An empirical model to estimate the demand for primary care in urban settings

Objective. To measure the demand for primary care and its associated factors by building and estimating a demand model of primary care in urban settings.^ Data source. Secondary data from 2005 California Health Interview Survey (CHIS 2005), a population-based random-digit dial telephone survey, conducted by the UCLA Center for Health Policy Research in collaboration with the California Department of Health Services, and the Public Health Institute between July 2005 and April 2006.^ Study design. A literature review was done to specify the demand model by identifying relevant predictors and indicators. CHIS 2005 data was utilized for demand estimation.^ Analytical methods. The probit regression was used to estimate the use/non-use equation and the negative binomial regression was applied to the utilization equation with the non-negative integer dependent variable.^ Results. The model included two equations in which the use/non-use equation explained the probability of making a doctor visit in the past twelve months, and the utilization equation estimated the demand for primary conditional on at least one visit. Among independent variables, wage rate and income did not affect the primary care demand whereas age had a negative effect on demand. People with college and graduate educational level were associated with 1.03 (p < 0.05) and 1.58 (p < 0.01) more visits, respectively, compared to those with no formal education. Insurance was significantly and positively related to the demand for primary care (p < 0.01). Need for care variables exhibited positive effects on demand (p < 0.01). Existence of chronic disease was associated with 0.63 more visits, disability status was associated with 1.05 more visits, and people with poor health status had 4.24 more visits than those with excellent health status. ^ Conclusions. The average probability of visiting doctors in the past twelve months was 85% and the average number of visits was 3.45. The study emphasized the importance of need variables in explaining healthcare utilization, as well as the impact of insurance, employment and education on demand. The two-equation model of decision-making, and the probit and negative binomial regression methods, was a useful approach to demand estimation for primary care in urban settings.^

Strategies for obesity prevention in child care settings: A literature review

Background. Children in the age group of 2-5 years spend substantial amount of time during the day in some kind of childcare setting. These settings are an excellent environmental infrastructure to enhance their nutrition and physical activity behavior and to promote healthy eating and physical activity habits. Due to the steep rise in overweight and obesity among children in the past three decades, it becomes essential to intervene early. There exists a need for literature on a comprehensive and sustainable approach to obesity prevention for younger children in these settings. ^ Methods. Systematic literature search was undertaken using databases like Medline Ovid, Pubmed, Medline Ebsco, and Cochrane Library. Articles published in English as well as English language abstracts of foreign articles were included. The inclusion criteria were as follows: (1) Studies conducted in any part of the world exploring relevant themes and a child care or preschool setting would be included. (2) The interventions promoted physical activity, nutrition/healthy eating/improved diet, reduced television viewing, reduced BMI, changed knowledge and behavior of children and or staff or affected policy/standards/regulations. (3) The population was children in the age group of at least 2 years to 5 years. (4) Articles published in English and English language abstracts for foreign articles would be included. ^ Results. 16 articles were included in the review that consisted of primary interventions in the form of randomized control trials or pre-post interventions were conducted in a preschool or child care or day care setting only. The outcomes pertaining to healthy weight in children were increased vegetable intake, reduced BMI and increased knowledge among others. ^ Conclusion. There is a dearth of data on strong intervention trials in the child care setting. Preschool research studies in the young children that have been conducted are not strong enough. There is a need for more randomized control trials and a well planned evaluation in the preschool age children. There is a need to develop outcome measures that can accurately assess the changes in diet and physical activity in this age group. Child care nutrition and physical activity standards need to be made stringent. ^

Computerizing Social-Emotional Assessment for School Readiness: First Steps toward an Assessment Battery for Early Childhood Settings

The transition into formal schooling is a crucial foundation that can set children on a cycle of success or failure in both academic and social domains. A child’s abilities to express healthy emotions, understand emotions of self and others, regulate emotion, attention, and behavior, make good decisions regarding social problems, and engage in a range of prosocial behaviors, all work together to promote a successful school experience. However, many children have deficits in these skills by school entry, and educators lack the requisite tools to identify, track and assess skills these children need to learn. Thus, because social-emotional learning (SEL) is so crucial, assessment tools to pinpoint children’s skills and progress are vitally necessary. Previous work by the authors and other researchers has led to the development of strong assessment tools; however, these tools are often developed solely for research use, not practitioner application. In the following, using our assessment battery as an example, we will discuss the steps necessary to adapt SEL assessment for computer-based administration and optimal utility in early childhood education programs.

Hacia un análisis cuantitativo de la Ciudad Informal: una aproximación desde la Habitabilidad Básica y la experiencia en Makeni (Sierra Leona)

La importantísima expansión urbana que sufren las principales ciudades de los países en vías de desarrollo, es el mayor reto que afronta la habitabilidad a nivel mundial. Dentro de la teoría general de la Habitabilidad Básica (HaB-ETSAM-UPM, 1995) la ordenación del territorio y el planeamiento urbanístico son las herramientas determinantes para orientar coherentemente los procesos de urbanización, como se reconoce también desde las principales esferas técnicas a nivel internacional. Pero tales herramientas deben enfocarse a una construcción eficiente del territorio, actuando desde una aproximación multidisciplinar, flexible y directa, que incida en las prioridades específicas de cada contexto. Para ello, resulta fundamental comprender a fondo las realidades específicas de estos ámbitos. La ciudad es un fenómeno complejo en esencia. El tejido construido, en constante proceso de cambio, es el caparazón visible que alberga una maravillosa mezcla entrelazada de espacios, funciones, flujos, personas.... Cada ciudad, diferente y única, se integra en su medio, se adapta a geografías, contextos y climas distintos, evoluciona según dinámicas propias, en incomprensibles (o casi) procesos evolutivos. El estudio de la ciudad, supone siempre una simplificación de la misma. La realidad urbana, por detallado que sea nuestro análisis, siempre contendrá indescifrables relaciones que se nos escapan. En cambio, necesitamos de métodos analíticos que nos ayuden a comprender algo esa complejidad. Acercarnos en ese análisis, es un paso previo fundamental para la formulación de respuestas. En este plano, de avance en la comprensión del hecho urbano, se sitúa este trabajo. Se pone el acento en el enfoque cuantitativo, profundizando en datos básicos concretos, siempre aceptando de partida que esta información es una componente mínima, pero esperamos que sustantiva, de un fenómeno inabordable. Y es esta búsqueda de comprensión material y cuantitativa de la ciudad, el objetivo esencial de la investigación. Se pretende proporcionar una base detallada de aquéllos aspectos fundamentales, que pueden ser medidos en los entornos urbanos y que nos proporcionan información útil para el diagnóstico y las propuestas. Para ello, se aportan rangos y referencias deseables, a través de una herramienta para la comprensión y la valoración de cada contexto, la Matriz de Indicadores. Esta herramienta se concibe desde la reflexión a la aplicación práctica, a la utilidad directa, al aporte concreto para quien pueda servir. Ésta es la voluntad decidida con la que se aborda este trabajo, centrado en los entornos urbanos donde el aporte técnico es prioritario: la Ciudad Informal. La Ciudad Informal, entendida aquí como aquélla que se desarrolla sin los medios suficientes (técnicos, económicos e institucionales) que proporciona la planificación, aquélla por donde la habitabilidad precaria se extiende. Es la ciudad que predomina en los países en vías de desarrollo, en los contextos de bajos recursos, allí donde, precisamente, se concentran los principales déficits y necesidades a nivel global. El enfoque nace de la teoría de la Habitabilidad Básica, de la definición de mínimos posibles para, desde allí, construir el espacio necesario para el desarrollo humano. Éste es el ámbito genérico objeto del trabajo que, a su vez, se nutre, de forma muy importante, de la experiencia directa en la ciudad de Makeni, en Sierra Leona. Esta ciudad nos sirve de prototipo experimental en un doble sentido. Por un lado, sirve como espacio empírico en el que chequear la metodología de valoración cuantitativa; y, por otro, el conocimiento de esta ciudad de tamaño medio africana, que se ha ido adquiriendo en los últimos cinco años, es una base directa para el desarrollo teórico de la propia metodología, que ayuda a atisbar lo esencial en contextos similares. El encaje de todo este recorrido se ha articulado desde una experiencia académica que, como docente, he coordinado directa e intensamente. Experiencia muy enriquecedora, que ha sumado muchas manos y mucho aprendizaje en este tiempo. Teoría y práctica en planeamiento urbano se alternan en el trabajo, nutriéndose la una de la otra y a la inversa. Trabajo que nace desde la pasión por la ciudad y el urbanismo. Desde la búsqueda por comprender y desde la vocación de actuar, de intentar mejorar y hacer más habitables los entornos urbanos. Especialmente allí donde las dificultades se agolpan y el camino se alarga, se llena de polvo. Acumular preguntas a cada paso. Cada vez más preguntas. Las respuestas, si existen, aparecen entrelazadas en dinámicas indescifrables de las que queremos formar parte. Fundirnos por momentos en la misma búsqueda, acompañarla. Sentirnos cerca de quiénes comienzan de cero casi cada día. Y otra vez, arrancar. Y compartir, desde el conocimiento, si acaso es que se puede. Y la ciudad. Brutal, imponente, asfixiante, maravillosa, imposible. Creación colectiva insuperable, de energías sumadas que se cosen sin patrón aparente. O sin más razón que la del propio pulso de la vida. Así se siente Makeni. ABSTRACT The important urban growth suffering major cities of developing countries, is the biggest challenge facing the global habitability. Within the general theory of Basic Habitability (HAB-ETSAM-UPM, 1995) spatial planning and urban planning are the crucial tools to consistently guide the urbanization process, as also recognized from the main technical areas worldwide. But such tools should focus on an efficient construction of the territory, working from a multidisciplinary, flexible and direct approach, that affects the specific priorities of each context. To do this, it is essential to thoroughly understand the specific realities of these areas. The city is essentially a complex phenomenon. The urban fabric in constant flux, is the visible shell that houses a wonderful mixture interlocking spaces, functions, flows, people.... Every city, different and unique, is integrated into its environment, adapted to geographies, contexts and climates, it evolves according to its own dynamics, along (almost) incomprehensible evolutionary processes. The study of the city, is always a simplification of it. The urban reality, even studied from a detailed analysis, always contain undecipherable relationships that escape us. Instead, we need analytical methods that help us understand something that complexity. Moving forward in this analysis is an essential first step in formulating responses. At this level, progressing in understand the urban reality, is where this work is located. The emphasis on the quantitative approach is placed, delving into specific basic data, starting always accepting that this information is just a minimal component, but we hope that substantive, of an intractable phenomenon. And it is this search for materials and quantitative understanding of the city, the main objective of the research. It is intended to provide a detailed basis of those fundamental aspects that can be measured in urban environments that provide us useful information for the diagnosis and proposals. To do this, desirable ranges and references are provided, through a tool for understanding and appreciation of each context, the Indicator Matrix. This tool is conceived from reflection to practical application, to a direct utility, concrete contribution to who can serve. This is the firm resolve with which this work is addressed, centered in urban environments where the technical contribution is a priority: the Informal City. The Informal City, understood here as the urban areas developed without the sufficient resources (technical, economic and institutional) which planning provides, where it is extended the precarious habitability. It is the city that prevails in developing countries, in low-resource settings, where, precisely, the main gaps and needs in the global context are concentrated. The approach stems from the theory of Basic Habitability, the definition of possible minimum, to build the necessary space for human development. This is the generic scope of the work object, that is also based in the direct experience in the town of Makeni, Sierra Leone. This city serves as an experimental prototype in two ways. On the one hand, it serves as a space where empirically check the quantitative assessment methodology; and, secondly, the knowledge of this African city of medium size, which has been acquired in the last five years, is a direct basis for the theoretical development of the methodology itself, which helps to glimpse the essence in similar contexts. The engagement of this whole journey has been articulated from an academic experience, directly and intensely coordinated as teacher. Enriching experience that has added many hands and much learning at this time. Theory and practice in urban planning are mixed at work, enriching the one of the other and vice versa. Work is born from the passion for the city and urbanism. From the search for understanding and from the vocation of acting, trying to improve and make more livable urban environments. Especially where the difficulties are crowded and the road is so long, full of dust. To accumulate questions at every turn. More and more questions. The answers, if do exist, appears inside indecipherable dynamics in which we want to be involved. Merge at times in the same search. Feel close to those who start from scratch almost every day. And again, move forward. And share, from knowledge, if possible. And the city. Brutal, impressive, suffocating, wonderful, impossible. Unsurpassed collective creation, combined energy mix that are sewn with no apparent pattern. Or for no reason other than the pulse of life itself. As it feels the city of Makeni.

Knowledge spirals, situational leadership and informal learning applied on b-learning methodology

The methodology “b-learning” is a new teaching scenario and it requires the creation, adaptation and application of new learning tools searching the assimilation of new collaborative competences. In this context, it is well known the knowledge spirals, the situational leadership and the informal learning. The knowledge spirals is a basic concept of the knowledge procedure and they are based on that the knowledge increases when a cycle of 4 phases is repeated successively.1) The knowledge is created (for instance, to have an idea); 2) The knowledge is decoded into a format to be easily transmitted; 3) The knowledge is modified to be easily comprehensive and it is used; 4) New knowledge is created. This new knowledge improves the previous one (step 1). Each cycle shows a step of a spiral staircase: by going up the staircase, more knowledge is created. On the other hand, the situational leadership is based on that each person has a maturity degree to develop a specific task and this maturity increases with the experience. Therefore, the teacher (leader) has to adapt the teaching style to the student (subordinate) requirements and in this way, the professional and personal development of the student will increase quickly by improving the results and satisfaction. This educational strategy, finally combined with the informal learning, and in particular the zone of proximal development, and using a learning content management system own in our University, gets a successful and well-evaluated learning activity in Master subjects focused on the collaborative activity of preparation and oral exhibition of short and specific topics affine to these subjects. Therefore, the teacher has a relevant and consultant role of the selected topic and his function is to guide and supervise the work, incorporating many times the previous works done in other courses, as a research tutor or more experienced student. Then, in this work, we show the academic results, grade of interactivity developed in these collaborative tasks, statistics and the satisfaction grade shown by our post-graduate students.

Motivational profiles Spanish students of Compulsory Secondary Education: Differential analysis of academic self-attributions

Academic goals and academic self-attributions are relevant variables in school settings. The objective of this study is to identify whether there are combinations of multiple goals that lead to different motivational profiles and to determine whether there are significant differences between the groups obtained regarding causal attributions of success and failure (ability, effort, or external causes) in Mathematics and Language and Literature, and in overall academic performance. The Goal Achievement Tendencies Questionnaire (AGTQ) and the Sydney Attribution Scale (SAS) were administered to a sample of 2022 students of compulsory secondary education, ranging in age from 12 to 16 years (M = 13.81, SD = 1.35). Cluster analysis identified four motivational profiles: a group of students with a high generalized motivation profile, a group of students with low generalized motivation profile, a group of students with predominance of learning goals and achievement goals, and a final group of students with predominance of social reinforcement goals. Results revealed statistically significant differences between the profiles obtained in academic self-attributions.

MOOCs, Open educational resources and social networking: bridging the gap between informal and formal learning

MOOCs and open educational resources (OER) provide a wealth of learning opportunities for people around the globe, many of whom have no access to formal higher education. OER are often difficult to locate and are accessed on their own without support from or dialogue with subject experts and peers. This paper looks at whether it is possible to develop effective learning communities around OER and whether these communities can emerge spontaneously and in a self-organised way without moderation. It examines the complex interplay between formal and informal learning, and examines whether MOOCs are the answer to providing effective interaction and dialogue for those wishing to study at university level for free on the Internet.

HELPING YOUTH WITH AUTISM SPECTRUM DISORDER DEVELOP SOCIAL COMPETENCE IN COMMUNITY-BASED SETTINGS

The purpose of the current dissertation is to identify the features of effective interventions by exploring the experiences of youth with ASD who participate in such interventions, through two intervention studies (Studies 1 and 2) and one interview study (Study 3). Studies 1 and 2 were designed to support the development of social competence of youth with ASD through Structured Play with LEGO TM (Study 1, 12 youths with ASD, ages 7–12) and Minecraft TM (Study 2, 4 youths with ASD, ages 11–13). Over the course of the sessions, the play of the youth developed from parallel play (children playing alone, without interacting) to co-operative play (playing together with shared objectives). The results of Study 2 showed that rates of initiations and levels of engagement increased from the first session to the final session. In Study 3, 12 youths with ASD (ages 10–14) and at least one of their parents were interviewed to explore what children and their parents want from programs designed to improve social competence, which activities and practices were perceived to promote social competence by the participants, and which factors affected their decisions regarding these programs. The adolescents and parents looked for programs that supported social development and emotional wellbeing, but did not always have access to the programs they would have preferred, with factors such as cost and location reducing their options. Three overarching themes emerged through analysis of the three studies: (a) interests of the youth; (b) structure, both through interactions and instruction; and (c) naturalistic settings. Adolescents generally engage more willingly in interventions that incorporate their interests, such as play with Minecraft TM in Study 2. Additionally, Structured Play and structured instruction were crucial components of providing safe and supportive contexts for the development of social competence. Finally, skills learned in naturalistic settings tend to be applied more successfully in everyday situations. The themes are analysed through the lens of Vygotsky’s (1978) perspectives on learning, play, and development. Implications of the results for practitioners and researchers are discussed.

Disentangling the Reform Gridlock: Higher Education in Germany. CES Germany & Europe Working Papers, No. 02.7, 2002

For more than a decade, bemoaning the many roadblocks to reforming important aspect of German politics has become commonplace. Explanations emphasize formal and informal veto points, such as the role of political institutions and the lack of elite and societal support for reform initiatives. Against this background, I was interested in factors that place policy issues on the political agenda and follow up with concrete courses of action; i.e., in factors that lead to a disentangling of the reform gridlock. I emphasize the importance of agenda setting in the emergence of higher education reform in Germany. Globalization, European integration and domestic pressures combined to create new pressures for change. In response, an advocacy coalition of old and new political actors has introduced a drawn-out and ongoing process of value reorientation in the direction of competition, including international competition, and greater autonomy. The result has been a burst of activities, some moderate, some more far-reaching in their potential to restructure German higher education.

The Silent Reform of Swiss Federalism: The New Constitutional Articles on Education

This article examines the decision-making process leading to the new constitutional articles on education in Switzerland. It analyzes how actors from both state levels (Confederation and cantons) could reach consensus in a process that was prone to a "joint-decision trap". To that end, we hypothesize which factors may be conducive to a "problem-solving" style of policy-making in a compulsory negotiation system. Rich empirical material from various sources supports our theoretical arguments: We show that shared beliefs and a common frame of reference, the procedural separation between constitutional and distributional issues, neutral brokers, and informal structures were all beneficial to the success of the reform project.

Crafting a Third Space: Teacher Beliefs and Practices in Curriculum Reform for Multicultural Education

Thesis (Ph.D.)--University of Washington, 2016-06

A randomized controlled trial of a nurse-administered educational intervention for improving cancer pain management in ambulatory settings

The persistence of negative attitudes towards cancer pain and its treatment suggests there is scope for identifying more effective pain education strategies. This randomized controlled trial involving 189 ambulatory cancer patients evaluated an educational intervention that aimed to optimize patients' ability to manage pain. One week post-intervention, patients receiving the pain management intervention (PMI) had a significantly greater increase in self-reported pain knowledge, perceived control over pain, and number of pain treatments recommended. Intervention group patients also demonstrated a greater reduction in willingness to tolerate pain, concerns about addiction and side effects, being a "good" patient, and tolerance to pain relieving medication. The results suggest that targeted educational interventions that utilize individualized instructional techniques may alter cancer patient attitudes, which can potentially act as barriers to effective pain management. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

Early practical experience and the social responsiveness of clinical education: Systematic review

Objectives To find how early experience in clinical and community settings (early experience) affects medical education, and identify strengths and limitations of the available evidence. Design A systematic review rating, by consensus, the strength and importance of outcomes reported in the decade 1992-2001. Data sources Bibliographical databases and journals were searched for publications on the topic, reviewed under the auspices of the recently formed Best Evidence Medical Education (BEME) collaboration. Selection of studies All empirical studies (verifiable, observational data) were included, whatever their design, method, or language of publication. Results Early experience was most commonly provided in community settings, aiming to recruit primary care practitioners for underserved populations. It increased the popularity of primary care residencies, albeit among self selected students. It fostered self awareness and empathic attitudes towards ill people, boosted students' confidence, motivated them, gave them satisfaction, and helped them develop a professional identity. By helping develop interpersonal skills, it made entering clerkships a less stressful experience. Early experience helped students learn about professional roles and responsibilities, healthcare systems, and health needs of a population. It made biomedical, behavioural, and social sciences more relevant and easier to learn. It motivated and rewarded teachers and patients and enriched curriculums. In some countries,junior students provided preventive health care directly to underserved populations. Conclusion Early experience helps medical students learn, helps them develop appropriate attitudes towards their studies and future practice, and orientates medical curriculums towards society's needs. Experimental evidence of its benefit is unlikely to be forthcoming and yet more medical schools are likely to provide it. Effort could usefully be concentrated on evaluating the methods and outcomes of early experience provided within non-experimental research designs, and using that evaluation to improve the quality of curriculums.

Shadowing experiences and the extension of communities of practice: A case study of women education managers

Recent developments in workplace learning have focused on relational and social network views of learning that introduce practitioners to the norms, values and assumptions of the workplace as well as the learning processes through which knowledge is acquired. This article reports on a qualitative study of a mentoring programme designed to assist women education managers gain promotion by broadening their networks and stimulating insights into the senior management positions for which they were being prepared. The findings are that members reflexively assess and reassess goals and values to demystify knowledge and resolved cognitive dissonance in these processes. Moreover, this article shows that women participants learn from the networks, and that the networks learn from the participant in a reciprocal and informal way. The article concludes that organizational learning programmes must focus on enabling such networks to flourish.