Search

Clinical supervision practices and workplace cultures are highly influential in shaping the quality of care that clients at risk for suicide receive. The purpose of this qualitative study was to document counselors' and supervisors' views regarding the supervisory practices and conditions that enable useful and life-enhancing practices when working with youth who struggle with living. We conducted two, 1.5-hour focus groups with counselors who work with youth at risk for suicide in two separate clinical sites in British Columbia, representing the views of seven counselors. Two clinical supervisors who each supervise a small team of counselors were interviewed individually. Reflexive thematic analysis, informed by a constructionist lens was used to organize and interpret the qualitative data, with a strong emphasis on researcher subjectivity, reflexivity, and the contextual nature of meaning-making. Four themes were generated: being guided by a flexible framework; addressing anxiety in a systemic way; resourcing self and others; and expanding possibilities for engaging with complexity. We argue in favor of flexible, relational, and reflexive approaches to supervision, where the development of useful responses to suicidal behavior can best be understood as a shared, system-wide responsibility, which does not place the onus for "saving lives" onto the shoulders of individual counselors. [ABSTRACT FROM AUTHOR]

Background: Current outcomes for mental illness are widely regarded as poor. Since the introduction of psychotropic medications in the mid 1950’s, previous psychosocial practices were minimized in favor of medication focused treatment. The majority of large U.S. state hospitals have closed with records destroyed or in storage, inaccessible to researchers. This creates barriers to studying and comparing outcomes before and after this shift in treatment practices. Aims: The study aim was to examine discharge outcomes in relation to length of stay and diagnosis in one U.S. state hospital. Methods: This case series study examined 5618 medical records of participants admitted to one state hospital from 1945 to 1954, the decade prior to adoption of psychotropic medications. Results: Of the 3332 individuals who left the facility, over half (59.87%) of first episode hospitalizations were discharged within 1 year, and 16.95% were hospitalized for more than 5 years. 46.17% of all admissions were discharged from hospital with no readmission. The most common diagnoses included schizophrenia, other forms of psychosis, and alcoholism. In the decade before the introduction of psychotropic medications, participants were often admitted for a single episode and returned to their homes within several years. Conclusions: Although limited to one site, findings suggest that discharge outcomes prior to psychotropic medication as a primary treatment for mental illness may be more positive than previously understood. [ABSTRACT FROM AUTHOR]

Low-level radioactive wastes were disposed at the Little Forest Legacy Site (LFLS) near Sydney, Australia between 1960 and 1968. According to the disposal records, 233U contributes a significant portion of the inventory of actinide activity buried in the LFLS trenches. Although the presence of 233U in environmental samples from LFLS has been previously inferred from alpha-spectrometry measurements, it has been difficult to quantify because the 233U and 234U α-peaks are superimposed. Therefore, the amounts of 233U in groundwaters, soils and vegetation from the vicinity of the LFLS were measured using accelerator mass spectrometry (AMS). The AMS results show the presence of 233U in numerous environmental samples, particularly those obtained within, and in the immediate vicinity of, the trenched area. There is evidence for dispersion of 233U in groundwater (possibly mobilised by co-disposed organic liquids), and the data also suggest other sources of 233U contamination in addition to the trench wastes. These may include leakages and spills from waste drums as well as waste burnings, which also occurred at the site. The AMS results confirm the historic information regarding disposal of 233U in the LFLS trenches. The AMS technique has been valuable to ascertain the distribution and environmental behaviour of 233U at the LFLS and the results demonstrate the applicability of AMS for evaluating contamination of 233U at other radioactive waste sites. [Display omitted] • First results for 233U contamination at a legacy radioactive waste site. • 233U data obtained by Accelerator techniques. • Unusually high levels of 233U in many samples, consistent with disposal records. • 233U concentrations decrease with distance from waste sources. [ABSTRACT FROM AUTHOR]

This article describes an interprofessional workforce development program that aims to train current and future behavioral health professionals in culturally- and developmentally-appropriate, integrated care for adolescents and transitional-aged youth. This federally-funded program is implemented in one region in the United States because the location has a substantial shortage of providers. The program meets the local needs by training a diverse group of master-level graduate students and community partners on evidence-based practices for substance misuse, including opioid misuse, and common mental health conditions. This article includes recommendations on key aspects to include in behavioral health workforce development programs. [ABSTRACT FROM AUTHOR]

Background: Conversations about death are often associated with fear, anxiety, avoidance and misunderstandings. Many adults feel that these discussions are inappropriate and confusing for young people. In this project, two fourth-year nursing students partnered with a local palliative care team to examine death education for children. The nursing students focused on children's understandings of death and their coping abilities, the lack of appropriate discussions about death with children, and the implementation of death education in public schools. Three online death education resources were identified and evaluated for use in public schools. This project fueled preliminary local discussions and advocacy efforts in the provision of death education for children. In the future, death education will need to be incorporated into education plans at local schools, and could be done in collaboration with the local palliative care team. [ABSTRACT FROM AUTHOR]

Objectives: Work is a critical part of recovery for many people with chronic health conditions, including Substance Use Disorders (SUD). Individual Placement and Support (IPS) is an evidence-based practice designed initially for adults with mental illness. Although the evidence for using IPS with individuals with severe mental illness is well documented, less is known about the efficacy of using IPS with consumers with substance use disorders, and the results have yet to be systematically evaluated and organized. Key components of zero exclusion, rapid competitive job search, and incorporation with treatment services as well as benefits are components that make IPS a strong practice to incorporate into substance abuse treatment. This study aims to evaluate and organize the evidence base of using IPS with adults with substance use disorders. Results: A systematic review was conducted of meta-analyses, reviews, and individual studies from 2000 through 2019, measuring the efficacy of IPS with individuals with SUD or comorbid SUD. Databases searched were Scopus, PubMed, and PsychInfo. Experimental and quasi-experimental studies are reviewed and critiqued for their application to a SUD population. Then, barriers and facilitators of IPS implementation with this population are discussed. Conclusions/Importance: There is a high evidence to support to application of IPS for persons with SUD, both singly and when combined with a mental health disorder. Barriers to IPS implementation including episodic treatment, risk of relapse, and housing or criminal justice instability make the IPS program a useful best practice to consider for this population. [ABSTRACT FROM AUTHOR]

The current sexual offender literature focuses on recidivism reduction in an effort to increase public safety. While cognitive-behavioral therapy (CBT) programs are considered a mainstream treatment method, it is essential to study recidivism as an indicator of treatment effectiveness. This meta-analysis examines research published since 1970 to determine the overall effectiveness of treatments in reducing recidivism among adult male sexual offenders. Decade of implementation and CBT treatment features are also assessed as moderator variables. The results from the 25 studies identified were converted into 42 weighted effect sizes utilizing a random-effects model. Significant overall effect sizes were found for sexual and violent/combination recidivism; however, multiple indices indicate heterogeneity in the effect sizes. Significant differences were found in the overall effectiveness of the treatments by decade, and the treatments delivered during the 1990s were found to be related to lower levels of sexual and violent/combination recidivism. [ABSTRACT FROM AUTHOR]

In 21st century social work education, faculty must build on student experiences to construct new learning opportunities. However, traditional academic approaches often struggle with this. One barrier is the lack of tools to facilitate assessment of learning and responsiveness to performance with proximal feedback. Education during field placement can be an added challenge as students are learning to apply knowledge, grappling with real life challenges, while geographically dispersed. Individualized goal setting and measurement is needed to engage today's learners and teachers in the process of knowledge, skill, and value development. This program incorporated technology to improve a collaborative outcome measure, Goal Attainment Scaling (GAS). This tool was then trialed in various interprofessional field settings to determine the utility and response. In an interprofessional training program for social work andoccupational therapy students, and peer supports, each student created and scaled both professional and personal development goals. GAS enabled measurement of incremental change over time in students' personal and professional development goals they had created for themselves. GAS professional goals (mean diff. = 2.41(1.09), t = 11.97(28)) and personal goals (mean diff. = 2.76 (1.09), t = 13.62(28)) both improved significantly (p <.01). Student feedback supported the value of GAS to improve self-awareness and learning. [ABSTRACT FROM AUTHOR]

Study abroad programs are increasingly encouraged as a method for students to develop cross-cultural competence and awareness of how to practice in diverse and multi-national settings. Barriers can exist to study abroad related to financing, scheduling, personal/professional obligations, and lack of international experience for novices. Short-term, faculty-led study abroad courses help to ameliorate these barriers, and still provide students with opportunities for experiential learning. A short-term interprofessional study course to Asia with business and health and human services undergraduate and graduate students provides opportunities for not only cross-cultural but transdisciplinary learning. The course provided participants with interprofessional learning about current issues in social justice, corporate social responsibility, development, and sustainability. Implementation, qualitative results, and future foci are discussed. [ABSTRACT FROM AUTHOR]

Mental health and substance use disorders co-occur frequently, and are associated with poorer outcomes in life domains including housing, employment, health, and recovery. Finding evidence-based interventions for engagement and recovery can be a challenge for practitioners and organizations, as it involves accepting new interventions, and then implementing and measuring the results. However, practitioners frequently use their opinions or non-generalizable experiences rather than evidence-based findings to guide their practice. Medication-assisted therapy programs, especially for individuals with co-occurring mental health and substance use disorders, is an area of treatment where there are solid evidence-based outcome findings and where, nonetheless, many practitioners continue to use less-, or non-effective treatment approaches. Conflict between groups of staff using two different approaches can have serious negative impact on treatment outcome. These can be effectively addressed through a combination of education and interventions aimed at resolving intra-staff conflict. [ABSTRACT FROM AUTHOR]

Systematic reviews and meta-analyses are increasingly common. This article aims to provide guidance for people conducting systematic reviews relevant to the healthcare of older people. An awareness of these issues will also help people reading systematic reviews to determine whether the results will influence their clinical practice. It is essential that systematic reviews are performed by a team which includes the required technical and clinical expertise. Those performing reviews for the first time should ensure they have appropriate training and support. They must be planned and performed in a transparent and methodologically robust way: guidelines are available. The protocol should be written--and if possible published--before starting the review. Geriatricians will be interested in a table of baseline characteristics, which will help to determine if the studied samples or populations are similar to their patients. Reviews of studies of older people should consider how they will manage issues such as different age cut-offs; non-specific presentations; multiple predictors and outcomes; potential biases and confounders. Systematic reviews and meta-analyses may provide evidence to improve older people's care, or determine where new evidence is required. Newer methodologies, such as meta-analyses of individual level data, network meta-analyses and umbrella reviews, and realist synthesis, may improve the reliability and clinical utility of systematic reviews. [ABSTRACT FROM AUTHOR]

Background: moving into long-term institutional care is a significant life event for any individual. Predictors of institutional care admission from community-dwellers and people with dementia have been described, but those from the acute hospital setting have not been systematically reviewed. Our aim was to establish predictive factors for discharge to institutional care following acute hospitalisation. Methods: we registered and conducted a systematic review (PROSPERO: CRD42015023497). We searched MEDLINE; EMBASE and CINAHL Plus in September 2015. We included observational studies of patients admitted directly to long-term institutional care following acute hospitalisation where factors associated with institutionalisation were reported. Results: from 9,176 records, we included 23 studies (n = 354,985 participants). Studies were heterogeneous, with the proportions discharged to a care home 3-77% (median 15%). Eleven studies (n = 12,642), of moderate to low quality, were included in the quantitative synthesis. The need for institutional long-term care was associated with age (pooled odds ratio (OR) 1.02, 95% confidence intervals (CI): 1.00-1.04), female sex (pooled OR 1.41, 95% CI: 1.03-1.92), dementia (pooled OR 2.14, 95% CI: 1.24-3.70) and functional dependency (pooled OR 2.06, 95% CI: 1.58-2.69). Conclusions: discharge to long-term institutional care following acute hospitalisation is common, but current data do not allow prediction of who will make this transition. Potentially important predictors evaluated in community cohorts have not been examined in hospitalised cohorts. Understanding these predictors could help identify individuals at risk early in their admission, and support them in this transition or potentially intervene to reduce their risk. [ABSTRACT FROM AUTHOR]

Effective evidence-based practice (EBP) implementation is crucial to eliminating the science-to-service gap and getting the research into a usable form for social workers and other practitioners. When EBPs are developed, their implementation over time in largescale models is often not well researched or understood. In an analysis of integrated dual disorder treatment (IDDT) implementation and fidelity for 2006-2012 among 68 teams in one entire state, fidelity significantly improved each year for both baseline reviews [F(6, 57) = 5.62, p < .001] and second reviews [F(3, 33) = 2.71, p = .03]. IDDT teams that first implemented later in time had significantly higher baseline fidelity scores than early or mid-adopter teams [F(2, 61) = 10.15, p < .001]. However, teams varied significantly in their baseline review and growth in review between occurrences. This suggests that IDDT and other EBPs can be successfully implemented over time. The article provides information on ways to support teams with training, policy support, and contractual incentives. [ABSTRACT FROM AUTHOR]

Objective: Adults with co-occurring mental illness and substance use disorders have poor outcomes in important quality of life areas, including hospitalization, incarceration, employment, and community housing. Integrated dual disorder treatment (IDDT) is a research-supported intervention for individuals with co-occurring disorders associated with improvements in outcome measures when implemented with high fidelity. Research-supported intervention IDDT was not designed with peer services, provided by people with lived experience with mental illness, but the practice has been altered to include peers. Methods: IDDT fidelity data were evaluated from 20 teams that also reported on peer services on their team in one state over a 7 year period, and paired with their fidelity data for the most recent review to analyze the relationship between peers and IDDT fidelity. Analysis of variance was utilized to determine a dose effect peers on fidelity. Results: Of these IDDT teams, 85% of teams incorporated a peer and 40% of teams had a full-time peer. Having a full-time peer (M = 4.22, SD =.41) was associated with significantly higher fidelity compared to teams with a part-time (M = 3.68, SD =.56) or no peer (M = 3.21, SD =.18, F(2, 17) = 5.88, p =.01). Conclusions: Peers on IDDT teams are associated with higher fidelity, leading to important possibilities about the incorporation of those with lived experience into research-supported interventions. Implications for team composition, implementation measurement, policy, and funding are discussed. [ABSTRACT FROM AUTHOR]

Adverse symptoms of immunosuppressants (ASI) impact quality of life (QOL) in solid organ transplant recipients; however, standardized approaches for active ASI surveillance and intervention are lacking. While management is highly clinician dependent, clinician views remain largely unexplored. We surveyed Canadian Society of Transplantation members on their perceptions of ASI including frequency, perceived QOL impact, causal attribution, management strategies, and success. Sixty-one clinicians participated in the survey of 12 ASI (tremor, diarrhea, nausea, constipation, dyspepsia, insomnia, edema, dyspnea, arthralgia, acne, mouth sores, paresthesias), for a 22% response rate. Forty-nine completed the survey (80% completion rate). Diarrhea, dyspepsia, and insomnia were most frequent, requiring management in ≥ 2% of patients by 96%, 90%, and 82% of respondents, respectively. Diarrhea, insomnia, and dyspnea were deemed to have an important QOL impact by 92%, 82%, and 69%. Immunosuppressants were universally implicated as causative of tremor, diarrhea, acne, and mouth sores. Over 80% reported success in managing mouth sores, dyspepsia, and constipation. Management strategies included adjustment of immunosuppressant or other medications, drug therapy, and nonpharmacologic approaches and varied according to perceived causal attribution. More study is needed to compare clinician and patient views. These results will be used to establish priorities for further investigation of ASI. [ABSTRACT FROM AUTHOR]

Evidence based medicine tells us that we should not accept published research at face value. Even research from established teams published in the highest impact journals can have methodological flaws, biases and limited generalisability. The critical appraisal of research studies can seem daunting, but tools are available to make the process easier for the non-specialist. Understanding the language and process of quality assessment is essential when considering or conducting research, and is also valuable for all clinicians who use published research to inform their clinical practice. We present a review written specifically for the practising geriatrician. This considers how quality is defined in relation to the methodological conduct and reporting of research. Having established why quality assessment is important, we present and critique tools which are available to standardise quality assessment. We consider five study designs: RCTs, nonrandomised studies, observational studies, systematic reviews and diagnostic test accuracy studies. Quality assessment for each of these study designs is illustrated with an example of published cognitive research. The practical applications of the tools are highlighted, with guidance on their strengths and limitations. We signpost educational resources and offer specific advice for use of these tools. We hope that all geriatricians become comfortable with critical appraisal of published research and that use of the tools described in this review - along with awareness of their strengths and limitations - become a part of teaching, journal clubs and practice. [ABSTRACT FROM AUTHOR]

Individuals with co-occurring illnesses are at risk for poor outcomes related to criminal justice, hospitalization, housing, and employment. High fidelity evidence-based models, including integrated dual disorder treatment (IDDT), are associated with significant outcome improvements. A descriptive analysis of secondary datasets including the full sample of IDDT fidelity reviews completed from 2006 to 2012 in one state was completed. Total IDDT fidelity significantly improved from baseline fidelity review (68) to second review (40) [t(38) = 35.00, p < .001], and from second review to third review (13) [t(12) = 22.60, p < .001], with adequate inner-rater reliability by the second review. Individual items that were lower across reviews included practice penetration and family interventions, and higher individual items included multi-disciplinary team, integrated treatment specialist, and time-unlimited services, and treatment measures are higher than organizational measures in baseline and subsequent reviews. In this large state-wide sample, IDDT took time to implement, and improved fidelity occurred from baseline to third review, and variance between components of the practice was significant. [ABSTRACT FROM AUTHOR]

Background: institutionalisation following acute hospital admission is common and yet poorly described, with policy documents advising against this transition. Objective: to characterise the individuals admitted to a care home on discharge from an acute hospital admission and to describe their assessment. Design and setting: a retrospective cohort study of people admitted to a single large Scottish teaching hospital. Subjects: 100 individuals admitted to the acute hospital from home and discharged to a care home. Methods: a single researcher extracted data from ward-based case notes. Results: people discharged to care homes were predominantly female (62%), widowed (52%) older adults (mean 83.6 years) who lived alone (67%). About 95% had a diagnosed cognitive disorder or evidence of cognitive impairment. One-third of cases of delirium were unrecognised. Hospital stays were long (median 78.5 days; range 14-231 days) and transfers between settings were common. Family request, dementia, mobility, falls risk and behavioural concerns were the commonest reasons for the decision to admit to a care home. About 55% were in the acute hospital when the decision for a care home was made and 44% of that group were discharged directly from the acute hospital. Conclusions: care home admission from hospital is common and yet there are no established standards to support best practice. Decisions should involve the whole multidisciplinary team in partnership with patients and families. Documentation of assessment in the case notes is variable. We advocate the development of interdisciplinary standards to support the assessment of this vulnerable and complex group of patients. [ABSTRACT FROM AUTHOR]

The UK has many excellent care homes that provide high-quality care for their residents; however, across the care home sector, there is a significant need for improvement. Even though the majority of care homes receive a rating of 'good' from regulators, still significant numbers are identified as requiring 'improvement' or are 'inadequate'. Such findings resonate with the public perceptions of long-term care as a negative choice, to be avoided wherever possible--as well as impacting on the career choices of health and social care students. Projections of current demographics highlight that, within 10 years, the part of our population that will be growing the fastest will be those people older than 80 years old with the suggestion that spending on long-term care provision needs to rise from 0.6% of our Gross Domestic Product in 2002 to 0.96% by 2031. Teaching/research-based care homes have been developed in the USA, Canada, Norway, the Netherlands and Australia in response to scandals about care, and the shortage of trained geriatric healthcare staff. There is increasing evidence that such facilities help to reduce inappropriate hospital admissions, increase staff competency and bring increased enthusiasm about working in care homes and improve the quality of care. Is this something that the UK should think of developing? This commentary details the core goals of a Care Home Innovation Centre for training and research as a radical vision to change the culture and image of care homes, and help address this huge public health issue we face. [ABSTRACT FROM AUTHOR]

LIFO, the accounting concept of "last-in, first-out" inventory costing, started in the early 20th century and saw remarkable expansion within several industries within the Unites States. Use of LIFO has been particularly dominant within the American oil and gas industry. However, recent political and cultural forces may see the end of this highly utilized principle of accounting practice. This paper tracks the history of LIFO, analyzes the possible changes to the methodology, and advocates for a broad-spectrum preparation against seemingly likely changes to this basic accounting procedure. [ABSTRACT FROM AUTHOR]

Background: In a research study, to give a comprehensive evaluation of the impact of interventions, the outcome measures should reflect the lived experience of the condition. In dementia studies, this necessitates the use of outcome measures which capture the range of disease effects, not limited to cognitive functioning. In particular, assessing the functional impact of cognitive impairment is recommended by regulatory authorities, but there is no consensus on the optimal approach for outcome assessment in dementia research. Our aim was to describe the outcome measures used in dementia and mild cognitive impairment (MCI) intervention studies, with particular interest in those evaluating patient-centred outcomes of functional performance and quality of life. Methods: We performed a focused review of the literature with multiple embedded checks of internal and external validity. We used the Cochrane Dementia and Cognitive Improvement Group’s register of dementia studies, ALOIS. ALOIS was searched to obtain records of all registered dementia and MCI intervention studies over a 10-year period (2004–2014). We included both published and unpublished materials. Outcomes were categorised as cognitive, functional, quality of life, mood, behaviour, global/disease severity and institutionalisation. Results: From an initial return of 3271 records, we included a total of 805 records, including 676 dementia trial records and 129 MCI trial records. Of these, 78 % (630) originated from peer-reviewed publications and 60 % (487) reported results of pharmacological interventions. Cognitive outcomes were reported in 70 % (563), in contrast with 29 % (237) reporting measures of functional performance and only 13 % (102) reporting quality of life measures. We identified significant heterogeneity in the tools used to capture these outcomes, with frequent use of non-standardised tests. Conclusions: This focus on cognitive performance questions the extent to which intervention studies for dementia are evaluating outcome measures which are relevant to individual patients and their carers. The heterogeneity in measures, use of bespoke tools and poor descriptions of test strategy all support the need for a more standardised approach to the conduct and reporting of outcomes assessments. [ABSTRACT FROM AUTHOR]

The optimal management of hypertension in people with dementia is uncertain. This review explores if people with dementia experience greater adverse effects from antihypertensive medications, if cognitive function is protected or worsened by controlling blood pressure (BP) and if there are subgroups of people with dementia for whom antihypertensive therapy is more likely to be harmful. Robust evidence is scant, trials of antihypertensive medications have generally excluded those with dementia. Observational data show changes in risk association over the life course, with high BP being a risk factor for cognitive decline in mid-life, while low BP is predictive in later life. It is therefore possible that excessive BP lowering in older people with dementia might harm cognition. From the existing literature, there is no direct evidence of benefit or harm from treating hypertension in people with dementia. So what practical steps can the clinician take? Assess capacity, establish patient preferences when making treatment decisions, use ambulatory monitoring to thoroughly assess BP, individualise and consider deprescribing where side effects (e.g. hypotension) outweigh the benefits. Future research might include pragmatic randomised trials of targeted deprescribing, which include patient-centred outcome measures to help support decision-making and studies to address mechanistic uncertainties. [ABSTRACT FROM AUTHOR]

Background: ambulatory blood pressure monitoring (ABPM) may be helpful for the management of hypertension, but little is known about its tolerability in people with dementia. Objective: to review the published evidence to determine the tolerability of ABPM in people with dementia. Methods: English language search conducted in MEDLINE and EMBASE, using Ambulatory blood pressure' AND 'Dementia' (and associated synonyms) from 1996 to March 2015. Inclusion criteria: people diagnosed with dementia AND in whom blood pressure was measured using ABPM. The initial search was undertaken using title and abstract reviews, with selected papers being agreed for inclusion by two reviewers. Potentially eligible papers were assessed, and high-quality papers were retained. Two reviewers agreed the abstracted data for analysis. Meta-analysis was used to combine results across studies. Results: of the 221 screened abstracts, 13 studies (6%) met inclusion criteria, 5 had sufficient data and were of sufficient quality, involving 461 participants, most of whom had mild--moderate dementia. 77.7% (95% CI 62.2-93.2%) were able to tolerate ABPM; agreement with office BP was moderate to weak (two studies only--coefficients 0.3-0.38 for systolic blood pressure and 0.11-0.32 for diastolic blood pressure). One study compared home BP monitoring by a relative or ambulatory BP monitoring with office BP measures and found high agreement (ϗ 0.81). The little available evidence suggested increased levels of dementia being associated with reduced tolerability. Conclusions: ABPM is well tolerated in people with mild-moderate dementia and provides some additional information over and above office BP alone. However, few studies have addressed ABPM in people with more severe dementia. [ABSTRACT FROM AUTHOR]

Unscheduled hospital admissions from care homes are common and potentially avoidable but little guidance is available as to what constitutes an appropriate hospital admission. We surveyed healthcare professionals' opinions on a range of common scenarios affecting care-home residents . We developed seven clinical vignettes and an accompanying questionnaire. We used purposive sampling to obtain opinions from relevant primary care and secondary care teams. We asked assessors to comment on whether they would favour hospital admission and to justify their response using pre-selected options and/or free text. Admission to hospital was judged inappropriate in 54.6% of responses. Opinion on admission varied according to the case, with fewer than half of respondents agreeing for three of the seven cases. Recurring themes were uncertainty around services available to care homes and anticipatory care planning. The lack of consensus suggests that concepts surrounding inappropriate care-home admission are not shared by staff who provide care for this patient group. [ABSTRACT FROM AUTHOR]

The uranium isotope 233 U is not usually observed in alpha spectra from environmental samples due to its low natural and fallout abundance. It may be present in samples from sites in the vicinity of nuclear operations such as reactors or fuel reprocessing facilities, radioactive waste disposal sites or sites affected by clandestine nuclear operations. On an alpha spectrum, the two most abundant alpha emissions of 233 U (4.784 MeV, 13.2%; and 4.824 MeV, 84.3%) will overlap with the 234 U doublet peak (4.722 MeV, 28.4%; and 4.775 MeV, 71.4%), if present, resulting in a combined 233+234 U multiplet. A technique for quantifying both 233 U and 234 U from alpha spectra was investigated. A series of groundwater samples were measured both by accelerator mass spectrometry (AMS) to determine 233 U/ 234 U atom and activity ratios and by alpha spectrometry in order to establish a reliable 233 U estimation technique using alpha spectra. The Genie™ 2000 Alpha Analysis and Interactive Peak Fitting (IPF) software packages were used and it was found that IPF with identification of three peaks ( 234 U minor, combined 234 U major and 233 U minor, and 233 U major) followed by interference correction on the combined peak and a weighted average activity calculation gave satisfactory agreement with the AMS data across the 233 U/ 234 U activity ratio range (0.1–20) and 233 U activity range (2–300 mBq) investigated. Correlation between the AMS 233 U and alpha spectrometry 233 U was r 2 = 0.996 (n = 10). [ABSTRACT FROM AUTHOR]

Frailty is a distinctive late-life health state in which apparently minor stressor events are associated with adverse health outcomes. This article considers how the conceptualisation of frailty as a long-term condition offers new management approaches based on systematically applied preventative and proactive interventions. Frailty shares the key features of the common longterm conditions: it can be ameliorated but not cured; it is costly at an individual and societal level; it is progressive; it impacts adversely on life experience and it has episodic crises. The recognition of frailty as a long-term condition is not merely a semantic issue—a wide range of benefits can be anticipated. Primary care-based registers for frailty could be established and chronic disease models applied systematically for co-ordinated and person-centred preventative and proactive care. A team approach is a key component of long-term condition management, incorporating support, follow-up and behaviour change interventions that go beyond the scope of a traditional medical approach. This approach would ideally require changes in secondary care to embrace greater community-based working and closer relationships with the primary health and care team. Although our understanding of interventions to modify or treat frailty has improved, there is considerable scope for further development. Identifying frailty as a long-term condition would be an important step in distinguishing people with frailty as a discrete population for new research. [ABSTRACT FROM AUTHOR]

Bitcoin is a mysterious "currency" that was developed by a person identified as Satoshi Nakamoto but no one seems to know whether such a person even exists. Individuals can obtain bitcoin by "mining" for them on their computers solving complex mathematical formulas that become increasing more complex as more and more bitcoins are mined. As accountants, of particular interest to the authors of this paper is the accounting for bitcoin transactions. Apparently, the Sacramento Kings of the National Basketball Association and Overstock.com, a Utah company, along with many other smaller establishments have begun accepting bitcoin as payment. The questions of how to account for the "currency" relates to whether it is even a currency at all. Perhaps the accounting ought to be related more as barter or as foreign currency transactions than as ordinary sales. [ABSTRACT FROM AUTHOR]

During the 1960s, radioactive waste containing small amounts of plutonium (Pu) and americium (Am) was disposed in shallow trenches at the Little Forest Burial Ground (LFBG), located near the southern suburbs of Sydney, Australia. Because of periodic saturation and overflowing of the former disposal trenches, Pu and Am have been transferred from the buried wastes into the surrounding surface soils. The presence of readily detected amounts of Pu and Am in the trench waters provides a unique opportunity to study their aqueous speciation under environmentally relevant conditions. This study aims to comprehensively investigate the chemical speciation of Pu and Am in the trench water by combining fluoride coprecipitation, solvent extraction, particle size fractionation, and thermochemical modeling. The predominant oxidation states of dissolved Pu and Am species were found to be Pu(IV) and Am(III), and large proportions of both actinides (Pu, 97.7%; Am, 86.8%) were associated with mobile colloids in the submicron size range. On the basis of this information, possible management options are assessed. [ABSTRACT FROM AUTHOR]

Radioactive waste containing a few grams of plutonium (Pu) was disposed between 1960 and 1968 in trenches at the Little Forest Burial Ground (LFBG), near Sydney, Australia. A water sampling point installed in a former trench has enabled the radionuclide content of trench water and the response of the water level to rainfall to be studied. The trench water contains readily measurable Pu activity (∼12 Bq/L of 239+240Pu in 0.45 μm-filtered water), and uhere is an associated contamination of Pu in surface soils. The highest 239+240Pu soil activity was 829 Bq/kg in a shallow sample (0-1 cm depth) near the trench sampling point. Away from the trenches, the elevated concentrations of Pu in surface soils extend for tens of meters down-slope. The broader contamination may be partly attributable to dispersion events in the first decade after disposal, after which a layer of soil was added above the trenched area. Since this time, further Pu contamination has occurred near the trench-sampler within this added layer. The water level in the trench-sampler responds quickly to rainfall and intermittently reaches the surface, hence the Pu dispersion is attributed to saturation and overflow of the trenches during extreme rainfall events, referred to as the 'bathtub' effect. [ABSTRACT FROM AUTHOR]

A correction to the article 'Systematic reviews: guidance relevant for studies of older people" by Susan D. Shenkin et al, is presented.

The migration of health professionals from low-income to high-income countries affects the smooth functioning of health systems. Nevertheless, health professionals who return home help strengthen the health sector, leading to national development. This exploratory study focuses on factors influencing the return migration of health professionals and the benefits thereof to Ghana. The qualitative method was used to gather information from sixty respondents who consented to participate. The pull factor for migration was high income, while for return migration, the completion of projects and imparting knowledge to young health professionals were the dominating pull factors. These health professionals come with skills and expertise and create employment opportunities. Challenges faced were bureaucracy and constraints on support from government agencies. [ABSTRACT FROM AUTHOR]

Assessing workforce diversity is an increasing area of evolution. A comprehensive assessment of socioeconomic diversity is important in that it can help identify needs and enable planned inclusion across a range of students. Subsequently, a more comprehensive set of background indicators is needed. The purpose of this brief report is to describe the approach we are using to determine socioeconomic background among individuals participating in a behavioral health workforce program. By using 3 strategies to assess background, we were able to determine that 4 individuals reported being unable to pay for housing, 3 indicated they had sold plasma, and 1 had experienced homelessness since starting graduate school. Our findings provide a starting point for using a comprehensive set of indicators to guide the recruitment and selection process in workforce development programs. [ABSTRACT FROM AUTHOR]

Background Lung transplant recipients have complex drug regimens. Study objectives were to assess drug therapy problems ( DTPs), pharmacist recommendations, and patient satisfaction with pharmacist services. Methods Using a pharmaceutical care assessment process, pharmacists identified DTPs and made therapeutic recommendations. Number of DTPs identified per pharmacist visit was calculated and compared to standard care visits through retrospective chart review. Potential clinical impact of recommendations was evaluated by blinded clinicians. Patient satisfaction was assessed via survey. Results Fifty-five DTPs were identified in 43 patients over 50 pharmacist visits (1.05 ± 1.34 DTPs per visit). In these same patients, rate of DTP identification was 0.51 ± 0.64 DTPs per standard visit in the preceding two-wk period (p = 0.018 vs. pharmacist visit). The most common DTPs identified by the pharmacist were adverse drug effect (27%) and untreated indication (25%). Overall, 62% of pharmacist recommendations were rated very significant or significant. Survey return rate was 58% and satisfaction scores ranged from 3 to 5 out of 5. Review of medications and teaching regarding the use of medications received the most 'very satisfied' and 'highly important' scores. Conclusions Pharmacists can make valuable contributions in a lung transplant clinic setting by identifying DTPs and making recommendations with a positive impact on patient outcomes and satisfaction. [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]

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]

Abstract: A technique for the isolation of thorium (Th), plutonium (Pu), americium (Am), uranium (U) and strontium (Sr) isotopes from various environmental matrices has been adapted from a previously published method specific to water samples (). Separation and isolation of the various elemental fractions from a single sub-sample is possible, thereby eliminating the need for multiple analyses. The technique involves sample dissolution, concentration via calcium phosphate co-precipitation, rapid column extraction using TEVA™, TRU™ and Sr-Spec™ resin cartridges, alpha spectrometry for Th, Pu, U and Am and Cerenkov counting for Sr. Various standard reference materials were analysed and chemical yields are in the range of 70–80% for Th, Am, U and Sr and 50–60% for Pu. Sample sizes of up to 10 L for water, 5 g for dry soil and sediment and 10 g for dry vegetation and seaweed can be processed using this technique. [Copyright &y& Elsevier]

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]

This exploratory study draws on the experiences, workplace learning and professional development of five beginning teacher educators in the first three years of their new careers. Examples of their developing pedagogic practices and reasoning and conceptions of their roles and identities as teacher educators in their new settings have been generated from interviews from this longitudinal case study. Individual differences, which emerged from the start, remain but greater confidence to be more experimental with their student-teachers, to plan for student-teacher-led learning and to undertake modelling and more open discussion about their pedagogical practice and principles are reported. Insights are being gained into the ways in which professional pedagogical learning has developed and into the particular workplace learning influences on the formation of their emerging professional identities as teacher educators. [ABSTRACT FROM AUTHOR]

This article highlights the blurring of boundaries as beginning teacher educators cope with the varying demands of teaching and research activities in higher education institutions (HEIs) in England. It suggests that the different forms of research and scholarly activities be made more transparent in order to support early professional learning in this area. Three cases of newcomers to higher education and working in different HEIs are examined over a two-year period. The concept of the 'turning point' as a betwixt state is adopted to help identify significant experiences which result in a developing sense of belonging (or not) to academic and scholarly life. Four different categories are also deployed to highlight the case studies' understanding of being a university researcher. All the newcomers saw research as a route to developing themselves personally. Over time there was a shift for some toward establishing oneself in the field, with an indication of the institutional and national pull towards fulfilling academic requirements. [ABSTRACT FROM AUTHOR]

This study presents the first measurements of anthropogenic plutonium (239Pu and 240Pu) concentrations and atom ratios (240Pu/239Pu) for Tasmania, in sediment collected from Bathurst Harbour, in the Tasmanian Wilderness World Heritage Area, Australia. The weighted mean 240Pu/239Pu atom ratio measured at this site was 0.172 ± 0.007 which is consistent with published data from mainland Australia and global and Southern Hemisphere averages. The 240Pu/239Pu atom ratios ranged between 0.11 and 0.21 with the earliest recorded 240Pu/239Pu atom ratios being the lowest, suggesting an influence of low atom ratio fallout from nuclear testing in Australia. Post-moratorium fallout 240Pu/239Pu atom ratios were consistent with other records. Lead-210 (210Pb) sediment chronologies indicate sediment accumulation rates have increased since the early part of the 19th century at this location. [Display omitted] • Presents the first measurements of fallout plutonium concentrations and 240Pu/239Pu atom ratios in Tasmania, Australia. • Uses an estuarine sediment record from a World Heritage Area to reconstruct fallout from global nuclear weapons testing. • Early 240Pu/239Pu atom ratios indicate contribution of fallout from British testing in Australia. [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.

We present interview data from the early stages of a longitudinal study on the emerging professional, academic identities of five beginning teacher educators. We identify the main facilitators and barriers which support different types of professional learning. Barriers in the early stages include: a reliance on trial and error learning, inappropriate induction courses, poor mentoring and support structures and relatively few opportunities for collaborative work. Facilitators include: flexible induction programmes, learning conversations with key colleagues and personal experience of learning at Masters' level. The data are discussed in relation to the described experiences of formal and situated (informal) learning. The positive impact of formal learning, as well as the capacity to 'fit in', show us that 'learning by participation' alone is an insufficient model to account for the complexities of becoming a teacher educator in new settings. Nous présentons des résultats d'entretiens issus... [ABSTRACT FROM AUTHOR]

The paper considers data in one Higher Education Institution (HEI) from written reports and from interviews with trainee teachers and their teachers charged with the assessment of one training standard for secondary Initial Teacher Training in England: Professional Values and Practice. It explores the extent to which four elements of this standard can be measured as outcomes of performance. It reveals that assessment judgements draw on a wide range of evidence and are often subjective, context-specific and broadly interpreted. In their current form these statements do not lend themselves easily to assessment. Recommendations include greater clarity in the statements about what might be expected of a beginning teacher in terms of particular professional competences as performance statements; opportunities for assessment in relation to a 'developing professionalism' rather than 'managed professionalism' (and compliance); and a broader framework that can take account of two dimensions in particular: (1) creating an environment for pupil learning and (2) teacher professionalism. [ABSTRACT FROM AUTHOR]

Abstract: The conditions that promote best practice in the mentoring of beginning teachers in secondary schools are explored in this paper in relation to the experiential model of learning put forward by Kolb [(1984). Experiential learning: Experience as the source of learning and development. New York: Prentice-Hall]. The underpinning processes of this learning cycle include the experience, the reflection, the learning that results and (further) experimentation. We present some empirical research from a two-year funded project on The Professional Development of Subject Induction Tutors and data derived from questionnaires completed by beginning teachers in three education authorities at the start and end of induction year and from semi-structured interviews with sub-samples of beginning teachers. The questionnaire data allowed us to distinguish three broad teacher ‘types’ in terms of their experiences of induction and the associated mentoring. In relation to these types we explored differences and similarities in the extent to which mentoring functions are distributed in schools, the extent to which different mentoring relationships allow beginning teachers to be empowered in their work, and the particular uses made of review and target setting and the value placed on these processes by beginning teachers and their mentors. Overall we found that best practice for ‘developmental mentoring’ involves elements of challenge and risk-taking within supportive school environments with clear induction systems in place and strong school ethos in relation to professional development. [Copyright &y& Elsevier]

This is an analysis of school tutors' assessments of aspects of Standard one, professional values and practice (DfES/TTA 2002) for secondary trainee teachers, together with interview data from a sample of trainee teachers and their school tutors/assessors. The paper examines teachers' interpretations of four sub‐categories within this Standard and considers these in terms of three key questions:1. How is the terminology of the standard being defined and described?2. How is the evidence for assessment selected and evaluated?3. What are the interpretative frameworks?While this standard is almost universally welcomed as an important component of teacher education in England, its assessment remains elusive for many teachers and tutors. As a result the standard is highly subject to personal interpretations of professionalism and what this might mean in terms of schools' provision for teacher development in this area. The paper supports the use of a framework of teachers' virtues and personal attributes, professional skills and learning and a set of professional behaviours, which might allow for institutional assessment procedures to take better account of both personal and professional development as well as professional competence. The place of critical reflection on practice is considered as a way of clarifying values and, the paper argues, it should become a central component of this standard.Il s'agit d'une analyse des appréciations de professeurs à propos d'aspects du Niveau 1, valeurs professionnelles et pratique (Standard one, professional values and practice) (DfES/TTA 2002) pour les professeurs du secondaire en apprentissage. Sont aussi analysés les résultats d'interviews réalisées auprès d'un échantillon de professeurs en apprentissage et de leurs superviseurs. L'article examine les interprétations des professeurs portant sur quatre sous‐catégories présentes dans ce Niveau et en rend compte sous forme de trois questions clés:1. Comment est‐ce que la terminologie du Niveau a été définie et décrite?2. Comment est‐ce que les avis sont sélectionnés et évalués?3. Quels sont les critères d'interprétations?Alors que ce Niveau est accueilli presque universellement comme un élément important de la formation des professeurs en Angleterre, beaucoup de professeurs ont des difficultés à l'évaluer. En effet, ce Niveau est hautement sujet aux interprétations personnelles du professionnalisme et ce que cela peut impliquer en terme d'apport des écoles pour le développement des professeurs dans ce domaine. L'article est en faveur de l'emploi d'un cadre de vertus et d'attributs personnels pour les professeurs, de compétences professionnelles et d'apprentissage, et une série de comportements professionnels qui pourrait permettre aux procédures institutionnelles d'évaluation de mieux prendre en compte le développement personnel et professionnel ainsi que la compétence professionnelle. La place accordée à une réflexion critique de la pratique est considérée comme un moyen de clarifier les valeurs et, selon l'article, cela devrait devenir un élément central de ce Niveau.Este es un análisis de profesores de escuela sobre el aspecto de evaluación del Standard Uno: Valores y Prácticas Profesionales (DfES/TTA 2002) para entrenamiento de profesores de secundaria con una muestra de datos en entrevista de profesores en entrenamiento en sus escuelas insitutos asignados de profesores/asesores. El documento examina la intepretación de profesores en cuatro subcategorías en este Standard y luego considera estos en tres preguntas claves;1. ¿Cómo es terminología de el Standard ha sido definida y descrita?2. ¿Cómo la evaluación de evidencia es selecionada y evaluada?3. ¿Cuáles son los sistemas interpretativos?Aunque este Standard por lo general universalmente acogido como un componente importante en la educación de profesorado en Inglaterra, su evaluación sigue siendo elusiva para muchos aprendices y educadores.Como resultado el Standard esta muy sometido a la interpretación personal del profesionalismo y el significado para la provision de desarrollo en este area. El documento propone el uso de una estructura de los valores de profesor y atributos personales, abilidad y conocimiento profesional, y prescripto conducta profesional, que podría permitir procedimiento de evaluación en institutos para mejorar tanto desarrollo personal y profesional así como competencia profesional. La reflexión crítica en práctica está considerada como una forma a clarar valores y, el documento argumenta, nucleo central de este Standard.Es handelt sich um eine Analyse der Einschätzungen von Lehrern von Aspekten des Standard Eins, Beruflicher Werte und Praxis (Standard one, professional values and practice) (DfES/TTA 2002) für Referendaren, zusammen mit Daten von Gesprächen mit einer Auswahl der Referendaren und ihrer Lehrer/Prüfer. Der Artikel untersucht die Interpretationen der Lehrer der vier Subkategorien dieses Standards und betrachtet sie im Rahmen drei Fragen:1. Wie wird die Terminologie des Standard definiert und beschrieben?2. Wie wird der Beweis für die Einschätzung ausgewählt und ausgewertet?3. Was sind die interpretierenden Rahmen?Dieser Standard wird zwar fast allgemein als wichtiges Teil der Lehrerausbildung in England begrüβt, trotzdem bleibt seine Einschätzung für viele Lehrer schwer definierbar. Folglich ist der Standard persönlichen Interpretationen von Professionalismus unterworfen, und könnte auch eine Wirkung auf die Versorgung der Schulen für Lehrerentwicklung in diesem Bereich haben. Der Artikel unterstützt die Anwendung der Rahmen (a) persönlicher Vorteile und Merkmale von Lehrern, (b) beruflicher Fähigkeiten und beruflichen Lernens, und (c) beruflichen Benehmens, die institutionelle Einschätzungsverfahren einrechnen könnten, die besser sowohl persönliche und berufliche Entwicklung, als auch berufliche Kompetenz, in Betracht ziehen. Der Platz kritischer Reflexion der Praxis wird als Methode, Werte zu klären, betrachtet; der Artikel behauptet, dass sie ein Zentralteil dieses Standards werden sollte. [ABSTRACT FROM AUTHOR]

This paper presents an analysis of some interview data from a small qualitative study of beginning teachers in their second year of teaching and selected mentors. It explores the extent of the opportunities for their further professional development and considers how the key ‘actors’ in these schools perceive, and experience, their school systems for performance management, appraisal and the associated mentoring, in relation to beginning teachers' professional needs and development. Rippon and Martin [(2003) ‘Supporting induction: relationships count’, Mentoring and Tutoring , 11(2), 211–226] highlight a need for the mentor to help in the development of a professional identity for teaching in the first year of teaching. For our sample of second year teachers, our analysis indicates that the support systems in school do not encourage the new teachers to become self-monitoring or critically reflective practitioners. Their professional development seems to be largely rooted in performance-led school managerial systems that may leave them unsupported in relation to their career aspirations and personal and professional targets. [ABSTRACT FROM AUTHOR]

The focus of this paper is the analysis of data from case studies of mentor meetings derived from an action research project on ‘The professional development of subject induction tutors’. Developing practice as a reflective teacher involves both reflection and action and a reflective teacher compares a teaching and learning situation with his or her own experiences and knowledge of educational theory that predict what might happen. This experiential learning cycle underpins a set of reflective practice strategies which were developed by the project team. These were offered as part of a set of interventions to the target induction tutors who were mentoring new teachers for their induction year in secondary schools in England. Analyses of transcripts of a series of recorded formal review meetings are presented and considered in terms of the evidence of changes in mentoring practice and in the practice of the new teachers to become more self‐evaluative and critically reflective. The implications of the observed changes are discussed in terms of how tailored mentor training can assist in developing critical reflective practice and a new teacher's increasing professional autonomy. Le thème de cet article est l'analyse de données provenant d'études portant sur des réunions de conseillers. Ces études sont issues d'un ‘Action Research Project’ (programme de recherche d'action) ayant pour sujet ‘The Professional Development of Subject Induction Tutors’ (‘L'épanouissement professionnel des ‘Educateurs Chargés d’Admission’)). Le développement de l'enseignement réfléchi nécessite aussi bien de la réflexion que de l'action. Un professeur réfléchi compare une situation d'enseignement et d'apprentissage à ses propres expériences et à sa connaissance de la théorie pédagogique qui prédit ce que peut se passer. Ce cycle d'apprentissage expérimental est à la base d'une série de ‘Reflective Practice strategies’ (‘stratégies de la Pratique Réfléchie’) qui ont été développées par l'Equipe du Projet. Celles‐ci proposaient entre autre une série d'interventions des Educateurs Chargés des Admissions qui conseillaient des nouveaux professeurs pour leur première année dans des écoles secondaires en Angleterre. Les analyses des transcriptions de la série de réunions officielles, revues et enregistrées sont présentées et considérées comme des preuves de changements de la pratique du conseil et de la pratique des nouveaux professeurs pour devenir plus critiques à l'égard de eux‐mêmes et plus s'auto‐évaluer. Les conséquences des modifications observées sont discutées pour savoir comment une assistance à la formation adaptée peut favoriser le développement de la pratique réfléchie critique et l'accroissement de l'autonomie professionnelle d'un nouveau professeur. El enfoque de este documento es el analisis de data de estudios de casos que se obtuvo del projecto de acción investigativa bajo el titulo “El Desarrollo Profesional de Tutores de Inducción”. Ayudando al profesor a hacer más reflexivo en sus prácticas que involucra ambos reflexión y acción, y un profesor reflectivo compara su enseñanza y situación de aprendizaje basada con su propia experiencias y conocimiento de la teoría educacional que predice lo que pueda pasar. Este ciclo de aprendizaje experimental informa un serie de prácticas reflexivas que fueron desarrollados por el Grupo del Projecto. Estos fueron ofrecidos como parte de una serie de intervenciones a los Tutores de Induccion que estaban entrenando nuevos profesores en el primer año de la escuela secondaria, en Inglaterra. Analisis de la transcripciones de series de reuniones formales, están presentadas y consideradas como evidencias de cambios de práctica de entrenamiento y en la prácticas del nuevos profesores para ser más evaluativo y crítico de si mismo. Las implicaciones de los cambios observados son discutidos como considerando como diseño especial para entrenamiento de entrenados que pueda ayudar al desarrollo crítico de prácticas reflectivas y un nuevo profesor con autonomía profesional. Im Mittelpunkt dieser Studie steht die Auswertung von Daten, die aus der Analyse von Mentorsitzungen im Rahmen eines ‘Action Research Project’ (Projekt, bei dem Handlungen untersucht werden) gewonnen wurden, das sich mit ‘The Professional Development of Subject Induction Tutors’ (Die berufliche Entwicklung von Lehrenden, die Lehrer in ihrem Probejahr beraten) beschäftigt. Damit Reflexion zu einem integralen Bestandteil des Lehrerverhaltens wird, ist sowohl Reflexion als auch aktives Tun erforderlich. Ein Lehrer, der sein Verhalten reflektiert, vergleicht eine Lehr‐ und Lernsituation mit seinen eigenen Erfahrungen und seinem Wissen über pädagogische Theorie, mit deren Hilfe man voraussagen kann, was möglicherweise passieren wird. Dieser auf Erfahrung aufbauende Lernzyklus stellt die Grundlage für eine Reihe von ‘Reflective Practice strategies’ (auf Reflexion beruhenden Strategien) dar, die von dem Projektteam entwickelt wurden. Diese Strategien wurden den Induction Tutors, die neuen Lehrer während ihres Probejahrs in Schulen der Sekundarstufe in England zur Seite standen, als eines von mehren möglichen Mitteln angeboten. In der vorliegenden Studie werden Auswertungen von Abschriften der aufgezeichneten formellen Besprechungen präsentiert und daraufhin untersucht, ob sich Änderungen im Verhalten der Mentoren und der neuen Lehrer zeigen in Richtung einer stärkeren Selbstevaluation und kritischen Reflexion. Die Bedeutung der beobachteten Veränderungen wird daraufhin untersucht, wie eine maßgeschneiderte Mentorenausbildung bei der Einübung kritischer Reflexion helfen sowie junge Lehrer in ihrer immer größer werdenden beruflichen Eigenständigkeit unterstützen kann. [ABSTRACT FROM AUTHOR]

The authors draw on the work of Maudsley and Scrivens (2000) to explore the elusive but crucial concept of critical thinking in terms of the extent to which it is reflective practice that joins discussion of critical thinking with experiential learning’. We present some of our evidence base derived from a sequences of formal professional review meetings between induction tutors (mentors) and their newly qualified teachers (NQT) (mentees). We describe the frameworks used for analyses for examination of critical questioning by mentors and the resulting articulation of practice by mentees, and for locating any shifts in the mentoring styles adopted by the mentors in the course of the year of study. We show that the adoption of particular reflective practice strategies, and/or associated interventions, are clearly linked to changes in ways of working by both mentor and mentee and which illustrate, in several instances to an increase in professional independence on the part of the NQT. Finally we present some emerging issues for a range of stakeholders including those involved in mentor training, school managers and policy makers, and the mentors themselves. [ABSTRACT FROM AUTHOR]

This article explores the connection between health and science education. In setting out to explore the interface between health and science education in order to determine important areas for further research, the author identified three key areas for further exploration. First, it is important to encourage a range of approaches to health education research, and to consider these in the context of the science curriculum. It is clear, on the one hand, that more substantial research funding, particularly for large-scale research projects outside of the U.S., is needed in order to examine and evaluate more closely particular health education interventions in schools. Second is listening to the voices of young people as an important part of a future research agenda at this interface. There appears to be a large gap between health education research and the real world of young people. Young people need to be asked, for example, to specify in their own words the factors that inhibit or help them to eat healthy foods. The third concluding point is that there should be specific focus on health-science pedagogical issues. Within the idea of Health Promoting Schools, science teachers might be expected to be clear about the particular aims and objectives of their lessons in relation to health-related knowledge, attitudes and behavioral outcomes.

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]