Irish dental practitioners perceived barriers to the care of patients with special healthcare needs and the effect of postgraduate training

Inequalities in oral healthcare service provision to people with special health needs have been reported in the Republic of Ireland. These include higher unmet dental treatment needs and longer waiting period to access routine dental treatment than the general population. Aim: The aims of this study were to determine the groups of patients with special needs which pose a challenge to manage in the dental surgery and to examine perceived barriers to the care of these patients. We aimed to determine whether postgraduate training in the management of these patients increases the practitioners’ frequency of treatment and their desire for further training in this area. Methods: A questionnaire was used to survey 326 randomly selected dentists from the Dental Council’s register of dentists. Questionnaire and information sheets explaining the purpose of the survey, confidentiality and anonymity of the responses were posted to the dentists. Results: The results showed that children with intellectual disability posed the biggest challenge for dentists to manage in the dental surgery. Behaviour management issues and the degree of disability were perceived by many dentists as factors that would have high effects on their willingness to treat patients with special needs. Dentists who have postgraduate training in the management of patients with special needs were significantly more willing to treat these patients and to seek additional training in the future. Conclusion: There are links between the training and the willingness of practitioners to undertake dental treatment or patients with special healthcare needs.

Green Economy and Employment: employment potential of the ecological transition in Spain

The Green Economy offers real possibilities for productive innovation, economic growth and employment creation in Spain. These three factors are critical to facilitate the necessary change in the productive model to overcome the crisis. However, the measures taken by the current Conservative government have moved in the opposite direction: significant cutting in incentives for renewable, increasing tax burden on renewable energy production to self-consumption and privatizing public spaces of social and environmental interest. This hinders the achievement of the environmental objectives of the Europe 2020 strategy. A strategy that is born already in itself highly limited, unambitious and subordinated to the interests of energy oligopolies and the imperatives of the Stability and Growth Pact (Maastricht) and the Austerity policies imposed from EU institutions to overcome the 2008 financial crisis. So the Ecological Transition goes further, claiming a substantially change in Economic Policy away form the increasing commodification proposed by the Green Economy. Despite these limitations, young and unemployed people have much to gain from a comprehensive development of environmental industries. Therefore, innovative-sustainable plans, investment and training in green sectors are necessary to make easier the transition from a services low-valued economy to an innovative and sustainable model to make our country an environmental reference in Europe.

Circus Workshop in the chid Psychiatry

The following paper is about the possible psychological effects of social circus, and our experiences with teaching circus methods in children psychiatry. In the beginning the paper try to place social circus in a wider theoretical frame, and searches for the place of it among psychological methods and therapies. We look at the wider and the more specific psychological constructs, what can be effected by social circus, especially the factors which are damaged in children with psycological or psychiatrycal problems. We examine the different parts of circus, how they can help in different problems. The further aim is to research the effects of a continuous social circus group, and to find it’s own way among psychotherapies.

Correlation between anxiety and academic self-concept in interpreter trainees

This paper focuses on two basic issues: the anxiety-generating nature of the interpreting task and the relevance of interpreter trainees’ academic self-concept. The first has already been acknowledged, although not extensively researched, in several papers, and the second has only been mentioned briefly in interpreting literature. This study seeks to examine the relationship between the anxiety and academic self-concept constructs among interpreter trainees. An adapted version of the Foreign Language Anxiety Scale (Horwitz et al., 1986), the Academic Autoconcept Scale (Schmidt, Messoulam & Molina, 2008) and a background information questionnaire were used to collect data. Students’ t-Test analysis results indicated that female students reported experiencing significantly higher levels of anxiety than male students. No significant gender difference in self-concept levels was found. Correlation analysis results suggested, on the one hand, that younger would-be interpreters suffered from higher anxiety levels and students with higher marks tended to have lower anxiety levels; and, on the other hand, that younger students had lower self-concept levels and higher-ability students held higher self-concept levels. In addition, the results revealed that students with higher anxiety levels tended to have lower self-concept levels. Based on these findings, recommendations for interpreting pedagogy are discussed.

Worker, workplace or families: What influences family focused practices in adult mental health?

Introduction: Family focused practice is thought to lead to positive outcomes for all family members. However, there are multiple barriers and enablers in adult mental health services to practitioners undertaking these actions.
Aim: The aim of this study was to examine the relative importance of worker, workforce and family factors to predict family focused practices (FFPs) in adult mental health services.
Method: Three hundred and seven adult mental health workers completed a 45 items family focused practice measure of 16 family focused practices.
Thesis: It was found that worker skill and knowledge about family work and an ability to assess the degree of parental insight into the child’s connections to other family members and the community were important predictors of FFP, along with the closely related-worker confidence. While aspects of the worker, workplace and family each contribute to FFPs, this study highlighted the importance of worker skill, knowledge and confidence as central issues for adult mental health workers.
Implications for practice: Study implications include the need for training in specific FFPs, the provision of time to engage with clients on parenting issues and the need 5 to ensure that there are adequate services for workers to refer family members to

Ultrasound in undergraduate medical education: A systematic and critical review

Introduction: Point-of-care ultrasound (POCUS) use in clinical care is growing rapidly, and advocates have recently proposed the integration of ultrasound into undergraduate medical education (UME). The evidentiary basis for this integration has not been evaluated critically or systematically. In this study, we conducted a critical and systematic review framed by the rationales enumerated by advocates of ultrasound in UME in academic publications.

Methods: This research was conducted in two phases. First, the dominant discursive rationales for the integration of ultrasound in UME were identified using techniques from Foucauldian critical discourse analysis (CDA) from an archive of 403 academic publications. We then sought empirical evidence in support of theses rationales, using a critical synthesis methodology also adapted from CDA.

Results: We identified four dominant discursive rationales, with different levels of evidentiary support. Ultrasound was not demonstrated to improve students’ understanding of anatomy. The benefit of ultrasound in teaching physical examination was inconsistent,and rests on minimal evidence. With POCUS, students’ diagnostic accuracy was improved for certain pathologies, but findings were inconsistent for others. Finally, the rationale that ultrasound training in UME will improve quality of patient care was difficult to evaluate.

Discussion: Our analysis has shown that the frequently repeated rationales for the integration of ultrasound in UME are not supported by a sufficient base of empirical research. The repetition of these dominant discursive rationales in academic publications legitimizes them and may preclude further primary research. Since the value of clinical ultrasound use by medical students remains unproven, educators must consider whether the associated financial and temporal costs are justified or whether more research is required.

Gaining by Giving? Peer Research into Service User and Carer Perceptions of Inclusivity in Higher Education

Service users and carers (SUAC) have made significant contributions to professional training in social work courses in Higher Education (HE) over the past decade in the UK. Such participation has been championed by government, academics and SUAC groups from a range of theoretical and political perspectives. Most research into the effectiveness of SUAC involvement at HE has come from the perspectives of academics and very little SUAC-led research exists. This qualitative peer research was led by two members of the University of Worcester’s SUAC group. Findings were that SUAC perceived their involvement brought benefits to students, staff, the University and the local community. Significant personal benefits such as finding a new support network, increased self-development and greater confidence to manage their own care were identified in ways that suggested that the benefits that can flow from SUAC involvement at HE are perhaps more far-reaching than previously recognised. Barriers to inclusion were less than previously reported in the literature and the humanising effects of SUAC involvement are presented as a partial antidote to an increasingly marketised HE culture.

A Comparison of Audio Recordings and Therapist's Process Notes in Child and Adolescent Psychoanalytic Psychotherapy

Therapistsʼ process notes - written descriptions of a session produced shortly afterwards from memory - hold a significant role in child and adolescent psychoanalytic psychotherapy. They are central in training, in supervision, and in developing oneʼs understanding through selfsupervision and forms of psychotherapy research. This thesis examines such process notes through a comparison with audio recordings of the same sessions. In so doing, it aims to generate theory that might illuminate the causes of significantly patterned discrepancies between the notes and recordings, in order to understand more about the processes at work in psychoanalytic psychotherapy and to explore the nature of process notes, their values and limitations. The literature searches conducted revealed limited relevant studies. All identified studies that compare process notes with recordings of sessions seek to quantify the differences between the two forms of recording. Unlike these, this thesis explores the meaning of the differences between process notes and recordings through qualitative data analysis. Using psychoanalytically informed grounded theory, in total nine sets of process notes and recordings from three different psychoanalytic psychotherapists are analysed. The analysis identifies eight core categories of findings. Initial theories are developed from these categories, most significantly concerning the role and influence of a ʻcore transference dynamicʼ between therapist and patient. Further theory is developed on the nature and function of process notes as a means for the therapistʼs conscious and unconscious processing of the session, as well as on the nature of the influence of the relationships – both internal and external – within which they are written. In the light of the findings, a proposal is made for a new approach for learning about the patient and clinical work, ʻthe comparison methodʼ (supervision involving a comparison of process notes and recordings), and, in particular, for its inclusion within the training of psychoanalytic psychotherapists. Further recommendations for research are also made.

An Exploration of Clinical Psychologist and Educational Psychologist Constructs of Mental Health in the Context of Secondary School Aged Children

Over the past decade, Mental Health (MH) has increasingly appeared on the ‘school agenda’, both in terms of rising levels of MH difficulties in the student population, and also the expectation that schools have a role to play in supporting good MH. MH is a term fraught with ambiguities leading to uncertainty around the most appropriate ways to provide support. A review of current literature reveals a wide range of definitions and interpretations, sometimes within the same team of supporting professionals. The current study seeks to explore the perspectives held by two professional groups seemingly well placed to support young persons’ (YPs’) MH. Six Clinical Psychologists (CPs) and six Educational Psychologists (EPs) are interviewed, exploring their constructs of MH, and their perceptions of their own role and the roles of others in supporting secondary school aged YPs’ MH. The data are analysed through Thematic Analysis. Findings suggest that there are variations between the two professions’ constructs of MH, and EPs in particular have no unified concept of MH. This is likely due to less experience or training in this area. CPs and EPs hold similar perceptions of the school’s role for promoting good MH, and flagging up concerns to more specialist professionals when necessary. However, there are discrepancies in the EP and CP perceptions of each other’s roles. The conflicting views appear to emerge through incomplete information about the other, and professional defensiveness in a context where resources and funding are scarce. The current study suggests that these challenges can be addressed through: greater reflectivity on professional biases, exploration of MH constructs within other epistemological positions, and greater communication regarding professional roles, leading to clearer collaboration in supporting the MH of YP.

Authentizität und Lernen - das Fach in der Fachdidaktik. Gesellschaft für Didaktik der Chemie und Physik Jahrestagung in Berlin 2015

Die 42. Jahrestagung der Gesellschaft für Didaktik der Chemie und Physik (GDCP) wurde im September 2015 an der Humboldt-Universität zu Berlin ausgerichtet. Zum Tagungsthema „Authentizität und Lernen - Das Fach in der Fachdidaktik“ diskutierten neben den Plenarreferentinnen und -referenten eine große Anzahl an Tagungsgästen. Der vorliegende Band umfasst die ausgearbeiteten Beiträge der Teilnehmerinnen und Teilnehmer. (DIPF/Orig.)

Role of emergency thoracic ultrasonography in spontaneous pneumomediastinum. Two case report

Early identification of spontaneous pneumomediastinum in an Emergency Department is possible with thoracic ultrasound. We report two cases of spontaneous pneumomediastinum, diagnosed in a 26-year old man with chronic asthma and a 19-year old athlete, and discuss the role of thoracic US alongside conventional X-ray and thoracic CT in emergency medicine. The patients were transferred to an Emergency Department, where conservative treatment produced a good outcome. The greater sensitivity and specificity of thoracic US over conventional supine X-ray in the detection of occult pneumothorax is ever more appreciated. However, training in the diagnosis of pneumomediastinum is required.

Assessment of faculty training program for the use of e-learning platforms: analysis of current use

5th International Conference on Education and New Learning Technologies (Barcelona, Spain. 1-3 July, 2013)

A rehabilitation intervention to promote physical recovery following intensive care: a detailed description of construct development, rationale and content together with proposed taxonomy to capture processes in a randomised controlled trial.

Background: increasing numbers of patients are surviving critical illness, but survival may be associated with a constellation of physical and psychological sequelae that can cause on going disability and reduced health-related quality of life. Limited evidence currently exists to guide the optimum structure, timing, and content of rehabilitation programmes. There is a need to both develop and evaluate interventions to support and expedite recovery during the post-ICU discharge period. This paper describes the construct development for a complex rehabilitation intervention intended to promote physical recovery following critical illness. The intervention is currently being evaluated in a randomised trial (ISRCTN09412438; funder Chief Scientists Office, Scotland). Methods: the intervention was developed using the Medical Research Council (MRC) framework for developing complex healthcare interventions. We ensured representation from a wide variety of stakeholders including content experts from multiple specialties, methodologists, and patient representation. The intervention construct was initially based on literature review, local observational and audit work, qualitative studies with ICU survivors, and brainstorming activities. Iterative refinement was aided by the publication of a National Institute for Health and Care Excellence guideline (No. 83), publicly available patient stories (Healthtalkonline), a stakeholder event in collaboration with the James Lind Alliance, and local piloting. Modelling and further work involved a feasibility trial and development of a novel generic rehabilitation assistant (GRA) role. Several rounds of external peer review during successive funding applications also contributed to development. Results: the final construct for the complex intervention involved a dedicated GRA trained to pre-defined competencies across multiple rehabilitation domains (physiotherapy, dietetics, occupational therapy, and speech/language therapy), with specific training in post-critical illness issues. The intervention was from ICU discharge to 3 months post-discharge, including inpatient and post-hospital discharge elements. Clear strategies to provide information to patients/families were included. A detailed taxonomy was developed to define and describe the processes undertaken, and capture them during the trial. The detailed process measure description, together with a range of patient, health service, and economic outcomes were successfully mapped on to the modified CONSORT recommendations for reporting non-pharmacologic trial interventions. Conclusions: the MRC complex intervention framework was an effective guide to developing a novel post-ICU rehabilitation intervention. Combining a clearly defined new healthcare role with a detailed taxonomy of process and activity enabled the intervention to be clearly described for the purpose of trial delivery and reporting. These data will be useful when interpreting the results of the randomised trial, will increase internal and external trial validity, and help others implement the intervention if the intervention proves clinically and cost effective.

Bananas adrift in time – a case study in the Solomons

Diseases, pests and environmental constraints pose a major threat to the sustainability of banana production globally. To address these challenges, the discovery and study of new sources of genetic resistance and adaptability are required, along with the general conservation of diversity. The Solomon Islands, located in the south-western Pacific region near Papua New Guinea, are a major center of banana diversity. Some collections had been made by nationals of some of the diversity present but little was known internationally of the rich genetic resource present. Two separate visits to the Solomon Islands characterized banana collections, documented and collected germplasm, recommended conservation strategies and provided training in cultivar characterization. A remarkable range of genetic diversity was found, including: many AA and AAA cooking types somewhat like those present in Papua New Guinea; nine Fei cultivars in relatively common usage, and two undescribed wild species as well as five AAB Pacific Plantains and four ABB cooking bananas belonging to the Kalapua subgroup. About six of the unique cultivars were successfully collected and established in the regional in vitro germplasm collection of SPC in Suva, Fiji. Nine Solomon Islanders were trained in the finer points of characterizing banana cultivars. Further collecting and study/evaluation of this rich diversity will promote its appreciation and potential utilization for meeting the challenges and opportunities ahead. Future studies could also determine the spread of the Awawe species and variability of morphological traits in the population. Community-based conservation could promote awareness of dietary diversity for better nutrition, via using the Fei bananas described in this paper. Establishing a virus-free regional field collection could help in comprehensively characterizing and evaluating regional Musa genetic resources. Existing sites could embrace the broader unique diversity of the Solomon Islands, and facilitate sharing this diversity in conjunction with a regional virus-tested in vitro collection.

Recent educational changes at higher educational level in Pakistan: English language teachers' perceptions and practices

Higher Education Institutes (HEIs) of any country could be a source of providing professionals to the country in many fields. By doing so, HEIs could play a pivotal role in the economic growth of the country. In Pakistan, it seems that, in the wake of this realization, steps have been taken to reform Higher Education. Drawing on the Triple I model of educational change covering Initiation, Implementation and Institutionalization (Fullan, 2007) this study focuses on the planning and implementation of reforms in the Education system of Pakistan at higher education level that have been introduced by the Higher Education Commission (HEC) since its inception in 2002. Kennedy’s model of hierarchical subsystems affecting innovation and Chin and Benne’s (1985) description of strategies for implementing change also provided guidelines for analyzing the changes in education in the country to highlight the role that the authorities expect the language teacher to play in the process of implementing these changes. A qualitative method is followed in this study to gather data from English language teachers at three universities of the Khyber Pakhtunkhwa province of Pakistan. A questionnaire was developed to look into the perceptions of English language teachers regarding the impact of these reforms. This was followed up by interviews. Responses from 28 teachers were received through questionnaire out of which 9 teachers were interviewed for detailed analysis of their perceptions. Thematic Content analysis was used to analyze and interpret the data. Some of the most significant changes that the respondents reported knowledge of included the introduction of Semester System, extending the Bachelors degree to four years from two years, promotion of research culture, and increased teachers’ autonomy in classroom practices. Implications of these reforms for English teachers’ professional development were also explored. The data indicate that the teachers generally have a positive attitude towards the changes. However, the data also show concerns that teachers have about the practical effectiveness of these changes in improving English language teaching and learning in Pakistani Universities. Some of the areas of concern are worries regarding resources, the assessment system, the number of qualified teachers, and instability in the educational policy. They are concerned about the training facilities and quality of the professional training available to them. Moreover, they report that training opportunities for their professional development are not available to all the teachers equally. Despite the HEC claims of providing regular training opportunities, the majority of the teachers did not receive any formal training in the last three years, while some teachers were able to access these opportunities multiple times. Through the recent reforms HEC has empowered the teachers in conducting the learning/teacher processes but this extra power has reduced their accountability and they can exercise these powers without any check on them. This empowerment is limited to the classroom and there appears to be no or minimal involvement in decision making at the top level of policy making. Such lack of involvement in the policy decisions seems to be generating a lack of sense of ownership among the teachers (Fullan 2003a:6). Although Quality Enhancement Cells have been developed in the universities to assure the desired quality of education, they might need a more active role to contribute in achieving the level of enhancement in education expected from them. Based on the perceptions of the respondents of this study and the review of the relevant literature, it is argued that it is unlikely for the reforms to be institutionalized if teachers are not given the right kind of awareness at the initiation stage and are not prepared at the implementation stage to cope with the challenge of a complex process. The teachers participating in this study, in general, have positive and enthusiastic attitudes towards most of the changes, in spite of some reservations. It could also be interesting to see if the power centers of the Pakistani Higher Education appreciate this enthusiasm and channel it for a strong Higher Education system in the country.