable concern about the prevalence of child sexual abuse. Sexual abuse is experienced by over 3,500 Australian children each year, causing long-term psychological, health and social problems to children, their families and communities, and significant economic costs to society as a whole. In many countries, the provision of school-based programs has been a core strategy in efforts to prevent child sexual abuse. However, little is known about the range of programs in use in Australia, the numbers of children who have received programs, and the contents and methods used in program delivery. This presentation reports on a detailed National survey of child sexual abuse prevention programs currently used in Australian primary schools. An online survey was conducted over a six-month period from November 2011 to April 2012 yielding detailed data from 38 programs. The presentation will provide an overview of: the scope and reach of programs; program content, teaching strategies and resources; barriers and facilitators to program adoption by schools; and program evaluation strategies.

The Watermemories Swimming Club

This pilot project aimed to try something different - rekindle positive memories of swimming in people with dementia who enjoyed swimming throughout their lives, and involve them in active swimming again using a swimming club intervention. Club members were recruited from two residential aged care facilities in Queensland, Australia (n=25 recruited, n=18 commenced, n=11 (median age=88.4, IQR=12.3; 1 male) completed the intervention). The 12 week program consisted of two, 45 minute sessions per week held at a municipal pool, using a trained instructor and assistants. Measures, taken at baseline, Week 6, Week 9 and post intervention included psychosocial and physical assessments such as the Revised Memory and Behavior Problems Checklist, Psychological Well-Being in Cognitively Impaired Persons, Seniors Physical Performance Battery and bioelectric impedance analysis. Stakeholder focus groups determined the barriers and facilitators for the club. Three outcomes have been achieved: 1) the development of a dementia specific, evidence-based, aquatic exercise program. This valuable resource will ensure that the benefits will be maximized with tailored exercises for strength, agility, flexibility, balance, relaxation and stress reduction, 2) improved quality of life for members, with statistically significant improvements in psychological wellbeing (χ2 =8.66, p<0.05), BPSD expression (χ2=16.91, p=0.001) and staff distress (χ2=16.86, p=0.001) and 3) an informative website with instructional video clips and a manual to assist others in implementing and maintaining a Watermemories Swimming Club. This pilot project has provided strong evidence that aquatic exercise can produce positive physical, psychosocial and behavioral outcomes for people with dementia.

The QUT innovation space : a trans-disciplinary learning environment for entrepreneurship education : final report

In the current climate of global economic volatility, there are increasing calls for training in enterprising skills and entrepreneurship to underpin the systemic innovation required for even medium-term business sustainability. The skills long-recognised as the essential for entrepreneurship now appear on the list of employability skills demanded by industry. The QUT Innovation Space (QIS) was an experiment aimed at delivering entrepreneurship education (EE), as an extra-curricular platform across the university, to the undergraduate students of an Australian higher education institute. It was an ambitious project that built on overseas models of EE studied during an Australian Learning and Teaching Council (ALTC) Teaching Fellowship (Collet, 2011) and implemented those approaches across an institute. Such EE approaches have not been attempted in an Australian university. The project tested resonance not only with the student population, from the perspective of what worked and what didn’t work, but also with every level of university operations. Such information is needed to inform the development of EE in the Australian university landscape. The QIS comprised a physical co-working space, virtual sites (web, Twitter and Facebook) and a network of entrepreneurial mentors, colleagues, and students. All facets of the QIS enabled connection between like-minded individuals that underpins the momentum needed for a project of this nature. The QIS became an innovation community within QUT. This report serves two purposes. First, as an account of the QIS project and its evolution, the report serves to identify the student demand for skills and training as well as barriers and facilitators of the activities that promote EE in an Australian university context. Second, the report serves as a how-to manual, in the tradition of many tomes on EE, outlining the QIS activities that worked as well as those that failed. The activities represent one measure of QIS outcomes and are described herein to facilitate implementation in other institutes. The QIS initially aimed to adopt an incubation model for training in EE. The ‘learning by doing’ model for new venture creation is a highly successful and high profile training approach commonly found in overseas contexts. However, the greatest demand of the QUT student population was not for incubation and progression of a developed entrepreneurial intent, but rather for training that instilled enterprising skills in the individual. These two scenarios require different training approaches (Fayolle and Gailly, 2008). The activities of the QIS evolved to meet that student demand. In addressing enterprising skills, the QIS developed the antecedents of entrepreneurialism (i.e., entrepreneurial attitudes, motivation and behaviours) including high-level skills around risk-taking, effective communication, opportunity recognition and action-orientation. In focusing on the would-be entrepreneur and not on the (initial) idea per se, the QIS also fostered entrepreneurial outcomes that would never have gained entry to the rigid stage-gated incubation model proposed for the original QIS framework. Important lessons learned from the project for development of an innovation community include the need to: 1. Evaluate the context of the type of EE program to be delivered and the student demand for the skills training (as noted above). 2. Create a community that builds on three dimensions: a physical space, a virtual environment and a network of mentors and partners. 3. Supplement the community with external partnerships that aid in delivery of skills training materials. 4. Ensure discovery of the community through the use of external IT services to deliver advertising and networking outlets. 5. Manage unrealistic student expectations of billion dollar products. 6. Continuously renew and rebuild simple activities to maintain student engagement. 7. Accommodate the non-university end-user group within the community. 8. Recognise and address the skills bottlenecks that serve as barriers to concept progression; in this case, externally provided IT and programming skills. 9. Use available on-line and published resources rather than engage in constructing project-specific resources that quickly become obsolete. 10. Avoid perceptions of faculty ownership and operate in an increasingly competitive environment. 11. Recognise that the continuum between creativity/innovation and entrepreneurship is complex, non-linear and requires different training regimes during the different phases of the pipeline. One small entity, such as the QIS, cannot address them all. The QIS successfully designed, implemented and delivered activities that included events, workshops, seminars and services to QUT students in the extra-curricular space. That the QIS project can be considered successful derives directly from the outcomes. First, the QIS project changed the lives of emerging QUT student entrepreneurs. Also, the QIS activities developed enterprising skills in students who did not necessarily have a business proposition, at the time. Second, successful outcomes of the QIS project are evidenced as the embedding of most, perhaps all, of the QIS activities in a new Chancellery-sponsored initiative: the Leadership Development and Innovation Program hosted by QUT Student Support Services. During the course of the QIS project, the Brisbane-based innovation ecosystem underwent substantial change. From a dearth of opportunities for the entrepreneurially inclined, there is now a plethora of entities that cater for a diversity of innovation-related activities. While the QIS evolved with the landscape, the demand endpoint of the QIS activities still highlights a gap in the local and national innovation ecosystems. The freedom to experiment and to fail is not catered for by the many new entities seeking to build viable businesses on the back of the innovation push. The onus of teaching the enterprising skills, which are the employability skills now demanded by industry, remains the domain of the higher education sector.

A qualitative exploration of sun safety beliefs among Australian adults

Informed broadly by the theory of planned behaviour, this study used qualitative methodology to understand Australian adults' sun-protective decisions. Forty-two adults participated in focus groups where they discussed behavioural (advantages and disadvantages), normative (important referents), and control (barriers and facilitators) beliefs, as well as potential social influences and images of tanned and non-tanned people. Responses were analysed using the consensual qualitative research approach to determine the dominant themes. Themes of fashion and comfort were prominent, the important role of friends and family in sun safe decision-making was highlighted, as was the availability of sun-protective measures (e.g., in an accessible place or in the environment). Additional themes included the need to model sound sun-protective behaviours to (current and future) children, the emphasis on personal choice and personal responsibility to be sun safe, and the influence of Australian identity and culture on tanning and socially acceptable forms of sun protection. These beliefs can be used to inform interventions and public health campaigns targeting sun safety among Australians, a population with the highest skin cancer incidence in the world.

Evidence-based practice

This chapter traces the history of evidence-based practice (EBP) from its roots in evidence-based medicine to contemporary thinking about its usefulness to public health practice. It defines EBP and differentiates it from ‘evidence-based medicine’, ‘evidence-based policy’ and ‘evidence-based healthcare’. As it is important to understand the subjective nature of knowledge and the research process, this chapter describes the nature and production of knowledge. This chapter considers the necessary skills for EBP, and the processes of attaining the necessary evidence. We examine the barriers and facilitators to identifying and implementing ‘best practice’, and when EBP is appropriate to use. There is a discussion about the limitations of EBP and the use of other information sources to guide practice, and concluding information about the application of evidence to guide policy and practice.

The effectiveness of using patient-reported outcome measures as quality improvement tools

Aim: To investigate the value of using PROMs as quality improvement tools. Methods: Two systematic reviews were undertaken. The first reviewed the quantitative literature on the impact of PROMs feedback and the second reviewed the qualitative literature on the use of PROMs in practice. These reviews informed the focus of the primary research. A cluster randomised controlled trial (PROFILE) examined the impact of providing peer benchmarked PROMs feedback to consultant orthopaedic surgeons on improving outcomes for hip replacement surgery. Qualitative interviews with surgeons in the intervention arm of the trial examined the view of and reactions to the feedback. Results: The quantitative review of 17 studies found weak evidence to suggest that providing PROMs feedback to professionals improves patient outcomes. The qualitative review of 16 studies identified the barriers and facilitators to the use of PROMs based on four themes: practical considerations, attitudes towards the data, methodological concerns and the impact of feedback on care. The PROFILE trial included 11 surgeons and 215 patients in the intervention arm, and 10 surgeons and 217 patients in the control arm. The trial found no significant difference in the Oxford Hip Score between the arms (-0.7, 95% CI -1.9-0.5, p=0.2). Interviews with surgeons revealed mixed opinions about the value of the PROMs feedback and the information did not promote explicit changes to their practice. Conclusion: It is important to use PROMs which have been validated for the specific purpose of performance measurement, consult with professionals when developing a PROMs feedback intervention, communicate with professionals about the objectives of the data collection, educate professionals on the properties and interpretation of the data, and support professionals in using the information to improve care. It is also imperative that the burden of data collection and dissemination of the information is minimised.

Living with acquired brain injury

This study found that natural community supports were comprised of two distinct groupings; firstly immediate families, friends and peer support groups; secondly neighbours and local community groups such as sporting and activity- based organisations and groups. The findings of this study indicate that living with acquired brain injury involves a process where the person moves from acute high intensity health services onto rehabilitative services and then onto re-establishing independent lives. It is evident that smooth transitions and interconnectivity of services are essential in facilitating this recovery process. Instrumental to the recovery is the support of immediate family and close friends, who form people’s immediate natural support network and go a long way towards facilitating individuals in rebuilding their lives. A key finding of this study is that broader natural community supports do not appear to play as central a role in supporting individuals to live independent lives when compared to the role of family and friends. The lack of involvement of broader community groups, in many ways, prompted individuals to contact formal support services. For the majority of participants, independence is facilitated through the combination of immediate natural community supports and formal services. The role of formal support services is key to developing broader community support networks. This study found a blurred division between formal services and broader community support networks. The authors recommended that the role of formal supports services in acting as a bridge between the needs of the individual and the development of meaningful community networks, be formally recognised and further developed. Additionally, they argued that the importance of the role of broader natural community, supports such as those provided by community and sporting groups must be enhanced. Greater awareness of the issues faced by people living with acquired brain injury and its often invisible nature is necessary in this endeavour. The authors stated it is important to recognise that there are multiple issues impacting on independent living and these issues intersect, for instance with age, gender, employment, qualifications and so on. A lack of public awareness of acquired brain injury was found to be a key barrier to independent living, along with issues relating to socialising, access to employment and finances. The findings of this study reflect the complexities of living with acquired brain injury and the need for holistic support that is cognisant of the factors which impact on integration. It is vital that flexible, personalised services are developed which are fit for purpose and meet the needs of not only people with acquired brain injury but also their immediate natural community support network. Recognition of the intersection between immediate/ broader natural community supports and formal services is also key to developing the comprehensive and practical supports required to achieve an independent life. This was a qualitative study and all participants were sourced through Headway, a community based service provider for people with ABI. Data collection was divided into two stages: firstly focus groups, followed by individual interviews. Four focus groups were convened in Cork (2), Dublin (1) and Limerick (1). Each focus group was facilitated by at least two members of the research team and a total of twenty-six individuals participated in the focus groups. Thematic analysis of the data was undertaken to guide and inform the second stage of the study; the individual interviews. Ten interviews were undertaken with individuals who presented with ABI in the Cork and Limerick regions.

The implementation of a translational study involving a primary care based behavioral program to improve blood pressure control: The HTN-IMPROVE study protocol (01295).

BACKGROUND: Despite the impact of hypertension and widely accepted target values for blood pressure (BP), interventions to improve BP control have had limited success. OBJECTIVES: We describe the design of a 'translational' study that examines the implementation, impact, sustainability, and cost of an evidence-based nurse-delivered tailored behavioral self-management intervention to improve BP control as it moves from a research context to healthcare delivery. The study addresses four specific aims: assess the implementation of an evidence-based behavioral self-management intervention to improve BP levels; evaluate the clinical impact of the intervention as it is implemented; assess organizational factors associated with the sustainability of the intervention; and assess the cost of implementing and sustaining the intervention. METHODS: The project involves three geographically diverse VA intervention facilities and nine control sites. We first conduct an evaluation of barriers and facilitators for implementing the intervention at intervention sites. We examine the impact of the intervention by comparing 12-month pre/post changes in BP control between patients in intervention sites versus patients in the matched control sites. Next, we examine the sustainability of the intervention and organizational factors facilitating or hindering the sustained implementation. Finally, we examine the costs of intervention implementation. Key outcomes are acceptability and costs of the program, as well as changes in BP. Outcomes will be assessed using mixed methods (e.g., qualitative analyses--pattern matching; quantitative methods--linear mixed models). DISCUSSION: The study results will provide information about the challenges and costs to implement and sustain the intervention, and what clinical impact can be expected.

A realist literature review of transition to adult services by young people with life-limiting conditions in ireland.

Background As a result of improvements in care and treatment more young people with life-limiting conditions are now living beyond childhood, meaning they must make the transition from children's to adult services. The loss of long-standing relationships with providers of children's services combines with poor co-ordination of services to make this a daunting prospect for young people and their families. However, there is little evidence on transition services for young people with life limiting conditions, with few models of good practice in the literature.


Aims The purpose of this review was to determine the factors that promote or hinder the transition to adult services for young adults with life limiting conditions, and identify gaps to be addressed.


Methods A comprehensive search of the literature was undertaken using key terms, of the following databases; MEDLINE and the Cochrane Database of Systematic Reviews. 314 articles were sourced and inclusion and exclusion criteria were applied to highlight the most relevant literature.


Results Studies were reviewed using a realist review approach and three themes emerged from the literature. Barriers and facilitators to the transition process were identified associated with: 1. The patient 2. Parents/carers 3. The organisation.


Conclusion It is unclear from the literature what the specific factors are that promote or hinder the transition process for young adults with life limiting conditions who go through the transition from children's to adult services, therefore, research is required to identify the factors that promote and hinder the transition process in Ireland. This research is currently being carried out by the author as part of Doctoral studies. The three year full time Doctoral study commenced in January 2013 and is funded by the All Ireland Institute of Hospice and Palliative Care.

Making the case for change: what researchers need to consider when designing behaviour change interventions aimed at improving medication dispensing.

There is a growing emphasis on behavior change in intervention development programmes aimed at improving public health and healthcare professionals' practice. A number of frameworks and methodological tools have been established to assist researchers in developing interventions seeking to change healthcare professionals' behaviors. The key features of behavior change intervention design involve specifying the target group (i.e. healthcare professional or patient cohort), the target behavior and identifying mediators (i.e. barriers and facilitators) of behavior change. Once the target behavior is clearly specified and understood, specific behavior change techniques can then be used as the basis of the intervention to target identified mediators of behavior change. This commentary outlines the challenges for pharmacy practice-based researchers in targeting dispensing as a behavior when developing behavior change interventions aimed at pharmacists and proposes a definition of dispensing to consider in future research.

“They should stay at their desk until the work’s done”: a qualitative study examining perceptions of sedentary behaviour in a desk-based occupational setting

Background: Workplace sedentary behaviour is a priority target for health promotion. However, little is known about how to effect change. We aimed to explore desk-based office workers’ perceptions of factors that influenced sedentary behaviour at work and to explore the feasibility of using a novel mobile phone application to track their behaviours.

Methods: We invited office employees (n = 12) and managers (n = 2) in a software engineering company to participate in semi-structured interviews to explore perceived barriers and facilitators affecting workplace sedentary behaviour. We assessed participants’ sedentary behaviours using an accelerometer before and after they used a mobile phone application to record their activities at self-selected time intervals daily for 2 weeks. Interviews were analysed using a thematic framework.

Results: Software engineers (5 employees; 2 managers) were interviewed; 13 tested the mobile phone application; 8 returned feedback. Major barriers to reducing workplace sedentary behaviour included the pressure of ‘getting the job done’, the nature of their work requiring sitting at a computer, personal preferences for the use of time at and after work, and a lack of facilities, such as a canteen, to encourage moving from their desks. Facilitators for reduced sedentariness included having a definite reason to leave their desks, social interaction and relief of physical and mental symptoms of prolonged sitting. The findings were similar for participants with different levels of overall physical activity. Valid accelerometer data were tracked for four participants: all reduced their sedentary behaviour. Participants stated that recording data using the phone application added to their day’s work but the extent to which individuals perceived this as a burden varied and was counter-balanced by its perceived value in increasing awareness of sedentary behaviour. Individuals expressed a wish for flexibility in its configuration.

Conclusions: These findings indicate that employers’ and employees’ perceptions of the cultural context and physical environment of their work, as well as personal factors, must be considered in attempting to effect changes that reduce workplace sedentary behaviour. Further research should investigate appropriate individually tailored approaches to this challenge, using a framework of behaviour change theory which takes account of specific work practices, preferences and settings.

Níveis de actividade e participação das pessoas com afasia: desenvolvimento de instrumentos de avaliação portugueses

A International Classification of Functioning, Disability and Health (ICF) (WHO 2001) realça a necessidade dos profissionais de saúde considerarem, na intervenção que realizam com a pessoa, as possíveis consequências de uma doença em diferentes domínios, nomeadamente nas suas Funções e Estruturas do Corpo, nas suas Actividades diárias e na sua Participação em situações da vida real. Realça ainda a possível interferência dos Factores Contextuais neste processo. Em Portugal, os instrumentos existentes utilizados pelos terapeutas da fala (TFs) na sua prática clínica com pessoas com afasia (PCAs), não permitem avaliar estes domínios, o que poderá limitar uma intervenção mais alargada, que integre estas directivas. Pretendeu-se com este estudo efectuar a tradução e adaptação à língua portuguesa do Communication Disability Profile (CDP) (Swinburn and Byng 2006) e do Participation Objective Participation Subjective (POPS) (Brown, Dijkers et al. 2004), ambos desenvolvidos à luz da ICF, de modo a apetrechar os TFs do país, com instrumentos de avaliação que lhes permitam abordar os diferentes domínios referidos. Pretendeu-se ainda conhecer as reais necessidades de PCAs portuguesas, ou seja, efectuar um levantamento das consequências dos AVCs e da afasia na sua vida diária e verificar de que modo os instrumentos escolhidos permitem identificar com precisão estas necessidades. Foram envolvidos três grupos distintos de participantes, nomeadamente catorze PCAs, catorze familiares e amigos (F/A) e dez TFs, consultados em três fases distintas. Recorreu-se ao uso de diferentes métodos e instrumentos de recolha de dados, nomeadamente o brainstorming e o uso de entrevistas aprofundadas semiestruturadas, realizadas individualmente e em grupo. Construíram-se dois instrumentos de raiz (o TAPP e a GABF) que permitiram complementar os dados recolhidos junto das PCAs. A análise dos dados foi predominantemente qualitativa (Análise Temática). Da análise dos resultados obtidos nestas três fases, resultaram as primeiras versões portuguesas do CDP e do POPS. No que diz respeito às consequências dos AVCs e da afasia na vida diária das PCAs na componente das Funções e Estruturas do Corpo, os três grupos consideraram a categoria das Funções Mentais Especificas como sendo a mais perturbada. Relativamente à componente das Actividades/Participação, as consequências relatadas centram-se nas categorias das Interacções e Relacionamentos Pessoais, Vida Comunitária Social e Cívica e Áreas Principais da Vida. Quanto às Barreiras e Facilitadores, os TFs valorizam as Barreiras de Informação e as Barreiras Estruturais como as que mais interferem com a Participação social das PCAs, enquanto estas e os F/A valorizam os Factores Pessoais, as Barreiras Ambientais e as Barreiras Atitudinais. Os TFs realçam a importância de existirem “redes de suporte familiar” como Facilitadores. As PCAs e os F/A valorizam os Facilitadores Ambientais e os Facilitadores Atitudinais. No que diz respeito aos instrumentos em estudo, a maioria dos TFs assim como o grupo dos F/A considerou a apresentação visual do POPS e mais especificamente as escalas de notação usadas como sendo muito complexas, enquanto as PCAs envolvidas no estudo não fizeram qualquer referência ou crítica às mesmas. A maioria dos TFs considerou os itens do POPS como sendo relevantes para a população portuguesa com afasia. Contudo, metade destes mostrou preocupação com a ambiguidade de alguns dos seus itens e cerca de um terço considerou as instruções difíceis de compreender. As PCAs, assim como os F/A consideraram os itens do POPS, na sua generalidade, como sendo claros, relevantes e não ambíguos. A maioria dos TFs e dos F/A referem falta de clareza de algumas das imagens utilizadas no CDP. Contudo, o grupo das PCAs considera que estas são claras e facilitam a compreensão dos itens. Nenhum dos três grupos consultados fez referência ao tipo e tamanho de letra usada no CDP pelo que se considera ser adequada. A maior parte dos TFs não faz qualquer referência à falta de clareza dos itens do CDP, contudo metade considera alguns dos seus itens ambíguos e um terço questiona também a sua relevância. Os itens do CDP são considerados claros, relevantes e não ambíguos quer pelo grupo das PCAs quer pelo grupo dos F/A. Conclui-se que ambos os instrumentos vão, de uma forma geral, ao encontro das necessidades apresentadas pelas PCAs envolvidas no nosso estudo. Poderá afirmar-se também que estes mostraram ser ferramentas terapêuticas importantes para utilizar em Portugal. Contudo, ambos deixam a descoberto algumas áreas consideradas importantes pelos grupos envolvidos e pela literatura internacional, sugerindo-se a sua utilização simultânea de modo a poderem complementar-se, assim como o recurso a outras formas de avaliação disponíveis, no sentido de colmatar possíveis lacunas encontradas após a sua utilização. Sugere-se o desenvolvimento de investigações futuras que permitam o seu aperfeiçoamento.

Gerir conhecimento em centros de investigação: barreiras/facilitadores

A gestão de conhecimento é crucial para a competitividade sustentável das organizações. Todavia, a gestão do conhecimento nos centros de investigação universitários tem sido alvo de uma parca atenção nas práticas destas instituições e a literatura sobre este tema também é escassa. O objetivo deste estudo é o de identificar as barreiras e os facilitadores em quatro processos de conhecimento (aquisição; criação; partilha; transferência de conhecimento), em centros de investigação universitários. Foi feito um estudo exploratório, sendo realizadas vinte e uma entrevistas a diretores, investigadores principais e investigadores juniores, em sete centros de investigação, em duas universidades portuguesas. Os resultados obtidos são: a) as principais barreiras mencionadas pelos participantes são: fraco capital social organizacional interno; deficientes mecanismos de implementação da estratégia nacional; fraco capital social/relacional individual; fraca cultura orientada para os resultados.b) os principais facilitadores mencionados são: forte capital social organizacional externo; forte capital social organizacional interno; boas práticas de formação; forte cultura organizacional orientada para os resultados e adequada estratégia nacional. Em síntese, o estudo sugere que as variáveis de natureza individual e socioorganizacional são relevantes para a produção de conhecimento nestas organizações. A liderança dos centros de investigação tem que ter em linha de conta estes fatores críticos. Adicionalmente não pode descurar o alinhamento das tecnologias com os processos de conhecimento, visto estas serem considerados um suporte do trabalho dos investigadores. Porque as organizações são entidades porosas, é necessário ainda uma liderança atenta aos fatores contextuais para que a gestão do conhecimento seja eficaz.

A Community Hub Approach to Older People’s Housing

Purpose. This paper explores the potential of housing with care schemes to act as community hubs. The analysis highlights a range of benefits, barriers and facilitators. Design/methodology/approach. Data is presented from the ASSET project (Adult Social Services Environments and Settings) which used a mixed methods approach including a review of the literature, surveys and in-depth case study interviews. Findings. Most housing with care schemes have a restaurant or café, communal lounge, garden, hairdresser, activity room and laundrette, while many also have a library, gym, computer access and a shop. Many of these facilities are open not just to residents but also to the wider community, reflecting a more integrated approach to community health and adult social care, by sharing access to primary health care and social services between people living in the scheme and those living nearby. Potential benefits of this approach include the integration of older people’s housing, reduced isolation and increased cost effectiveness of local services through economies of scale and by maximising preventative approaches to health and wellbeing. Successful implementation of the model depends on a range of criteria including being located within or close to a residential area and having on-site facilities that are accessible to the public. Originality and Value. This paper is part of a very new literature on community hub models of housing with care in the UK. In the light of new requirements under the Care Act to better coordinate community services, it provides insights into how this approach can work and offers an analysis of the benefits and challenges that will be of interest to commissioners and providers as well as planners. This was a small scale research project based on four case studies. Caution should be taken when considering the findings in different settings.

As representações dos professores acerca da participação de alunos com necessidades educativas especiais em diversas atividades escolares

Os paradigmas concernentes à educação e ao atendimento de crianças com necessidades educativas especiais têm evoluído ao longo do tempo. De facto, se no paradigma da segregação o foco de incapacidade se situava no indivíduo, com o paradigma da inclusão o foco desloca-se para o ambiente, na medida em que este se deve organizar e preparar para dar resposta aos indivíduos com incapacidade. Por conseguinte, o meio deve assumir-se como facilitador à participação de todas as crianças. Tal fundamento comporta desafios para os professores e educadores, aos quais compete identificar as pressões de exclusão que inibem a participação plena de todos os alunos em todas as atividades inerentes ao meio escolar e acionar os suportes necessários para que tal não suceda. Com a realização deste estudo pretendemos conhecer de modo mais aprofundado as representações dos professores acerca da participação de alunos com diferentes tipos de incapacidade em variadas atividades e contextos escolares, identificando barreiras e facilitadores à sua participação e analisando os possíveis contributos pessoais dos professores para incrementar o nível de participação dos alunos com incapacidade em atividades inerentes ao meio escolar. O estudo operacionalizou-se através da aplicação de um inquérito por questionário, destinado a professores de todos os níveis de ensino e grupos de recrutamento. Através da aplicação deste instrumento, procurámos obter informações sobre os inquiridos, as representações dos professores acerca da participação de alunos com diferentes tipos de incapacidade em diversas atividades escolares, e, por fim, possíveis contributos para incrementar o nível de participação desses mesmos alunos. Os resultados sugerem que o tipo de incapacidade apresentado pelo aluno influencia as expetativas de participação de educadores e professores do ensino regular e da educação especial. Contudo, não confirmámos a existência de diferenças estatisticamente significativas entre os dois grupos de professores. No que concerne a possíveis contributos para incrementar a participação de alunos com incapacidade em diversas atividades escolares, identificámos a necessidade de se fomentar e desenvolver uma cultura de inclusão na escola.