‘Occasional’ and ‘social’ smokers: potential target groups for smoking cessation campaigns?

OBJECTIVE: To describe the characteristics of self-described 'occasional' and 'social' Australian smokers. DESIGN: Analysis of a national cross-sectional survey of smoking patterns, conducted in Australia in 2004. SETTING AND PARTICIPANTS: Australian adults in 2004 who responded to a survey question about self-described smoking status. MAIN OUTCOME MEASURES: Demographic characteristics, patterns of alcohol and tobacco use, smoking cessation attempts in the past year, and interest in cessation. RESULTS: Smokers who described themselves as 'occasional' and 'social' smokers comprised 29% of all smokers. A significant proportion of occasional and social smokers had been daily smokers, but the majority either believed that they had 'already quit' or had no intention of quitting smoking. CONCLUSIONS: Self-ascribed occasional and social smokers potentially represent an important target group for cessation. These types of smokers may be more resistant to public health messages regarding cessation because they do not view their smoking behaviour as presenting a high risk.     

‘Coalition’1 – what does it mean for schools?

Since the formation of a coalition government in May 2010, there have been substantial changes in government policies relating to the education system in England and Wales. The previous Labour administration strengthened education in food and nutrition and promoted healthy eating in schools. The National Curriculum relating to food technology states what pupils should learn, making reference to practical cooking skills, food safety and hygiene and nutrition and healthy eating. This remains a statutory requirement. The Comprehensive Spending Review (CSR), announced in October 2010, meant that substantial financial cuts would be made across government, including the Department for Education. A huge swathe of quangos has already been cut, including the Qualifications and Curriculum Development Agency (QCDA) and the National Healthy Schools Programme (NHSP). The School Food Trust (SFT) has faced budget cuts, and further massive savings will come from the scrapping of Building Schools for the Future (BSF). The White Paper and Education and Children's Bill will provide greater freedom for schools and academies to determine their own curriculum, length of the school day and lesson times. David Cameron's vision of a ‘Big Society’ will require greater collaboration from a wide range of organisations, including industry and charitable organisations to support high quality education in food and nutrition in schools. Individual Headteachers will be freed to make decisions at a local level. This will leave individual schools with greater decision making and funding responsibility.     

Do ‘clumsy’ children have visual recognition problems?

OBJECTIVE: Visual recognition by 8-year-old children with hand-eye co-ordination problems (HECP), and by a control group of children without such problems was tested using a task of visual closure. DESIGN: The task required the children to identify common objects from an incomplete visual presentation. RESULT: As predicted, it was found that the HECP children, who were designated as such solely on the basis of their motor difficulties, identified significantly fewer correct objects than their control counterparts. CONCLUSIONS: This finding raises the possibility that the visual processing problems of clumsy children contribute to, or even strongly determine, not only their movement problems but also their learning difficulties.     

Faculty development: a ‘Field of Dreams’?

Objectives  Participants in faculty development workshops often comment that 'those who need faculty development the most attend the least'. The goals of this study were to explore the reasons why some clinical teachers do not participate in centralised faculty development activities and to learn how we can make faculty development programmes more relevant to teachers' needs.
Methods  In 2006, we conducted focus groups with 16 clinical teachers, who had not participated in faculty development activities, to ascertain their perceptions of faculty development, reasons for non-participation and perceived barriers to involvement. Content analysis and team consensus guided the data interpretation.
Results  Focus group participants were aware of faculty development offerings and valued the goals of these activities. Important reasons for non-participation emerged: clinical reality, which included volume of work and lack of (protected) time; logistical issues, such as timing and the central location of organised activities; a perceived lack of financial reward and recognition for teaching, and a perceived lack of direction from, and connection to, the university.
Conclusions  Clinical reality and logistical issues appeared to be greater deterrents to participation than faculty development goals, content or strategies. Moreover, when asked to discuss faculty development, teachers referred to their development as faculty members in the broadest sense, which included personal and career development. They also expressed the desire for clear guidance from the university, financial rewards and recognition for teaching, and a sense of 'belonging'. Faculty development programmes should try to address these organisational issues as well as teachers' personal and professional needs.     

Just how wide should ‘wide reading’ be?

Educationalists introduce students to literature search strategies that, with rare exceptions, focus chiefly on the location of primary research reports and systematic reviews of those reports. These sources are, however, unlikely to adequately address the normative and/or metaphysical questions that nurses frequently and legitimately interest themselves in. To meet these interests, non‐research texts exploring normative and/or metaphysical topics might and perhaps should, in some situations, be deemed suitable search targets. This seems plausible and, moreover, students are encouraged to ‘read widely’. Yet accepting this proposition creates significant difficulties. Specifically, if non‐research scholarly sources and artistic or literary (humanities) products dealing with normative/metaphysical issues were included in what are, at present, scientifically orientated searches, it is difficult to draw boundaries around what – if anything – is to be excluded. Engaging with this issue highlights problems with qualitative scholarship's designation as ‘evidence’. Thus, absurdly, if qualitative scholarship's findings are labelled evidence because they generate practice‐relevant understanding/insight, then any literary or artistic artefact (e.g. a throwaway lifestyle magazine) that generates kindred understandings/insights is presumably also evidence? This conclusion is rejected and it is instead proposed that while artistic, literary, and qualitative inquiries can provide practitioners with powerful and stimulating non‐evidential understanding, these sources are not evidence as commonly conceived.     

‘What is it?’: findings on preschoolers’ responses to play with medical equipment

When young people enter a hospital they are exposed to a foreign world of unfamiliar people, medical equipment and language. Children diagnosed with leukaemia are particularly vulnerable to repeated exposure to these distressing hospital visits. Assessing a child's understanding of the stresses associated with treatment during hospitalization is now seen as a key element of caring for the paediatric patient. A population particularly vulnerable to the effects of the stress of intensive treatments during hospitalization are preschool children. In order to understand the impact on leukaemia preschool children of intensive hospital treatment it is necessary to have comparative information on healthy peers who have not been exposed to such treatment experiences. This article presents findings from recent qualitative research that explored the beliefs held by healthy preschoolers about what happens in hospital, what it means to be sick, their reactions to and knowledge of medical equipment and their level of knowledge regarding cancer and leukaemia. It is the hope and expectation that the findings will be used comparatively to contribute to a deeper understanding of the world of the child coping with leukaemia and related disorders.     

What constitutes ‘good care’ and ‘good carers’? The normative implications of introducing reablement in Danish home care

As populations worldwide are ageing, Western welfare states are currently implementing welfare reforms aimed at curbing the rising need for social and healthcare services for ageing populations. A central element in home‐care reforms in several welfare countries is reablement: short‐term home‐based training programmes aimed at re‐enabling older people to live in their own homes independently of care. In this paper, we explore how transitioning from compensatory care to reablement care is not merely a practical process, but also a deeply normative one. Drawing on Annemarie Mol's concept of ‘ontonorms’ we analyse the normative dynamics involved in transitioning from one form of care to another as reflected in reablement professionals' practices and discourses. The paper draws on 10 months of multisited ethnographic fieldwork carried out from April 2015 to February 2016 in a Danish municipality, including participant observations of reablement practices as well as qualitative interviews with 13 professionals working with reablement. We demonstrate that professionals generally consider reablement to represent a desirable shift in home care from ‘bad care’ practices of making people passive through compensatory care, towards ‘good care’ practices of ‘keeping people going’ despite their limitations. Moreover, we demonstrate that while therapists are valued as ‘good carers’ due to their ability to focus on development and training, nurses and in particular home helpers are devalued as ‘bad carers’ due to their ‘caring genes’ and lack of technical and theoretical skills necessary for documentation work. Finally, we discuss the implications of these normative dynamics, which may risk stigmatising compensating care practices, although this form of care to a large extent continues to coexist with reablement practices. In conclusion, we argue for a more nuanced approach to care, recognising compensatory care and reablement as complementary forms of care, each doing good under different circumstances.     

The Dutch ‘Folic Acid Campaign’–have the goals been achieved?

Periconceptional folic acid use considerably reduces the risk of neural tube defects. The aim of this study was to measure the effect of the national and the local 'Folic Acid Campaign' on periconceptional folic acid use. Before (1995 survey) and 1 year after the campaign (1996 survey), the awareness and use of folic acid was measured among pregnant women in four regions of the Netherlands. To this end, pregnant women who visited the midwife, general practitioner or obstetrician for the first or second prenatal visit were asked to complete a questionnaire. The results showed that use of folic acid for any period around conception increased from 25.1% in 1995 to 53.5% in 1996. Appropriate use (4 weeks before until 8 weeks after conception) increased from 4.8% in 1995 to 21.0% in 1996. No additional effect of the local Folic Acid Campaign was found (adjusted odds ratio= 1.0; 95% confidence interval = 0.7, 1.4). It was possible to conclude that folic acid use at the recommended time increased considerably as a result of the national and the local Folic Acid Campaign, but the target (use in 46% of women wishing to conceive) was not achieved. New health education programmes are needed to increase further its use at the appropriate times.