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The most recent data from the Australian Children's Education and Care Quality Authority (ACECQA) present good news; 79% of Australia's Early Childhood Education and Care services are now meeting the National Quality Standard (NQS). Yet one in five services remain below standard. Understanding the context and characteristics of these services, and those of their workforce, and identifying features that distinguish them from services meeting the NQS are the first step in directing quality improvement supports. We compared services rated Working Towards with those Meeting or Exceeding the standard, through analysis of two discrete datasets: (1) ACECQA snapshots providing service data and (2) The Early Years Workforce Study providing data on educators and educator experience. We identified distinguishing structural characteristics and relational factors within services rated Working Towards. Based on the findings, strategic directions for bringing the last 21% of services across the line to meet the National Quality Standard are detailed. [ABSTRACT FROM AUTHOR]

The international agenda for quality improvement in early childhood education and care (ECEC) has driven policies targeting workforce professionalisation. Increased training and accountability have been required, but without commensurate renumeration. Attendant staff turnover and educator stress threaten to undermine the achievement of intended policy goals. In a study of the Australian ECEC workforce, we conducted a national survey. We also longitudinally tracked staff turnover in a stratified sample of ECEC centres in remote, regional and urban locations, each with different populations and economic ecosystems. National survey data (N = 916) showed intended exit (22%) was associated with upgrading qualifications and positive motivations at entry to the workforce while intention to stay was associated with having a career role and personal satisfaction. The small variations in wages or work demands in the sector did not moderate these relationships but supportive workplaces increased intention to stay. In tracked centres (N = 98 staff), annual turnover (37%) was explained by personal (e.g., maternity) and workplace factors, both positive (promotion, removing unsuited staff) and negative (dissatisfaction). Highest turnover was in remote locations (47%). We conclude that long term sustainability should attend to appropriate reward of professionalisation. In the short-term supportive workplace culture is critical in retaining and sustaining educators. [ABSTRACT FROM AUTHOR]

Purpose: To provide detailed long-term data after initial observation for patients after histological confirmation of low grade (WHO II) gliomas according to molecular stratification. Methods: A series of 110 patients with watchful waiting strategy after initial surgery for LGG and re-surgery at tumor progression were analyzed. Progression-free survival, time to malignant transformation, post-recurrence survival, and overall survival were estimated with the Kaplan–Meier method. Prognostic factors were identified by the Log Rank test and Cox multivariate proportional hazards model. Results: The cohort comprised 18 IDH wild type (IDHwt) and 53 IDH mutated (IDHmut) astrocytomas, and 39 IDH mutated and 1p 19q co-deleted (IDHmut/codel) patients. The median follow-up was 126 (95% CI 109–143) months. Surgery was gross total resection in 58, subtotal resection in 28, and biopsy in 24 patients. Progression-free survival rates at 5, 10 and 15 years was 38% 18% and 1%. The corresponding malignant transformation rates were 17%, 39% and 71%. The initial extent of resection influenced progression-free survival, time to malignant transformation and overall survival. Molecular subtype IDHmut/codel was the strongest prognostic factor for overall survival and for time to malignant transformation. Conclusion: The strongest determinant of the patients' course after initial watchful waiting was the molecular tumor status. Extensive resection may increase time to progression and malignant transformation. Observation may be justified in selected patients. [ABSTRACT FROM AUTHOR]

Background Telephone helplines providing 24-h specialist-nurse contact present a source of immediate support for women encountering challenges with breastfeeding and may serve to prolong breastfeeding duration by building self-efficacy. To date there is little evidence on interaction effectiveness and still less on the relative effectiveness for women from different socio-economic backgrounds. Research Aim To establish the effect on maternal breastfeeding self-efficacy of calls made to a nurse-led parenting helpline. Methods From a corpus of calls made to the Australian Child Health Line (N = 723), those made by women presenting a breastfeeding concern as a prime issue (n = 60) were scored for breastfeeding self-efficacy at commencement and completion of recorded interactions. Analyses examined the significance and direction of change from beginning to end of calls and compared difference in change across calls originating from high and low social advantage locations. Results A significant increase in self-efficacy was found, but with low effect size. There was considerable variation among calls; 53% showed improvement, 25% showed no change and 22% showed reduction in breastfeeding self-efficacy. While most calls were made by women from socially advantaged locations, change was more positive for the small number of callers from disadvantaged locations. Conclusion The potential of nurse-led reactive telephone support is evident, but dependent on qualities of the interaction. For women living in disadvantaged locations telephone support may be of particular significance given the greater social barriers to breastfeeding they are likely to encounter. [ABSTRACT FROM AUTHOR]

Internationally, professionalization has become a key policy strategy targeting quality improvement in early childhood education and care (ECEC), utilizing top-down managerial strategies including implementation of quality standards and increased workforce qualifications. Set against this backdrop, this study explored educators’ accounts of their professional status and professionalism in their work. Data were collected from a representative sample of Australian educators (n = 98) participating in a national ECEC workforce study. Educator accounts were inductively and deductively coded, while statistical analysis examined association of codes with educator personal and professional characteristics. Educators overwhelmingly named their work as a profession, with three categories of explanation: purpose (educating children), qualification, and public opinions. However, analysis of educator accounts of their work practices, drawing on Moss’s (2006) understandings of the ECEC workforce, found that less than half of the educators presented their roles as other than technical or nurturing/laboring. Degree qualified teachers were more likely than less qualified educators to define professionalization in terms of purpose and professionalism in terms of autonomous decisions based on expert knowledge. Policy or practice: The study provides grassroots perspectives on professionalization and professionalism in ECEC and draws attention to three areas of misalignment between current policy and educators’ views and practices that require attention. [ABSTRACT FROM AUTHOR]