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The purpose of this paper is to highlight how accreditation of prior experiential learning (APEL) is implemented, the challenges faced by the APEL assessors while assessing candidates as well as to suggest recommendations for improving the APEL process.

This paper is written based on the critical reflection of two accreditation of prior experiential learning: admissions (APEL-A) assessors appointed from a Malaysian Qualifications Agency approved assessment centre. This process would add depth and breadth to the study based on the assessor’s experience.

The study identified five challenges in the implementation of APEL-A. They are limited literature and records of the existing practices, conceptualisation of the APEL process, complicated and time-consuming APEL process, standard of acceptance vary according to discipline and lack of continuous training for APEL assessors. The four recommendations for improvements are as follows: the need for transparent and clear guidelines, ensuring consistency in practices and fairness to those from conventional learning, integrating APEL as part of the institution’s academic policy and providing continuous training for all APEL assessors.

Until now, not much research has been done regarding its implementation in Malaysia. The number of learners enrolled through this form of assessment may be low but growing. The feedback on the implementation of the APEL-A assessment process would be greatly beneficial to the stakeholders involved in improving its implementation process. The highlighted challenges faced as well as the recommendations put forth may also be useful for the continuous improvement of the APEL-A assessment process. Relevant stakeholders would benefit from this study.

Recognition of prior learning (RPL) is a process by which both formal learning for recognised awards, informal learning from experience and non-formal learning for uncertificated but planned learning is given academic recognition. The paper aims to discuss these issues.

This paper refers to international developments in RPL and then focuses upon the extensive and innovative use of RPL by Middlesex University and the developing RPL work at the Australian Institute of Business.

The Middlesex experience of recognition of learning from experience as part of the development of customised work-based learning programmes demonstrates the potential of RPL for business and management programmes.

The use of RPL for admission and/or credit in standard programmes enables individuals to have their work-based knowledge acknowledged as relevant, worthwhile and equivalent to learning obtained in the higher education classroom.

The purpose of this study is to highlight a paradox between inclusion/exclusion at the level of the organisation and classroom practices, as well as between general and disability/special educational needs (SEN)-specific approaches to diversity in the classroom. The authors recommend better alignment between school policies and teaching practices to offer all students an equal chance to benefit from inclusive pedagogies.

This study analyses a school that has gained public reputation as an innovative, inclusive school in Austria. Applying a case study with an ethnographic methodological approach, the authors explore what strategies are implemented to become more inclusive at the level of school organisation and classroom practices? What are the pedagogical beliefs and actions relating to diversity that drive inclusive efforts? How is this school's general approach to diversity enacted with students with SEN?

The findings show that context-specific circumstances shape inclusive school development, which comes with a set of affordances and challenges. The authors argue that in this case, striving for inclusion indicated two ways of “doing difference differently”. First, the school has built on many cornerstones of inclusion when relating and responding to student diversity, that was remarkably different than in other mainstream schools in Austria. On the contrary, while creating new educational and pedagogical norms, it also recycled conventional segregating tendencies, and as such, reproduced hierarchised difference, but in other ways than schools typically do in mainstream schooling.

This school and its pedagogical mission have never been analysed through the rich data that two researchers were able to gather and work through.

The purpose of this paper is to describe Karen refugee women’s experience of resettlement and the factors which structured community capacity to support their mental health and well-being.

A postcolonial and feminist standpoint was used to bring Karen women’s voice to the knowledge production process. Data were collected through ethnographic field observation, in-depth semi-structured individual and focus group interviews with Karen women as well as healthcare and social service providers.

Three interrelated themes emerged from the data: Karen women’s construction of mental health as “stress and worry”; gender, language and health literacy intersected, shaping Karen women’s access to health care and social resources; flexible partnerships between settlement agencies, primary care and public health promoted community capacity but were challenged by neoliberalism.

Karen women and families are a diverse group with a unique historical context. Not all the findings are applicable across refugee women.

This paper highlights the social determinants of mental health for Karen women and community responses for mitigating psychological distress during resettlement.

Public health policy requires a contextualized understanding of refugee women’s mental health. Health promotion in resettlement must include culturally safe provision of health care to mitigate sources of psychological distress during resettlement.

This research brings a postcolonial and feminist analysis to community capacity as a public health strategy.

The purpose of this research was first to determine the competencies mandatory of risk managers, and second, to consider the implications of such competencies in determining modules appropriate for inclusion in any prospective undergraduate qualification with specialisation in risk management.

A qualitative research approach was followed, involving academics teaching risk management in a focus group and making use of interactive qualitative analysis (IQA).

The competencies identified were business management skills, financial knowledge, an understanding of the risk management process, governance and compliance, people management and technical skills. These will be explained in greater detail in the paper.

The implications for teaching are that an undergraduate curriculum in risk management will have to combine majors such as business management, financial management, risk management, industrial psychology and communication. These majors need to be complemented by modules in governance and compliance management, as well as information and communication technology.

The implication for practice is that risk management professionals and members of the Institute of Risk Management of South Africa need to avail themselves to serve on an advisory board of academic departments offering risk management qualifications. Risk management is a developing science and requires inputs about research and the curriculation of qualifications.

The implication for public policy is that the South African Qualifications Authority and the Council for Higher Education should reconsider their requirements for designators (specialised qualifications). The implications for research are that IQA provides clarity on the knowledge and skills required to develop a competency-based qualification in risk management. Further research should benchmark qualifications and propose a curriculum for a bachelor’s degree in risk management.

The use of IQA is a novel way of ensuring rigour and objectivity in arriving at a description of the required knowledge, skills, values and attributes of risk managers. This paper will assist in the compilation of a new curriculum for an undergraduate qualification in risk management; thus, ensuring such qualification will provide a competency-based qualification that will meet the needs of the profession.

Studying abroad is not new for Hong Kong students, especially those from the middle class. For a variety of reasons, traversing to Mainland universities has been an unconventional path confined mostly to students who pursued specific programs, or had family or social ties. Beginning in 2012, an admission scheme was launched for Hong Kong students applying to Mainland universities. The purpose of this paper is to review the admission scheme.

This paper draws on both quantitative and qualitative data sources. It includes statistics from official records of students’ application and enrollment figures, and documents obtained from multiple sources, as well as qualitative data through interviews of Hong Kong students who are studying in the Mainland universities.

The key findings are that since the implementation of the admission scheme, the number of applicants is rather stable irrespective of the changing socio-economic and political context. With the preferential treatment for Hong Kong students, low tuition fees, government financial assistance and scholarships, most students still consider studying in the Mainland a backup plan rather than a first choice. The academic performance of the students and academic/career aspirations have influenced their choice and decisions.

This paper contributes through providing both primary and secondary data to help understand the level of acceptance on the scheme since its implementation. It also reveals the perceptions of the students who have made their choice to study cross the border. In facing the emergent economic, socio-cultural and political challenges, some policies recommendations are proposed to boost the acceptance of the scheme. Moreover, it fills the research gap on student mobility from Hong Kong to Mainland China in the corpus of literature.

This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.

This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.

Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.

The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.

Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.

To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.

Asylum seekers, refugees and immigrants’ access to healthcare vary in South Africa and Cape Town due to unclear legal status. The purpose of this paper is to shed light on the source of this variation, the divergence between the 1996 South African Constitution, the immigration laws, and regulations and to describe its harmful consequences.

Based on legal and ethnographic research, this paper documents the disjuncture between South African statutes and regulations and the South African Constitution regarding refugees and migrants’ access to healthcare. Research involved examining South African jurisprudence, the African Charter, and United Nations’ materials regarding rights to health and health care access, and speaking with civil society organizations and healthcare providers. These sources inform the description of the immigrant access to healthcare in Cape Town, South Africa.

Asylum-seekers and refugees are entitled to health and emergency care; however, hospital administrators require documentation (up-to-date permits) before care can be administered. Many immigrants – especially the undocumented – are often unable to obtain care because of a lack of papers or because of “progressive realization,” the notion that the state cannot presently afford to provide treatment in accordance with constitutional rights. These explanations have put healthcare providers in an untenable position of not being able to treat patients, including some who face fatal conditions.

The research is limited by the fact that South African courts have not adjudicated a direct challenge to being refused care at healthcare facility on the basis of legal status. This limits the ability to know how rights afforded to “everyone” within the South African Constitution will be interpreted with respect to immigrants seeking healthcare. The research is also limited by the non-circulation of healthcare admissions policies among leading facilities in the Cape Town region where the case study is based.

Articulation of the disjuncture between the South African Constitution and the immigration laws and regulations allows stakeholders and decision-makers to reframe provincial and municipal policies about healthcare access in terms of constitutional rights and the practical limitations accommodated through progressive realization.

In South Africa, immigration statutes and regulations are inconsistent and deemed unconstitutional with respect to the treatment of undocumented migrants. Hospital administrators are narrowly interpreting the laws to instruct healthcare providers on how to treat patients and whom they can treat. These practices need to stop. Access to healthcare must be structured to comport with the constitutional right afforded to everyone, and with progressive realization pursued through a non – discriminatory policy regarding vulnerable immigrants.

This paper presents a unique case study that combines legal and social science methods to explore a common and acute question of health care access. The case is novel and instructive insofar as South Africa has not established refugee camps in response to rising numbers of refugees, asylum seekers and immigrants. South Africans thus confront a “first world” question of equitable access to healthcare within their African context and with limited resources in a climate of increasing xenophobia.

Emergency care delivery is a process requiring input from various healthcare professionals within the hospital. To deliver efficient and effective emergency care, professionals must integrate rapidly at multiple interfaces, working across functional, spatial and professional boundaries. Yet, the interdisciplinary nature of emergency care presents a challenge to the optimization of patient flow, as specialization and functional differentiation restrict integration efforts. This study aims to question what boundaries exist at the level of professionals and explores how these boundaries may come to influence integration and operational performance.

To provide a more holistic understanding of the inherent challenges to integration at the level of professionals and in contexts where professionals play a key role in determining operational performance, the authors carried out an in-depth case study at a busy, Level 1 trauma center in The Netherlands. In total, 28 interviews were conducted over an 18-month period.

The authors reveal the existence of structural, relational and cultural barriers between (medical) professionals from different disciplines. The study findings demonstrate how relational and cultural boundaries between professionals interrupt flows and delay service processes.

This study highlights the importance of interpersonal and cultural dynamics for internal integration and operational performance in emergency care processes. The authors unveil how the presence of professional boundaries creates opportunity for conflict and delays at important interfaces within the emergency care process, and can ultimately accumulate, disrupting patient flow and increasing lead times.

Background: Rising food bank usage in the UK suggests a growing prevalence of food insecurity. However, a formalised, representative measure of food insecurity was not collected in the UK until 2019, over a decade after the initial proliferation of food bank demand. In the absence of a direct measure of food insecurity, this article identifies and summarises longitudinal proxy indicators of UK food insecurity to gain insight into the growth of insecure access to food in the 21st century.

Methods: A rapid evidence synthesis of academic and grey literature (2005–present) identified candidate proxy longitudinal markers of food insecurity. These were assessed to gain insight into the prevalence of, or conditions associated with, food insecurity.

Results: Food bank data clearly demonstrates increased food insecurity. However, this data reflects an unrepresentative, fractional proportion of the food insecure population without accounting for mild/moderate insecurity, or those in need not accessing provision. Economic indicators demonstrate that a period of poor overall UK growth since 2005 has disproportionately impacted the poorest households, likely increasing vulnerability and incidence of food insecurity. This vulnerability has been exacerbated by welfare reform for some households. The COVID-19 pandemic has dramatically intensified vulnerabilities and food insecurity. Diet-related health outcomes suggest a reduction in diet quantity/quality. The causes of diet-related disease are complex and diverse; however, evidence of socio-economic inequalities in their incidence suggests poverty, and by extension, food insecurity, as key determinants.

Conclusion: Proxy measures of food insecurity suggest a significant increase since 2005, particularly for severe food insecurity. Proxy measures are inadequate to robustly assess the prevalence of food insecurity in the UK. Failure to collect standardised, representative data at the point at which food bank usage increased significantly impairs attempts to determine the full prevalence of food insecurity, understand the causes, and identify those most at risk.