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Background and objectives: delirium is a distressing but potentially preventable condition common in older people in long-term care. It is associated with increased morbidity, mortality, functional decline, hospitalization and significant healthcare costs. Multicomponent interventions, addressing delirium risk factors, have been shown to reduce delirium by one-third in hospitals. It is not known whether this approach is also effective in long-term care. In previous work, we designed a bespoke delirium prevention intervention, called 'Stop Delirium!' In preparation for a definitive trial of Stop Delirium, we sought to address key aspects of trial design for the particular circumstances of care homes. Design: a cluster randomized feasibility study with an embedded process evaluation. Setting and participants: residents of 14 care homes for older people in one metropolitan district in the UK. Intervention: Stop Delirium!: a 16-month-enhanced educational package to support care home staff to address key delirium risk factors. Control homes received usual care. Measurements: we collected data to determine the following: recruitment and attrition; delirium rates and variability between homes; feasibility of measuring delirium, resource use, quality of life, hospital admissions and falls; and intervention implementation and adherence. Results: two-thirds (215) of eligible care home residents were recruited. One-month delirium prevalence was 4.0% in intervention and 7.1% in control homes. Proposed outcome measurements were feasible, although our approach appeared to underestimate delirium. Health economic evaluation was feasible using routinely collected data. Conclusion: a definitive trial of delirium prevention in long-term care is needed but will require some further design modifications and pilot work. [ABSTRACT FROM AUTHOR]

There have been a number of attempts to legalise euthanasia and physician assisted suicide (PAS) in the UK over the past decade. The potential impact of legalising euthanasia and PAS in the UK on the training of medical students, the next generation of doctors, is examined in this discussion paper. [ABSTRACT FROM AUTHOR]

This study focuses on critical incident analysis in initial teacher education and the part played by the professional learning conversation. A reflection framework was used to identify changes in levels of reflective practice. Conversational skills of the supervising teacher in recognising the 'person' in the student teacher, and their management of the student's emotions, appear central to unlocking and increasing critical reflective practice. Dialogues that focused only on training standards, using evidence from practice to 'sign off' particular standards, were concerned more with the routines of teaching and less with increased and considered analysis of practice and change. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue including one by Kari Smith and Miriam Welicker-Pollak on academic thinking from Norway and Israel, and another by Sandy Schuck, Peter Aubusson and John Buchanan on an intra professional initiative to promote learning.

The authors explore the Foucauldian concept of self-surveillance in the context of the use of Individual Action Planning (IAP) as a central process of a 1-year teacher training course. Drawing on work that examined whether IAP was experienced by student-teachers as empowerment or control, the article postulates that Action Planning can be seen as a central technique of a system of self-surveillance. The effect of IAPs in creating self-surveillance is investigated empirically, utilizing an original and non-Foucaldian pre-post questionnaire technique, in order to attract the widest possible audience to the idea of self-surveillance as a key process of governance in advanced liberal societies. The findings support the idea that self-surveillance is one of the outcomes of the IAP process, but also finds Foucauldian 'resistances' among the cohort investigated. [ABSTRACT FROM AUTHOR]

This article provides a critical analysis of recent policy initiatives associated with 'Healthy Schools'. Its specific focus is upon evaluation research conducted by the authors at the School of Education, University of Leicester. The evaluation team investigated healthy school programmes in two Midlands authorities as they related to anticipated accreditation for the National Healthy School Standard (NHSS). Analysis is of findings that sought to identify the most effective approaches for supporting schools and colleges to achieve healthy school status. A specific focus is upon schools' capacity, and those of the health and educational professionals with whom they work, to meet the myriad expectations that are part of the standard. The 'Healthy School' is seen as a critical case where connections between health and education are expected to mirror government department interests in 'joined-up' thinking, evaluation strategies and concerns about accountability and performance among schools and local authorities. This is illustrated in the language of the NHSS, where healthy schools are assumed to provide settings for promoting children's and young people's health through the curriculum, the school environment, and in partnership with parents, governors and local stakeholder communities drawn from education, health, social and community services. Curricular themes of citizenship and personal social and health education are being pulled together to provide a revised non-statutory curriculum for Personal, Social and Health Education (PSHE) and, by September 2002, a new curriculum framework for citizenship. What are the prospects for such an ambitious linking of rhetoric and practice? The article identifies key aspects of the healthy schools challenge, namely the need to ascertain ways in which its development can be simultaneously extended yet sufficiently inclusive to meet the multiple interests of a healthy and educated citizenry, and of schools in which that challenge is supposed to be met. Yet the article also sounds warnings of a standard that, with limited resources and prioritization, might drown under the weight of its own inclusiveness. The concluding counterpoint is an illustrative case-study of effective practice that pre-dates yet anticipates proposed curriculum changes. [ABSTRACT FROM AUTHOR]