Nurses’ perceptions of mental healthcare in primary-care settings in Kenya

Kenya maintains an extraordinary treatment gap for mental health services because the need for and availability of mental health services are extraordinarily misaligned. One way to narrow the treatment gap is task-sharing, where specialists rationally distribute tasks across the health system, with many responsibilities falling upon frontline health workers, including nurses. Yet, little is known about how nurses perceive task-sharing mental health services. This article investigates nurses’ perceptions of mental healthcare delivery within primary-care settings in Kenya. We conducted a cross-sectional study of 60 nurses from a public urban (n?=?20), private urban (n?=?20), and public rural (n?=?20) hospitals. Nurses participated in a one-hour interview about their perceptions of mental healthcare delivery. Nurses viewed mental health services as a priority and believed integrating it into a basic package of primary care would protect it from competing health priorities, financial barriers, stigma, and social problems. Many nurses believed that integrating mental healthcare into primary care was acceptable and feasible, but low levels of knowledge of healthcare providers, especially in rural areas, and few specialists, would be barriers. These data underscore the need for task-sharing mental health services into existing primary healthcare in Kenya.     

The influence of simulations on family engagement – prospective early childhood educators’ perceptions

Nurturing experiences in preparation for prospective early childhood educators’ work with families during their training are critical for establishing empowering relationships. This article details a qualitative case study of 77 prospective early childhood educators engaged with the Parent, Family and Community Engagement Simulation. An electronic questionnaire exploring their beliefs regarding the use of the simulation was conducted at the Universidad Rey Juan Carlos (Spain). The results demonstrate the simulation can be a very effective classroom technique to provide students with the necessary competencies to engage with families effectively and promote school readiness. These results also suggest that the simulation provided important insights into how successful partnership occurs and how to strengthen relationships, helping students to reflect on the importance of family involvement.     

A case study of gendered play in preschools: how early childhood educators’ perceptions of gender influence children's play

This research aimed to explore children's play in relation to gender stereotypes and beliefs and practices of educators in preschool settings. A feminist poststructuralist approach framed the design of the research and data were collected in two settings through predetermined categories of play during periods of spontaneous free play. The question asked in this research was, do early childhood educators’ perceptions of gender influence children's play? Findings suggest that there were differences between these two settings and these differences are explained through individual beliefs and practices of the educators.     

Regulators’ views of quality in early childhood care and education settings in Ireland

There is a substantial literature on the importance of good-quality early childhood care and education services. There is also, however, some agreement that service quality is a nebulous concept which is difficult to define and therefore difficult to assess. While there is growing literature in the area, the views of one stakeholder group—that of regulators—is relatively scarce in the academic literature. This article presents the views of this stakeholder group using the findings from a systematic analysis of reports of pre-school inspections carried out in the Republic of Ireland. A total of 3007 individual inspection reports comprising 81,189 regulation references were analysed in this study. The findings indicate that regulators are of the view that the majority of services are compliant across most of the 27 regulations inspected, with three-quarters (73%) of all services inspected reported to be non-compliant on five or fewer regulations. The three areas reported to have the highest levels of non-compliance were “management and staffing“ (46.2%), “safety“ (43%) and “records“ (35%). Variation in the findings was identified according to the type of inspection (follow-up inspections had the highest levels of non-compliance), type of service (drop-in services had the highest levels of non-compliance), geography (Dublin North East had the highest level of non-compliance) and extent of the commentary (children's health, welfare and development generated extensive commentary, far in excess of other regulation areas). While international comparisons are not possible due to different approaches and foci for assessment, variation has also been a feature of studies conducted in other jurisdictions including Scotland and the United States. The findings from this study provide an understanding of the views of regulators across the breadth of regulations that legally underpin the service and can act as a benchmark for a variety of stakeholders.     

Experts or good educators – or both? The development of early childhood educators’ expertise in Finland

Well-educated staff consists of multidimensional experts, and this staff is one of the strengths of the Finnish day-care system. The aim of this article is to clarify the development of the expertise of those early childhood educators who have qualified as kindergarten teachers. The data consisted of the early educators’ stories (n?=?80) of their growth towards expertise. The analysis was carried out as content analysis. As the results, four key factors in the process of growth towards expertise were created. According to the informants, personal life history, education, work experience and personal attitudes towards work had been the most influential factors in the process of growth towards their expertise. The working environment both facilitated and hindered the growth of the expert. It is possible to foster educators’ professional growth with an individual development plan.     

Digital technologies in early childhood education – a frame analysis of preservice teachers’ perceptions

Research on early childhood teachers’ perceptions of technology integration has been criticized for not paying enough attention to the unique pedagogical characteristics of early childhood education. This qualitative study contributes to resolving this need by scrutinizing preservice teachers’ perceptions of technology usage through the frames of education, socialization, and care, which form a harmonious whole referred to as the EDUCARE approach. The findings suggest that an individual preservice teacher can be for or against technology usage depending on the frame they reflect on technology integration through. Children’s ages and participants’ beliefs about the children’s access to technology at home were the most significant factors behind the variation in dynamics between and within the frames. The implications for future research are also discussed.     

Preservice early childhood students’ perceptions of written feedback on their essays

Lecturer feedback on students’ essays is important to the quality of the experience students have at university (). The aim of the present study was to investigate whether early childhood students at one university actually read lecturer feedback on their essays and, if they did, what they found helpful and not helpful to their learning. Feedback was defined as ‘giving students information on how well or how poorly they are doing in their academic work’ (, p. 109). Using the Vygotskian concept of learning as a socially shared activity, qualitative data were collected from second‐year students from a four‐year early childhood degree programme via an anonymous survey and four focus groups. Major findings were that, in contrast with studies of students in other programmes, early childhood students read lecturer feedback on their essays and used feedback that was detailed and explanatory as a learning tool. Types of feedback students found to be most and least useful were identified.     

Investigating early childhood teachers’ views on science teaching practices: the integration of science with visual art in early childhood settings

This study investigates early childhood teachers’ views about science teaching practices in an early childhood settings. It was conducted in a preschool located in Ankara, Turkey. The data of the study were collected through multiple sources of information such as interviews with early childhood teachers and observations of their practices in the classroom. The findings of this study indicated that early childhood teachers believed in the importance of science activities in their practices and they claimed that they provided child-centred activities for children to enrich their science experiences. Moreover, the findings showed that they used different learning experiences that were naturalistic, informal, and structured. The findings also revealed that an integrated curriculum improved children’s developmental progress. More specifically, participant teachers used art as an assessment tool in science activities because they considered that they were able to evaluate children’s understanding on the basis of their art work such as their drawings.     

Interpreters’ knowledge and perceptions of childhood vaccines: Effect of an educational session

BackgroundInterpreters improve the care of patients with limited English proficiency. They can potentially act as unofficial health educators to help dispel misunderstandings about medical risks in a culturally appropriate manner. Somali parents in Minnesota are less likely to immunize their children for MMR than other parents because they believe the MMR vaccine causes autism. The low MMR vaccination rate contributed to measles outbreaks in the state in 2011 and 2017.ObjectiveTo investigate the effects of an educational session on interpreter beliefs and knowledge about childhood vaccines.MethodsA large interpreter service in Minneapolis holds quarterly educational sessions for their interpreters. The investigators presented a one-hour interactive session on childhood vaccinations at one of the meetings. The interpreters were surveyed pre- and post-training to assess their (1) beliefs regarding childhood vaccines, (2) knowledge of childhood vaccination indications and safety, and surveyed pre-training about their perceived impact on patient decision-making.ResultsFifty-five of the 78 interpreters attending the training session completed both the pre- and post-training surveys. Participants made significant improvements in their knowledge of vaccines after the training. Interpreters were less likely to believe that vaccines causes autism after the presentation (p = 0.02), and were more likely to indicate that the current evidence does not support a vaccine – autism connection (p < 0.001).Nineteen percent of the interpreters were from Somalia. Somali interpreters were significantly more likely to expand on what is said by the physician than their non-Somali colleagues (OR = 16.2, 95% CI = 2.8–92.9). They were also significantly more likely to encounter parental worry over vaccine safety (OR = 16.2, 95% CI = 1.9–140.5), and to believe that children get too many vaccines (OR = 30.1, 95% CI = 3.4–271.5).ConclusionsThe training was an effective method to improve interpreters’ knowledge and perceptions of vaccine safety. By training Somali interpreters, they can become a part of a team working toward better MMR vaccination rates.     

Consumers’ perceptions of biocidal products in households

Biocidal products are commonly used in households and can pose a risk to human health and the environment. The aim of this study was to evaluate consumers’ use and understanding of biocidal products in order to identify starting points for minimising their exposure to these products and reducing possible emissions to the environment. In a case study, standardised questionnaires were used to interview consumers in 133 households in three neighbourhoods in Northern Germany, representing the urban–rural typologies in Europe: predominantly urban, intermediate and predominantly rural regions. The questions focussed on the comprehension of the term ‘biocide’, pest control habits, sources of information, risk perception of different product groups and possible emission reduction measures.Only 21% of the respondents understood the term ‘biocide’ correctly, whereas 29% thought of ‘something that had to do with organic pest control’, and 28% were not able to think of a possible meaning. The risk perception of biocidal products compared to plant protection products varied depending on the living conditions. In the urban neighbourhood, biocidal products were perceived as more dangerous than in the rural area. The main pests to be fought were ants, mould and fruit fly. The results of the study indicate that there is a considerable difference between the types of biocidal products that interviewees claimed to own and those that they actually did have in their households. Most notably, respondents did not realise that they owned surface disinfectants. This result indicates that consumers often seem not to be aware of using specific biocidal products. Also, this shows the limitations of collecting data on products owned with only one method, as the results from products inventories of the households deviate from the data collected in interviews.Our results show that the term ‘biocide’ is not fully understood by many people. To communicate possible risks of biocidal products, other terms would have to be used. Online information regarding general facts on necessary general hygiene measures and biocidal products against bacteria and insects are likely to be of highest relevance for consumers. However, risk communication for biocidal products in general is difficult because consumers are often not aware of using biocidal products. For this reason, information and awareness raising campaigns should be accompanied by further measures such as sales restrictions for specific user-groups or prohibitions of certain uses for a sustainable use of biocidal products.     

Patients’ perceptions of generic drugs in Greece

The use of generic drugs is growing increasingly around the world and in Greece, in particular, in order to reduce pharmaceutical expenditure. However, patients’ perceptions and attitudes about generics have only partially been studied so far in Greece.ObjectiveThis study aimed to examine the factors that influence the attitude of patients and consumers regarding generic drugs.MethodsA questionnaire survey of 364 patients visiting a pharmacy was conducted. The questionnaire consisted of 29 questions, including questions regarding their knowledge about generics, the reasons for using them, their previous experience, their willingness for generic substitution, and the factors behind these choices.ResultsNearly half of the participants in the survey know the term ‘generic’ and that it has a lower price compared to the brand name drug. Their views on safety and efficacy vary significantly and the main source of information on generics is the media and the internet. The lack of knowledge is the main barrier for attitudes of doctors. Health professionals play the most influential role for the substitution of a branded drug by a generic, followed by the cost of the generic.ConclusionsAlmost half of the patients know about generic drugs, with their lower price being the most popular feature which most patients are familiar with. It seems that primarily the doctor and, subsequently the pharmacist play the most important role in a patient's decision to replace his/her medicine with a generic.     

‘Youth-friendly’ characteristics of professionals in mental health settings

Abstract

Adolescents have a unique developmental vulnerability to suicide, with youth presenting as the second most vulnerable group to suicide across the lifespan. Youth have been recognized as underserved mental health service recipients, with only one in six of those in need receiving care. Calls for innovative mental health services to better serve youth have been articulated for over a decade and the adolescent health and mental health communities have responded. However, to date there has been little empirical discussion of the caregiver characteristics that would increase the likelihood of youth feeling comfortable discussing their mental health concerns. Objectives of this study were twofold: (1) to ask a large sample of Canadian youth [n?=?11 171: 5146 males, 6001 females (n?=?24 participants did not indicate their sex )] to identify characteristics of mental health professionals they would define as ‘youth-friendly’, and (2) to test which youth-friendly characteristics are deemed important to youth based on their circumstances, including those experiencing recent suicidality. Gender differences are also tested and explored. The absence of youth-friendly mental health service provision is proposed to be a modifiable barrier to help seeking in at-risk youth.     

Parent perceptions of dentists’ role in HPV vaccination

IntroductionOffering HPV vaccine in settings beyond the traditional medical home holds promise for increasing the currently low levels of coverage. As adolescents frequently visit dentists, dental practices may be one such alternative vaccination setting. This study assessed parent attitudes about the roles dental providers could play in HPV prevention, including vaccine provision.MethodsIn September 2016, we conducted an online survey using a national sample (n = 1209) of U.S. parents of adolescent children aged 11–17. Adolescents’ mean age was 14; 53% were male and 62% were non-Hispanic white. We identified correlates of parents’ comfort with dentists as HPV vaccinators using multivariable logistic regression.ResultsOverall, 23% of parents reported that they would feel comfortable with their child receiving HPV vaccine from a dentist. In multivariable analyses, parents had greater odds of being comfortable if they had higher trust in their child’s primary care provider (OR = 1.27, 95% CI: 0.96–1.68) and lower odds if their child was female (OR = 0.65, 95% CI: 0.50–0.86). Convenience (20%) and oral health expertise (20%) were the most commonly cited benefits of dentists administering the vaccine. Wanting their child’s regular provider to administer and track vaccinations (61% and 58%, respectively), and lack of insurance coverage (30%) were the most commonly cited concerns. Parents expressed somewhat greater comfort with roles dentists might play in promoting HPV vaccination other than vaccine delivery, such as providing education.ConclusionsParents in this sample had low comfort with dentists as HPV vaccinators. Findings from this study highlight potential concerns to be addressed before dental practices consider offering HPV vaccination in the future. Further research should assess dentists’ perspectives and explore alternative roles for dental providers in HPV prevention efforts.     

Diversity gain? An exploration of inclusive and exclusive perceptions in early years settings in England

This article explores inclusive and exclusive perceptions within early years practice settings in England. Inclusion is understood to involve the acknowledgement and celebration of difference, rather than its problematization. A deficit-based discourse regarding diversity is challenged and the concept of diversity gain is explored. A study was undertaken involving seven early years practice settings. The study involved the use of a critical communicative methodological approach due to its focus on exploration and listening with a view to understanding. The results and data analysis supplied three key findings. Firstly, practitioners are able to articulate their understanding of diversity gain and a desire for inclusion to a far greater extent than parents involved in the settings. Secondly, parental involvement within the settings is fundamental to authentic inclusion. Finally, practitioners felt that there was a distinct lack of resources, including funding, time and expertise, to support inclusive practice appropriately.     

Early childhood administrators’ attitudes and experiences in working with gay- and lesbian-parented families

This study examined the attitudes, preparation, and comfort of early childhood administrators in working with gay and lesbian (GL) parented families and the use of GL inclusive practices within centers. Data were gathered from 203 participants in the state of North Carolina using an online survey. Overall, administrators held a positive attitude towards GLs. Specifically, administrators with higher levels of education held a more positive attitude towards lesbians than gay men. Attitudes also correlated highly with administrator’s comfort in working with GL parented families and use of inclusive practices within their center; however, it did not correlate with preparation or training in the field. Participants who identified themselves as very religious had lower scores on all measures used within the study, compared to administrators who were somewhat religious or not religious. Finally, most of the inclusive strategies implemented within centers were perfunctory, which required minimal change and effort by administrators.     

Parents and preschool workers’ perceptions of competence,collaboration, and strategies for addressing bullying in early childhood

The purpose of this study was to explore and compare parents’ (n?=?141) and preschool workers’ (n?=?81) perceptions of bullying with respect to preschool workers’ competence, collaboration with parents, and strategies for dealing with bullying. Whereas most participants held positive views about their collaboration, preschool workers tended to be more critical of parents than vice versa. With respect to strategies, we found that the order of preferred approaches was largely consistent across groups, yet the two groups differed in the degree to which they supported certain approaches. Among parents, lower perceptions of children’s well-being and increased exposure to bullying were associated with more negative views of collaboration and preschool competence. Parents who had little direct exposure to bullying were more likely to report that they lacked the knowledge needed to evaluate the competence of preschool workers. Taken together with previous research, these findings suggest that preschools often rely on a reactive approach to including parents in the process of addressing bullying. We argue that a more proactive stance is warranted.     

Using relationships as a tool: early childhood educators’ perspectives of the child–caregiver relationship in a childcare setting

Children's early years are critical for development and many children access out-of-home care during this time. Services offering high-quality childcare afford an opportunity to impact positively on children's development, including acquisition of communication skills. A strong, responsive relationship between child and carer is important in facilitating children's communication development. For infants who are not yet verbal, early childhood educators (ECEs) need to be highly sensitive to the child's communication, and they need to develop a relationship with the child to interpret their signals and facilitate their communication. This study investigated the perspectives of ECEs on their relationships with infants in their care. Individual semi-structured interviews with ECEs were conducted and the interview data were triangulated with videoed observational data. The results demonstrate that these ECEs use the relationship with the children in their care as a tool for provision of optimal learning experiences across multiple developmental domains.