599RCT of Harti Hauora Tamariki: a holistic family-centred programme for child health and equity

Background In Aotearoa NZ, preventable paediatric admissions and readmissions with diseases of poverty are common, particularly for Māori (Indigenous) children. In response, the Harti Hauora Tamariki (HHT) was developed. This is a multilevel programme of: culturally safe engagement; comprehensive high-quality screening; standardised evidence-based protocols for addressing need(s) and navigation. Methodological innovations are required for a RCT of HHT effectiveness within the context of whānau (family) wellbeing. Methods Approximately 980 children admitted to paediatrics at Waikato Hospital were randomised (with whānau) to HHT or usual care. Measures of effectiveness include: level of unmet need identified; impact of HHT on meeting needs; qualitative assessment of HHT support for health outcomes and whānau satisfaction with care. The primary quantitative endpoint is relative readmission risk. Results Qualitative case studies demonstrate the importance of engagement and the high-trust environment of HHT enabling whānau to reveal needs. Needs are common. Many needs identified (such as food insecurity, lack of resources) are not recognised through standard hospital care. HHT adaptations were required. Quantitative outcome analyses are underway. Conclusions The whole health system has responsibility and ability to improve whānau health promotion, prevention, and wellbeing support. HHT provides a model for action. RCT assessment of HHT needed to be whānau-centred and flexible to match programme evolution and provide evidence for effectiveness. Key messages A family-centred holistic screening programme, with culturally-safe engagement, improves inpatient care and enhances determinants of health. Indigenous leadership and commitment to Indigenous wellbeing and equity facilitates effective programme improvement, within an adaptable RCT framework.

‘E-TAP’ CURRICULUM FOR VIRTUE EDUCATION: A FIT ANALYSIS TO THE ‘SKOLA-2030’ CURRICULUM

The virtue education curriculum ‘e-TAP’ is one of the recent efforts for improving character and virtue education at school in Latvia from preschool till grade nine. The objective of this research was to provide evidence regarding whether this curriculum is appropriate (‘fits’) to the Latvian context, in particular in reference to the Skola-2030 curriculum. Based on fit and feasibility theory, this work addressed the research question: “How does the treatment of virtues of the e-TAP curriculum fit to the treatment of virtues of the new Skola-2030 curriculum?”. The analysis used statistical descriptive frequency analysis of the virtues of each programme and comparative analysis between the two document sets included in each of them, using Excel software. The results show that Skola-2030 programme stresses performance and civic virtues, while the e-TAP programme underlines moral and intellectual virtues. Performance virtues are the most important ones in Skola-2030 (38 %), but account only for 17 % in the e-TAP curriculum. In addition, in Skola-2030 curriculum civic virtues account for 23 %, while in e-TAP they are only 8 %. In the e-TAP curriculum, moral virtues account for half of all the mentions (50 %) and intellectual virtues for 25 %, whereas in Skola-2030 those virtue groups account for 22 % and 18 %, respectively. The high ‘complementarity fit’ of both programmes suggests that the e-TAP curriculum could considerably enrich the Skola-2030 educational offer. Suggestions for e-TAP programme improvement and further research are put forward.

Facilitators and Barriers to the Implementation of Preschool Oral Healthcare Programme in Malaysia from the Perspective of Dental Therapists: A Qualitative Study

The Preschool Oral Healthcare Programme (POHP) was introduced in Malaysia by the Ministry of Health in 1984 to provide oral healthcare for 5–6-year-old children. Most of its evaluations were directed towards assessing children’s oral health status. Little emphasis has been placed on assessing the programme feasibility from the perspectives of the oral health personnel. The objective of the study was to explore the facilitators and barriers to the implementation of the POHP using the perspectives of dental therapists (DT) in Selangor state, Malaysia. This study took a qualitative approach using focus group discussion (FGD) as the data collection method. The data were transcribed verbatim followed by thematic analysis using NVivo 12 Pro version software. A total of 13 FGDs had been conducted involving 114 DT. The main facilitators were good dental teamwork, assistance from schools and teachers, sufficient training of DT, adequate support from dental administration, and good cooperation from the children. The main barriers were lack of financial support, manpower, time, inadequate support from preschools and children, language barrier, and accessibility to sugary food and drinks at schools. The study provided important insights regarding the POHP that would be useful for programme improvement through policy changes, workforce training, and enhanced school participation.

How does embedded implementation research work? Examining core features through qualitative case studies in Latin America and the Caribbean

Innovative strategies are needed to improve the delivery of evidence-informed health interventions. Embedded implementation research (EIR) seeks to enhance the generation and use of evidence for programme improvement through four core features: (1) central involvement of programme/policy decision-makers in the research cycle; (2) collaborative research partnerships; (3) positioning research within programme processes and (4) research focused on implementation. This paper examines how these features influence evidence-to-action processes and explores how they are operationalized, their effects and supporting conditions needed. We used a qualitative, comparative case study approach, drawing on document analysis and semi-structured interviews across multiple informant groups, to examine three EIR projects in Bolivia, Colombia and the Dominican Republic. Our findings are presented according to the four core EIR features. The central involvement of decision-makers in EIR was enhanced by decision-maker authority over the programme studied, professional networks and critical reflection. Strong research–practice partnerships were facilitated by commitment, a clear and shared purpose and representation of diverse perspectives. Evidence around positioning research within programme processes was less conclusive; however, as all three cases made significant advances in research use and programme improvement, this feature of EIR may be less critical than others, depending on specific circumstances. Finally, a research focus on implementation demanded proactive engagement by decision-makers in conceptualizing the research and identifying opportunities for direct action by decision-makers. As the EIR approach is a novel approach in these low-resource settings, key supports are needed to build capacity of health sector stakeholders and create an enabling environment through system-level strategies. Key implications for such supports include: promoting EIR and creating incentives for decision-makers to engage in it, establishing structures or mechanisms to facilitate decision-maker involvement, allocating funds for EIR, and developing guidance for EIR practitioners.

Non-economic Emigration Factors that Might be Pushing Citizens Out of Lithuania

Based on a systematic and comprehensive review of literature on emigration, we identify potential non-economic push factors that might drive Lithuanian citizens to emigrate. Based on a random sample nationwide survey conducted in spring 2019 with Lithuanian citizens living in Lithuania, two categories have emerged as most critical non-economic drivers to lead to higher intention to emigrate: quality of working life and confidence in the future. Further research can add necessary nuance to understanding these factors while also experimenting with possible policy and project interventions that can reduce intent to emigrate and/or encourage return migration. This research is implemented under the project "The importance of non-economic factors to the emigration of the Lithuanian population", funded by the Research Council of Lithuania under the Programme "Improvement of researchers' qualification by implementing world-class R&D projects" (Agreement No. 09.3.3-LMT-K-712-01-170).

Principles and Practice of the Maintenance of Physical Education Curriculum Facilities and Equipment in Schools

The focus of this paper is to discuss an enhancing approach to the maintenance of physical education curriculum facilities and equipment in schools. In the course of doing this, the role of administrative policy, finance, information, process studies, proficiency and attitude measures, follow-up studies, programme improvement, making decisions about individuals; and administrative regulation were elucidated upon. The writer further explained the role and importance of Teacher’s Aptitude, Magnitude and Attitude (TAMA) and Teacher’s Aptitude Disposition and Attitude (TADA) on the outcome of physical education curriculum programme evaluation. He also emphasized the Analysis of Programme Performance (APP) as being more informative for the effective maintenance of physical education curriculum implementation facilities and equipment

PEDAGOGINĖS PRAKTIKOS GERINIMAS: KAI KURIE ASPEKTAI [IMPROVEMENT OF PEDAGOGICAL INTERNSHIP: SOME ASPECTS]

Future teacher preparation remains a meaningful field of every country and Lithuania as well. Pedagogical internship, undoubtedly, remains a very significant element of pedagogical study structure and process. Competence, practical experience acquisition, personal improvement and all-round knowledge of educational institution are considered the most important advantages of the internship. This is not only a certain future teacher’s self-examination in a real educational environment, but also a proper way to improve. On the other hand, internship organisation is not appropriate enough. A few very important things are obvious: a short pedagogical internship time, coherence with the studies at university, and not sufficiently purposefully defined internship activities (content aspect). Mentors’ work should be improved; however, this is not treated as a very important drawback. Also, two improvement spheres have been exposed: internship content/programme improvement (to concretise, optimise, and more clearly regulate the activities) and strengthening interaction effectiveness between university and basic internship schools. Pedagogical internship effectiveness (from the point of view of pedagogical ability consolidation, improvement) remains undoubted. On the other hand, certain requirements should be raised for the institution, in which students would like and could perform pedagogical internship. Educational institution’s democracy and openness, technological supply, ecological friendliness/suitability are considered the most essential requirements. The existing pedagogical internship model in Lithuania has to be improved in two main directions – process (internship length increasing, guaranteeing the acquaintance with the variety of pedagogical institutions, interaction with the internship leaders and mentors improvement) and content (activity optimisation, innovativeness, variety increase) improvement. Key words: qualitative research, pedagogical internship, pre-service teachers, university students.

Evaluation of Higher Diploma in Medical Librarianship Programme offered by SQU Department of Information Studies in the Light of the Professional Competences Approved by MLA

The paper aims to evaluate the programme of Higher Diploma in Medical Librarianship offered by the Department of Information Studies, Sultan Qaboos University, in the light of the professional competences approved by the Medical Library Association (MLA). The process covers the offered courses and their instructors, labs and existing sources of information in this area. The study is based on surveys conducted to identify the competences and specifications of medical librarians as defined by medical informatics professional associations. It has applied the analytic, descriptive approach to assessing the programme’s course descriptions and the extent to which the courses conform to the professional competences mentioned above. The findings suggest that the courses have achieved 94.11% of such competences. Recommendations have been made as to ways and means of programme improvement and applicability in other information studies departments in the Arab world. professional competence,