Planning and implementation efficacy as a determinant of health risk communication outcomes: Case studies of the U.S. Public Health Service (PHS)

This study was conducted under the auspices of the Subcommittee on Risk Communication and Education of the Committee to Coordinate Environmental Health and Related Programs (CCEHRP) to determine how Public Health Service (PHS) agencies are communicating information about health risk, what factors contributed to effective communication efforts, and what specific principles, strategies, and practices best promote more effective health risk communication outcomes.^ Member agencies of the Subcommittee submitted examples of health risk communication activities or decisions they perceived to be effective and some examples of cases they thought had not been as effective as desired. Of the 10 case studies received, 7 were submitted as examples of effective health risk communication, and 3, as examples of less effective communication.^ Information contained in the 10 case studies describing the respective agencies' health risk communication strategies and practices was compared with EPA's Seven Cardinal Rules of Risk Communication, since similar rules were not found in any PHS agency. EPA's rules are: (1) Accept and involve the public as a legitimate partner. (2) Plan carefully and evaluate your efforts. (3) Listen to the public's specific concerns. (4) Be honest, frank, and open. (5) Coordinate and collaborate with other credible sources. (6) Meet the needs of the media. (7) Speak clearly and with compassion.^ On the basis of case studies analysis, the Subcommittee, in their attempts to design and implement effective health risk communication campaigns, identified a number of areas for improvement among the agencies. First, PHS agencies should consider developing a focus specific to health risk communication (i.e., office or specialty resource). Second, create a set of generally accepted practices and guidelines for effective implementation and evaluation of PHS health risk communication activities and products. Third, organize interagency initiatives aimed at increasing awareness and visibility of health risk communication issues and trends within and between PHS agencies.^ PHS agencies identified some specific implementation strategies the CCEHRP might consider pursuing to address the major recommendations. Implementation strategies common to PHS agencies emerged in the following five areas: (1) program development, (2) building partnerships, (3) developing training, (4) expanding information technologies, and (5) conducting research and evaluation. ^

Assessment of learning outcomes in computing studies

The assessment of learning outcomes is a key concept in the European Credit Transfer and Accumulation System (ECTS) since credits are awarded when the assessment shows the competences which were aimed at have been developed at an appropriate level. This paper describes a study which was first part of the project of the Bologna Experts Team-Spain and then developed as an independent study. It was carried out with the overall goal to gain experience in the assessment of learning outcomes. More specifically it aimed at 1) designing procedures for the assessment of learning outcomes related to these compulsory generic competences; 2) testing some basic psychometric features that an assessment device with some consequences for the subjects being evaluated needs to prove; 3) testing different procedures of standard setting, and 4) using assessment results as orienting feedback to students and their tutors. The process of development of tests to carry out the assessment of learning outcomes related to these competences, as well as some basic features regarding their reliability and validity is described and first results on the comparison of results achieved at two academic levels, will also be described at a later stage.

Open-Source Computerized Patient-Reported Outcomes: Case Studies Illustrating Fifteen Years of Evolution

Thesis (Master's)--University of Washington, 2016-06

Employment outcomes and plant closure in a post-industrial city:an analysis of the labour market studies of MG Rover workers three years on

This paper examines how the loss of 6300 jobs from the closure of MG Rover (MGR) in the city of Birmingham (UK) in April 2005 affected the employment trajectories of ex-workers, in the context of wider structural change and efforts at urban renewal. The paper presents an analysis of a longitudinal survey of 300 ex-MGR workers, and examines to what extent the state of local labour markets and workers’ geographical mobility—as well as the effectiveness of the immediate policy response and longer-term local economic strategies—may have helped to balance the impacts of personal attributes associated with workers’ employability and their reabsorption into the labour markets. It is found that the relative buoyancy of the local economy, the success of longer-run efforts at diversification and a strong policy response and retraining initiative helped many disadvantaged workers to find new jobs in the medium term. However, the paper also highlights the unequal employment outcomes and trajectories that many lesser-skilled workers faced. It explores the policy issues arising from such closures and their aftermath, such as the need to co-ordinate responses, to retain institutional capacity, to offer high-quality training and education resources to workers and, where possible, to slow down such closure processes to enable skills to be retained and reused within the local economy.

Anti-VEGF treatment of patients with diabetic macular edema : Studies of visual acuity, macular edema and patient-reported outcomes

The aim of this thesis was to describe and evaluate visual acuity, macular edema and patientreported outcomes (PRO) following anti-VEGF treatment of diabetic macular edema (DME) patients in a real-world setting. Using a longitudinal study design, a cohort of DME patients was followed from baseline to 1 year after treatment start. Data were collected from two eye clinics at two county hospitals. Social background characteristics, medical data and PRO were measured before treatment initiation, at four month and after 1 year. A total of 57 patients completed the study. Mean age was 69 years and the sample was equally distributed regarding sex. At baseline, the patients described their general health as low. One year after treatment initiation, 30 patients had improved visual acuity and 27 patients had no improvement in visual acuity. The patients whose visual acuity improved reported an improvement in several subscales in patient-reported outcome measures (PROM), which was in contrast to the group that experienced a decline in visual acuity, where there was no improvement in PROM. Outcomes from the study can be useful for developing and providing relevant information and support to patients undergoing this treatment.

Who or what decides how stakeholders are optimally engaged by governance networks delivering public outcomes?

As the problems involving infrastructure delivery have become more complex and contentious, there has been an acknowledgement that these problems cannot be resolved by any one body working alone. This understanding has driven multi-sectoral collaboration and has led to an expansion of the set of actors, including stakeholders, who are now involved in delivery of infrastructure projects and services. However, more needs to be understood about how to include stakeholders in these processes and the optimal ways of developing the requisite combination of stakeholders to achieve effective outcomes. This thesis draws on stakeholder theory and governance network theory to obtain insights into how three networks delivering public outcomes within the Roads Alliance in Queensland engage with stakeholders in the delivery of complex and sensitive infrastructure services and projects. New knowledge about stakeholders will be obtained by testing a model of Stakeholder Salience and Engagement which combines and extends the stakeholder identification and salience theory (Mitchell, Agle, and Wood, 1997), ladder of stakeholder management and engagement (Friedman and Miles, 2006) and the model of stakeholder engagement and moral treatment of stakeholders (Greenwood, 2007). By applying this model, the broad research question: “Who or what decides how stakeholders are optimally engaged by governance networks delivering public outcomes?” will be addressed. The case studies will test a theoretical model of stakeholder salience and engagement which links strategic management decisions about stakeholder salience with the quality and quantity of engagement strategies for engaging different types of stakeholders. The outcomes of this research will contribute to and extend stakeholder theory by showing how stakeholder salience impacts on decisions about the types of engagement processes implemented. Governance network theory will be extended by showing how governance networks interact with stakeholders through the concepts of stakeholder salience and engagement. From a practical perspective this research will provide governance networks with an indication of how to optimise engagement with different types of stakeholders.

The relationship between deformity correction and clinical outcomes after thoracoscopic scoliosis surgery

Surgical treatment of scoliosis is quantitatively assessed in the clinic using radiographic measures of deformity correction, as well as the rib hump, but it is important to understand the extent to which these quantitative measures correlate with self-reported improvements in patients’ quality of life following surgery. The purpose of this prospective study was to evaluate the relationship between clinical outcomes of thoracoscopic anterior scoliosis surgery and deformity correction using the Scoliosis Research Society questionnaire (SRS-24). Patients undergoing thoracoscopic anterior scoliosis correction report good SRS scores which are comparable to those reported in previous studies for both open and thoracoscopic scoliosis correction procedures. Major Cobb correction is a significant predictor of patient satisfaction when comparing subgroups of patients with the highest and lowest major curve corrections.

Benefits of e-learning benchmarks : Australian case studies

In 2004, the Australian Flexible Learning Framework developed a suite of quantitative and qualitative indicators on the uptake, use and impact of e-learning in the Vocational Education and Training (VET) sector. These indicators were used to design items for a survey to gather quantitative data for benchmarking. A series of four surveys gathered data from VET providers, teachers, students and their employers. The data formed baseline indicators that were used to establish organisational goals and benchmarks for e-learning. These indicators were the first know set for benchmarking e-learning in Australia. The case studies in this paper illustrate ways in which VET providers have approached e-learning benchmarking, the benefits achieved and the lessons that they learned. The cases exemplify how VET providers have adapted the baseline indicators, how the indicators informed organisational plans and e-learning outcomes. The benefits of benchmarking are categorised under three purposes: reporting, performance management, and service improvement. A set of practical strategies is derived from the cases for consideration by other organisations interested in benchmarking e-learning services.

Maternal age and paternal age are associated with distinct childhood behavioural outcomes in a general population birth cohort

Abstract Background Recent studies show that advanced paternal age (APA) is associated with an increased risk of neurodevelopmental disorders such as autism, bipolar disorder and schizophrenia. A body of evidence also suggests that individuals who develop schizophrenia show subtle deviations in a range of behavioural domains during their childhood. The aim of the study was to examine the relationship between paternal and maternal ages and selected behavioural measures in children using a large birth cohort. Method Participants were singleton children (n = 21,753) drawn from the US Collaborative Perinatal Project. The outcome measures were assessed at 7 years. The main analyses examined the relationship between parental age and behavioural measures when adjusted for a range of potentially confounding variables, including age of the other parent, maternal race, socio-economic measures, sex, gestation length, maternal marital status, parental mental illness, and child's age-at-testing. Results Advanced paternal age was associated with a significantly increased risk of adverse ‘externalizing’ behaviours at age seven years. For every five year increase in paternal age, the odds of higher ‘externalizing’ behaviours was increased by 12% (OR = 1.12; 95% CI = 1.03, 1.21, p < 0.0001). The relationship persisted after adjusting for potential confounding factors. ‘Internalizing’ behavioural outcome was not associated with advanced paternal age. In contrast, advanced maternal age was significantly protective against adverse ‘externalizing’ behavioural outcomes, but associated with an increased risk of adverse ‘internalizing’ behavioural outcomes. Discussion The offspring of older fathers show a distinctly different pattern of behaviours compared to the offspring of older mothers. The diverse socio-cultural and biologically-mediated factors that underpin these findings remain to be clarified. In light of secular trends related to delayed parenthood, the mechanisms underlying these findings warrant closer scrutiny.

Alternative schooling programs for at risk youth : three case studies

This thesis develops a critical realist explanatory critique of alternative schooling programs for youth at risk taking place at three case study sites. Throughout the thesis the author pursues the question, \Are alternative provisions of schooling working academically and socially for youth at risk?. The academic lens targets literacy learning and associated pedagogies. Social outcomes are posited as positive social behaviours and continued engagement in learning. A four phased analysis, drawing on critical realism, interpretive and subject specific theories is used to elicit explanations for the research question. An overall framework is a critical realist methodology as set out by Danermark, Ekstrom, Jakobsen and Karlsson (2002, p. 129). Consequently phase one describes the phenomena of alternative schooling programs taking place at three case study sites. This is reported first as staff narratives that are resolved into imaginable historical causal components of \generative events., \prior schooling structures., \models of alternative schooling., \purpose., \individual agency., and \relations with linked community organisations.. Then transcendental questions are posed about each component using retroduction to uncover structures, underlying mechanisms and powers, and individual agency. In the second phase the researcher uses modified grounded theory methodology to theoretically redescribe causal categories related to a \needed different teaching and administrative approach. that emerged from the previous critique. A transcendental question is then applied to this redescription. The research phenomena are again theoretically redescribed in the third phase, this time using three theoretically based constructs associated with literacy and literacy pedagogies; the NRS, the 4 Resources Model, and Productive Pedagogies. This redescription is again questioned in terms of its core or \necessary. components. The fourth phase makes an explanatory critique by comparing and critiquing all previous explanations, recontextualising them in a wider macro reality of alternative schooling. Through this critical realist explanatory critiquing process, a response emerges not only to whether alternative provisions of schooling are working, but also how they are working, and how they are not working, with realistically based implications for future improvement.

Exploring the impact of context-specific job stressors on employee work outcomes

A path model was developed to examine the impact of context-specific job stressors on the work outcomes of 132 customer service employees. Respondents who reported a moderate and high level of context-specific stressors report a higher level of job demand and work family conflict. Respondents who reported a higher level of job control tend to receive more work-related support and are more satisfied with their job. Surprisingly, respondents who experienced a higher level of work family conflict tend to receive less work-related support. We found that respondents who obtained more work-related support tend to report a higher level of job satisfaction. There was also a positive relationship between positive job satisfaction and a lower level of intention to quit.

High quality/high equity systems of education: Curriculum, teachers and reform in the search for equitable outcomes for all students

The issue of what an effective high quality / high equity education system might look like remains contested. Indeed there is more educational commentary on those systems that do not achieve this goal (see for example Luke & Woods, 2009 for a detailed review of the No Child Left Behind policy initiatives put forward in the United States under the Bush Administration) than there is detailed consideration of what such a system might enact and represent. A long held critique of socio cultural and critical perspectives in education has been their focus on deconstruction to the supposed detriment of reconstructive work. This critique is less warranted in recent times based on work in the field, especially the plethora of qualitative research focusing on case studies of ‘best practice’. However it certainly remains the case that there is more work to be done in investigating the characteristics of a socially just system. This issue of Point and Counterpoint aims to progress such a discussion. Several of the authors call for a reconfiguration of the use of large scale comparative assessment measures and all suggest new ways of thinking about quality and equity for school systems. Each of the papers tackles different aspects of the problematic of how to achieve high equity without compromising quality within a large education system. They each take a reconstructive focus, highlighting ways forward for education systems in Australia and beyond. While each paper investigates different aspects of the issue, the clearly stated objective of seeking to delineate and articulate characteristics of socially just education is consistent throughout the issue.

Recruiting older adults to health research studies : a systematic review

Objective: To provide a systematic review of papers comparing the effectiveness of different strategies to recruit older adults (aged 50 years and over) to participate in health research studies, to guide successful recruitment in future research. Methods: Four major databases were searched for papers published between 1995 and 2008 with: target group aged 50 years or over; participants allocated to receive one of two or more recruitment strategies; and an outcome measure of response rate or enrolment in study. Results: Twelve papers were included in the review. Conclusion: For postal questionnaires, recruitment strategies used with older adults had comparable outcomes to those used to recruit from the general population. For other types of studies, strategies involving face-to-face contact may be more effective than indirect methods, but this needs to be balanced against feasibility. Overall, little evidence on the topic exists and more rigorous investigation is necessary.