Diabetes checks: delays in treatment are reduced when support staff assess eye images

2021 ◽  
Keyword(s):  
Author(s):  
Nadine Ballam ◽  
Anne Sturgess

In February 2018, a full-time provider of gifted education opened in New Zealand with its initial cohort of children. This provider catered for learners from ages 1-15 years who did not ‘fit’ in mainstream education settings. This paper reports on a research project that focused on the effectiveness of the learning approach at this school in its inaugural year. Two sources of data informed this research, including semi-structured interviews with parents and learning and support staff, and an analysis of documents related to the philosophy, curriculum, and learning approach. This paper reports on benefits and limitations of the learning approach identified by the parent participants in the study.


Author(s):  
Megan O'Neill

Police Community Support Officers: Cultures and Identities within Pluralized Policing presents the first in-depth ethnographic study of Police Community Support Officers (PCSOs) since the creation of the role in 2002. Situated within the tradition of police ethnographies, this text examines the working worlds of uniformed patrol support staff in two English police forces. Based on over 350 hours of direct observation and thirty-three interviews with PCSOs and police constables in both urban and rural contexts, the book offers a detailed analysis of the operational and cultural realities of pluralized policing from within. Using a dramaturgic framework, the author finds that PCSOs have been undermined by their own organizations from the beginning, which has left a lasting legacy in terms of their relationships and interactions with police officer colleagues. The implications of this for police cultures, community policing approaches, and the success of pluralization are examined. The author argues that while PCSOs can have similar occupational experiences to those of constables, their particular circumstances have led to a unique occupational culture, one which has implications for existing police culture theories. The book considers these findings in light of budget reductions and police reforms occurring across the sector, processes in which PCSOs are particularly vulnerable.


2021 ◽  
Vol 7 (2) ◽  
pp. e001018
Author(s):  
Craig Barden ◽  
Keith A Stokes ◽  
Carly D McKay

ObjectivesThe implementation of the Activate injury prevention exercise programme has not been assessed in an applied context. This study aimed to (1) describe the knowledge and perceptions of school rugby coaches and players towards injury risk, prevention and Activate and (2) evaluate Activate implementation in schoolboy rugby using the reach, effectiveness, adoption, implementation and maintenance framework.MethodsBespoke electronic surveys were administered to coaches (including support staff) and players at participating English schools (2018–2020). Most questions and statements were answered using a 7-point Likert scale. At baseline, participants detailed their Activate awareness and perceptions of injury risk and prevention in schoolboy rugby. At postseason, participants reported Activate use throughout the study and their perceptions towards the programme.ResultsAt baseline, significant differences existed between coaches (n=106) and players (n=571) in Activate awareness (75% and 13% respectively; χ2=173.5, p<0.001). Coaches perceived rugby had a significantly greater injury risk than players, while holding more positive perceptions towards injury prevention. At postseason, coaches reported greater Activate adoption compared with players (76% and 18% respectively; χ2=41.8, p<0.001); 45% of players were unaware if they used the programme. Median session adherence was twice weekly, with a median duration of 10–15 min. This suggests Activate was not implemented as intended, with recommendations of three 20 min sessions per week. Both groups identified common barriers to implementation, such as lack of time and inclusion of a ball.ConclusionCoaches are instrumental in the decision to implement Activate. Targeting behavioural change in these individuals is likely to have the greatest impact on intervention uptake.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mtisunge Joshua Gondwe ◽  
Marc Y. R. Henrion ◽  
Thomasena O’Byrne ◽  
Clemens Masesa ◽  
Norman Lufesi ◽  
...  

Abstract Background Despite health centres being the first point of contact of care, there are challenges faced in providing care to patients at this level. In Malawi, service provision barriers reported at this level included long waiting times, high numbers of patients and erratic consultation systems which lead to mis-diagnosis and delayed referrals. Proper case management at this level of care is critical to prevent severe disease and deaths in children. We aimed to adopt Emergency, Triage, Assessment and Treatment algorithm (ETAT) to improve ability to identify severe illness in children at primary health centre (PHC) through comparison with secondary level diagnoses. Methods We implemented ETAT mobile Health (mHealth) at eight urban PHCs in Blantyre, Malawi between April 2017 and September 2018. Health workers and support staff were trained in mHealth ETAT. Stabilisation rooms were established and equipped with emergency equipment. All PHCs used an electronic tracking system to triage and track sick children on referral to secondary care, facilitated by a unique barcode. Support staff at PHC triaged sick children using ETAT Emergency (E), Priority (P) and Queue (Q) symptoms and clinician gave clinical diagnosis. The secondary level diagnosis was considered as a gold standard. We used statistical computing software R (v3.5.1) and used exact 95% binomial confidence intervals when estimating diagnosis agreement proportions. Results Eight-five percentage of all cases where assigned to E (9.0%) and P (75.5%) groups. Pneumonia was the most common PHC level diagnosis across all three triage groups (E, P, Q). The PHC level diagnosis of trauma was the most commonly confirmed diagnosis at secondary level facility (85.0%), while a PHC diagnosis of pneumonia was least likely to be confirmed at secondary level (39.6%). The secondary level diagnosis least likely to have been identified at PHC level was bronchiolitis 3 (5.2%). The majority of bronchiolitis cases (n = 50; (86.2%) were classified as pneumonia at the PHC level facility. Conclusions Implementing a sustainable and consistent ETAT approach with stabilisation and treatment capacity at PHC level reinforce staff capacity to diagnose and has the potential to reduce other health system costs through fewer, timely and appropriate referrals.


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