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The Nurturing Care Framework for Early Childhood Development urges stakeholders to implement strategies that help children worldwide achieve their developmental potential. Related programmes range from the WHO’s and UNICEF’s Care for Child Development intervention, implemented in 19 countries, to locally developed programmes, such as non-governmental organisation Tostan’s Reinforcement of Parental Practices in Senegal. However, some researchers argue that these programmes are unethical as they impose caregiving practices and values from high-income countries (HICs) on low-income communities, failing to consider local culture, communities’ goals for their children and generalisability of scientific findings from HICs. We explore these criticisms within a public health framework, applying principles of beneficence, autonomy and justice to the arguments. To facilitate the change communities themselves desire for their children, we recommend that practitioners codevelop programmes and cooperate with communities in implementation to harness local beliefs and customs and promote evidence-based and locally adapted practices.

This case study analyzes the introduction of democracy and human rights into the educational program of Tostan, a nongovernmental organization working in Africa. The authors show how Tostan’s original educational approach created a meaningful context for integrating democracy and human rights into its curriculum, a process that took place from 1995 to 2003. The integration produced unexpected results: a participant-led social movement to end harmful practices such as female genital cutting and child and/or forced marriage. After describing the phases of curricular revision in the case, the authors draw out themes to show how the phases interacted to produce social transformation. A visioning exercise at the beginning of the program created a discursive context for the introduction of democracy and human rights, the democracy and human rights sessions created critical reflection about past practices, and awareness of an international human rights framework emboldened participants to undertake actions that created new social norms.

This study examined the frequency of small groups in university students’ coursework and how that related to their general attitudes toward learning in groups and their views about different aspects of group work. We administered a survey to 208 students in an upper-division interdisciplinary arts and sciences program. Students reported that they had been in multiple groups, of different duration and types, both in their current program and in courses at their lower-division institutions. A regression analysis uncovered strong relationships between students’ past and present group experiences, peers, and instructor clarity about group purpose. The findings suggest that successful group work is no longer a matter of instructor effort but requires campus initiatives and interdepartmental coordination if students are to understand and experience the benefits of learning in small groups.

OBJECTIVE: This study aimed to interrogate the decisions and approaches used by family doctors in responding to the needs of young people in distress. The research sought to explore how practitioners balanced young people's needs for confidentiality and self-determination with their parents' concerns and needs as caregivers. METHODS: Interviews were undertaken with 30 family physicians in the United Kingdom using a semi-structured schedule to elicit reactions to a case scenario. RESULTS: While family physicians identified the ethical and clinical benefits of patient confidentiality for young adults, a wide range of approaches was adopted with respect to providing feedback and reassurance to parents. Likewise, there were substantial variations in the extent to which clinicians were prepared to adopt a proactive stance to engage a young person who was reluctant to seek help. CONCLUSION: These diverging practice examples can be used to inform training programs and offer a means by which the caregiver's need for information and support can be emphasized in psychiatric and clinical education. Language: en

The chapter opens Tostan’s classroom doors by close examination of how participants described their learning experiences during class sessions. Participants appreciate that they are taught in their native language, Pulaar, so that all can understand. They find the curriculum engaging, frequently citing culturally relevant references, such as proverbs, songs, and examples from daily life. They say facilitators draw out their experiences and beliefs during discussions, intermixing new information presented in the sessions with what is familiar. Respondents speak about importance of facilitators’ questions for their learning and thinking anew about their communities’ practices. But what they find most engaging are the skits performed in class. Active learning skills increase over time and help them practice democratic citizenship skills that they use in expanded public settings.

The chapter discusses categories that emerged from the 2010 and the 2011 data and from the three sensitizing concepts introduced earlier in the book—schema theory, capacity to aspire, and social norm theory—to explain the processes of individual and collective change. A new sensitizing concept, revision of self-schemas, is added. The change process begins with a self-sustaining status quo, which is perturbed by new and unsettling experiences of the participants in the class, to their reconsideration of local values and practices in a human rights framework, to the organized diffusion by participants of those unsettling and resettling experiences to communities beyond, and finally to adoption of beneficial individual and community changes. The authors support their claim that the process is empowering by linking their discussion to current thinking about empowerment.

This chapter describes the social and personal values of respondents at the outset of Tostan’s Community Empowerment Program (CEP). Several themes or categories emerge from the interviews gathered after the first session and from recollections expressed later in the Democracy and Human Rights Sessions (DHRS). The themes and subthemes (italicized below) provide a baseline from which changes are tracked over time. Participants’ hopes (Beyond the Individual) are for increased well-being of their families, finding the right path and desiring honesty and forgiveness in relationships. Their Commonly Shared Personal Values include working to achieve one’s goals (Working Hard), fulfilling gender roles (Being Men and Women), and raising children (Caring about Children). Their Commonly Shared Aspirations are Education, a Better Future, Better Health, Working Together, and Being in Public.

The chapter contextualizes the study’s results by summarizing several independent evaluations of the processes and later outcomes of Tostan’s Community Empowerment Program (CEP) completed in other villages. These include evaluations by agencies such as UNICEF, Frontiers for Health (with the Population Council), Senegal’s Ministry of the Family and The Center for Research in Human Development. Generally, these studies’ findings parallel the processes and outcomes disclosed by Cislaghi, Gillespie, and Mackie’s study of the Kaolack communities. The other studies also suggest that the Kaolack communities can expect to realize more beneficial changes in later years of the program and after its departure, and that the changes tend to be stable. The authors also relate a qualitative study (master’s thesis) with very similar findings to theirs.

The chapter summarizes how respondents’ values and aspirations developed as the Democracy and Human Rights (DHR) deliberations progressed, and how those changes created new intentions to act for the benefit of all. From participants’ discourse, the authors trace the process of change and the key topics that animated deliberation and sparked re-assessment of practices. Respondents learned to deliberate publicly; engage in organized diffusion, from class members to a broader public; imagine a better future; develop new self-understandings; and work together to realize a better future. Justice and rights, equality, and peace are now salient values needed to create enhanced community well-being. New practices in healthcare, education, gender relations and child protection are needed to end what they call bad habits and take up good habits.

The chapter analyzes 2011 interviews and focus groups and compares them to 2010 findings. In 2010 respondents report intentions to acquire beneficial practices; in 2011 they report successful efforts to acquire them. Respondents in 2011 describe remarkable changes, for example, increased school attendance, new health practices, and expanded roles for women. A new theme becomes apparent: changing self-understandings. New schemas of the self are woven into their descriptions of an expanding, inclusive public sphere; organized diffusion; and aligning community actions with their knowledge of human rights and responsibilities. In portrayals of community action, they identify their own and others’ new capacities and self-understandings, which enable them to create more just and caring practices. Revised self-schema through action emerges as a mechanism critical to the theory of change.

Scholars in teaching and learning value student research and program assessment as strategies to promote excellence in undergraduate education. Yet, in practice, each can be complex and difficult to sustain. This case study demonstrates how undergraduate research, mentoring of junior faculty, and assessment can be integrated in ways that enrich the educational experiences of students and the professional development of faculty and improve research on teaching and learning. The authors describe a lively undergraduate research project that became tied to the mentoring of assistant professors and then to program assessment. We conclude with recommendations for implementing such a project in other academic settings.

Due to their high incidence and associated morbidity and mortality, musculoskeletal injuries place an enormous burden on society. For example, in the 2004 to 2005 period 62,000 people with hip fracture accounted for 2.9% of the total number of hospital bed days in England. Between 12% and 37% of people with hip fracture die in the first year. Of the survivors, most are less mobile and many lose their independence. Soft-tissue joint injuries during sports and exercise-related activities in young adults constitute another important group. Of these, ankle sprain is the most common single injury and it predisposes people to further recurrence. Members of the Cochrane Bone, Joint and Muscle Trauma Group prepare systematic reviews (Cochrane Reviews) of the evidence for interventions used in the prevention and management of musculoskeletal injuries. These reviews serve to facilitate evidence-based decision making by policy makers, healthcare professionals and consumers, and to guide future research. This article focuses on two major groups of injuries: osteoporotic fractures and soft-tissue joint injuries, and discusses some of the fundamental issues and questions associated with the prevention and management of these. Drawing insights from relevant Cochrane Reviews, this article examines the different approaches used for preventing, and the role of surgery and immobilisation for treating, these injuries. Brief illustrations of the inherent complexity of rehabilitation are also provided. This article also gives examples of how these reviews are helping to inform healthcare choices and practice, and guide research in this area.

This article describes and assesses "Research Circles" as a mechanism for enhancing faculty collegiality and research. Recently established on our campus, these circles, composed of three to four faculty members, have had a particularly powerful effect on the new faculty members' adjustment to their tenure track positions, especially since they entered a context that might otherwise have been challenging: a new interdisciplinary upper-division campus with high expectations for teaching excellence. Based on the end-of-year evaluations, journals, and focus groups, the co- authors described themes that emerged from their participation in these circles. Circle participation not only facilitated faculty writing throughout their first year, but it also fostered the development of an interdisciplinary community which nurtured creativity and risk taking in writing.

With more than 100 orthopaedic, sports medicine, or hand surgery journals indexed in MEDLINE, it is no longer possible to keep abreast of developments in orthopaedic surgery by reading a few journals each month. Electronic resources are easier to search and more current than most print sources. We provide a practical approach to finding useful information to guide orthopaedic practice. We focus first on where to find the information by providing details about many useful databases and web links. Sources for identifying guidelines, systematic reviews, and randomized controlled trials are identified. The second section discusses how to find the information, from the first stage of formulating a question and identifying the concepts of interest, through to writing a simple strategy. Sources for additional self-directed learning are provided.

In this article, the authors describe a four-phase pedagogical project they undertook in response to the strong resistance they encountered from a number of their white women students who objected to the readings and discussions of white skin privilege. In an interdisciplinary program where 73% of the students are white women, the authors teach upper-level university social science courses that include the study of racism. White women themselves, the authors found their stories of students' resistance to be useful springboards for reflection. Reading and discussing the literature on teaching about whiteness as they worked with their stories, the authors were able to reframe their own initial concerns about how to read their students' discontent. This article reviews key themes from the literature on student resistance in anti-racist classrooms, describes the interview process the authors used to elicit each other's teaching stories, analyzes five of these stories, and presents some of the approaches that ...

Very motivated to succeed in college, Tracy, a deaf student, confronts an instructor who seems unprepared to teach her. His expressions in class and his comments on her paper challenge her, and she must decide how to respond.

Kate Brown and Diane Gillespie introduce a performative text, created in the ethics classroom, that they argue has the power to transform participants. Relying on the work of Paulo Friere and Augusto Boal, Brown and Gillespie bring improvisational theater exercises to their occupational therapy students in an attempt to make students' experiences the center of the syllabus and to represent the turmoil of ethical decision making in a classroom turned laboratory. Multi-authored and multi-read, the dramatic text embodies its authors and readers in its protagonists, as the boundaries among reading and writing and decision making dissolve.

Two models of recovery based on the concepts of independence and interdependence are contrasted from a feminist perspective. Drawing on social and psychological analyses, the authors critique the overemphasis of independence as the goal of health care and instead advocate a more relational model of therapy that reinforces social and emotional connections between people. Two narratives from occupational therapy are used to illustrate the differing assumptions underlying these models. The authors discuss some of the structural and interactional barriers to the expression of interdependence in health care institutions. They suggest that through purposefully sharing practice experiences and instating collaborative, nonhierarchical models of organization, practitioners can begin to overcome these barriers.

BACKGROUND: Hip fracture in the elderly is usually the result of a simple fall. Hip protectors have been advocated as a means to reduce the risk of sustaining a fracture in a fall on the hip. OBJECTIVES: To determine if external hip protectors reduce the incidence of hip fractures in elderly persons following a fall. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Injuries Group trials register (April 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2003), MEDLINE (1966 to April 2003), EMBASE (1988 to 2003 week 14), CINAHL (1982 to April 2003) and reference lists of relevant articles. Trialists were contacted, and ongoing trials identified in The National Research Register (http://www.update-software.com/national/ accessed 20/01/03) and Current Controlled Trials (http://controlled-trials.com/ accessed 20/01/03). SELECTION CRITERIA: All randomised or quasi-randomised controlled trials (RCTs) comparing the use of hip protectors with a control group. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality, using a 10-item scale, and extracted data. Additional information was sought from all trialists. Wherever appropriate and possible, the data are presented graphically. MAIN RESULTS: In this third update, 13 randomised controlled trials were included. One, which was a study of compliance lasting 12 weeks, contributed no fracture outcome data. Five studies involving 4316 participants were cluster randomised by care unit, nursing home or nursing home ward rather than by the individual. Individually, each of these studies reported a reduced incidence of hip fractures within those units allocated to receive the protectors. Because of the use of cluster randomisation pooling of results of these studies was not undertaken. Pooling of data from five individually randomised trials conducted in nursing/residential care settings (1426 participants) showed no significant reduction in hip fracture incidence (hip protectors 37/822, controls 40/604, RR 0.83, 95% CI 0.54 to 1.29). Two individually randomised trials of 966 community dwelling participants, reported no reduction in hip fracture incidence with the hip protectors (RR 1.11, 95% CI 0.65 to 1.90). No important adverse effects of the hip protectors were reported but compliance, particularly in the long term, was poor. REVIEWER'S CONCLUSIONS: There is no evidence of effectiveness of hip protectors from studies in which randomisation was by individual patient within an institution, or for those living in their own homes. Data from cluster randomised studies indicates that, for those living in institutional care with a high background incidence of hip fracture, a programme of providing hip protectors appears to reduce the incidence of hip fractures. Acceptability by users of the protectors remains a problem, due to discomfort and practicality. Cost effectiveness remains unclear.

Cet article montre la valeur pedagogique d'une etude de cas dans l'enseignement de la diversite en classe multiculturelle. En particulier, des affirmations implicites concernant la race et les privileges des Blancs sont susceptibles d'etre formules par les etudiants, et d'alimenter ainsi la reflexion sur le sujet

BACKGROUND: Hip fracture in the elderly is usually the result of a simple fall. Hip protectors have been advocated as a means to reduce the risk of sustaining a fracture in a fall on the hip. OBJECTIVES: To determine if external hip protectors reduce the incidence of hip fractures in elderly persons following a fall. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Injuries Group trials register (April 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2003), MEDLINE (1966 to April 2003), EMBASE (1988 to 2003 week 14), CINAHL (1982 to April 2003) and reference lists of relevant articles. Trialists were contacted, and ongoing trials identified in The National Research Register (http://www.update-software.com/national/ accessed 20/01/03) and Current Controlled Trials (http://controlled-trials.com/ accessed 20/01/03). SELECTION CRITERIA: All randomised or quasi-randomised controlled trials (RCTs) comparing the use of hip protectors with a control group. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality, using a 10-item scale, and extracted data. Additional information was sought from all trialists. Wherever appropriate and possible, the data are presented graphically. MAIN RESULTS: In this third update, 13 randomised controlled trials were included. One, which was a study of compliance lasting 12 weeks, contributed no fracture outcome data. Five studies involving 4316 participants were cluster randomised by care unit, nursing home or nursing home ward rather than by the individual. Individually, each of these studies reported a reduced incidence of hip fractures within those units allocated to receive the protectors. Because of the use of cluster randomisation pooling of results of these studies was not undertaken. Pooling of data from five individually randomised trials conducted in nursing/residential care settings (1426 participants) showed no significant reduction in hip fracture incidence (hip protectors 37/822, controls 40/604, RR 0.83, 95% CI 0.54 to 1.29). Two individually randomised trials of 966 community dwelling participants, reported no reduction in hip fracture incidence with the hip protectors (RR 1.11, 95% CI 0.65 to 1.90). No important adverse effects of the hip protectors were reported but compliance, particularly in the long term, was poor. REVIEWER'S CONCLUSIONS: There is no evidence of effectiveness of hip protectors from studies in which randomisation was by individual patient within an institution, or for those living in their own homes. Data from cluster randomised studies indicates that, for those living in institutional care with a high background incidence of hip fracture, a programme of providing hip protectors appears to reduce the incidence of hip fractures. Acceptability by users of the protectors remains a problem, due to discomfort and practicality. Cost effectiveness remains unclear.

Given the ever-increasing numbers of Virginia Woolfs constructed by readers of her work, it becomes essential to devise-and continually to revisemental maps of the critical landscape. Any recent map would reveal the multiplication of theoretical sites and of national and international transportation and communication networks. Woolf's work, reflecting as it does her own increasingly fluid, complex, and multiple visions of self and world, lends itself to a wide variety of readings. Most satisfying are those by people who, aware of their assumptions and, like Woolf herself, wary of their own authority, consciously join the widely reverberating, boundary-transcending conversations about her texts. Less satisfying, although often sources of valuable insights for the larger discussions, are studies that present their readings as keys to everything Woolf thought and accomplished. In this context, it is heartening to read books on Virginia Woolf's life and works that see her as more than a victim-of sexually abusive half brothers, of a domineering husband, of the entire male medical profession, among other people and institutions. In contemporary Western societies where increasingly informed and sensitive audiences encourage oppressed individuals and groups to confess and to protest (often in the law courts) their victimization, such studies are perhaps inevitable. On at least one level, they are also laudable. The cases against the variety of victimizers offered

When helping others is an expression of conventional goodness, it stifles women's cognitive and emotional development and disables those they are trying to help. Drawing on Gilligan's theory of moral development, the author analyzes the dysfunctional aspects of helping and the paradox of conventional goodness. She argues that women persist in this behavior because they have developed a conceptual schema that habitually guides them in resolving moral dilemmas. Practitioners and educators need to explore these issues further, since the majority of social workers are women and hence have been socialized to equate "helping" with being "good."

During the past two decades there has been an increase in the number of women who campaign for and attain political office. This clearly has the potential to influence attitudes toward women in politics. In particular, it has the potential to influence the attitudes of adolescents, who, according to socialization theory, are especially affected by role models. In this study we used a quasiexperimental design to examine adolescents' attitudes toward female political candidates. We found that the junior and senior high school students we surveyed did not, as a group, use candidate sex as a voting cue. However, females were more willing than males and blacks were more willing than whites to vote for the female candidate.

Recent studies of political attitudes have documented increasing support for women political candidates among college students and adults. This study examined junior and senior high school student's attitudes toward women in politics and analyzed the effect of gender and race on their attitudes. We found that adolescent girls had very positive and optimistic views of the role of women in politics; adolescent boys, particularly blacks, had more negative and pessimistic views.