“It’s the People That Drive It”: Motivating and Supporting Collaborative Data Use Practices in Three Teacher Education Programs

Thesis (Ph.D.)--University of Washington, 2016-08

Effects of protected area downsizing on habitat fragmentation in Yosemite National Park (USA), 1864 – 2014

Protected area downgrading, downsizing, and degazettement (PADDD) has been documented worldwide, but its impacts on biodiversity are poorly understood. To fill this knowledge gap, we reviewed historical documents to identify legal changes that altered the boundaries of Yosemite National Park. We identified two downsizes and five additions between 1905 and 1937 that reduced the size of Yosemite National Park by 30%. To examine the effects of these downsizing events on habitat fragmentation by roads, we compared protected, never-protected, and downsized lands at three spatial scales using four habitat fragmentation metrics: road density, fragment (land surrounded by roads) area-to-perimeter ratio, fragment area, and fragment density. In general, lands that were removed from protection, e.g., downsized, were more highly fragmented than protected lands and indistinguishable from never-protected lands. Lands where downsizes were reversed were less fragmented than lands where downsizes were not reversed. These results suggest that protected area downsizing may exacerbate habitat fragmentation, a key contributor to biodiversity loss globally. Furthermore, the case study in Yosemite National Park demonstrates that iconic protected areas in developed countries are not immune to downsizing. These findings underscore the need to account for PADDD and governance histories in ecological research, monitoring, and evaluation. As we move toward more evidence-based conservation policy, a rigorous understanding of PADDD is essential to ensure that protected areas fulfill their promise as a strategy for conserving global biodiversity.

Mental health nurses’ attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder: systematic, integrative literature review

Aims and objectives To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. Background There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses’ attitudes have had limited success. Design Systematic, integrative literature review. Methods Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses’ attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Results Forty studies were included. Only one used direct observation of clinical practice. Nurses’ knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals’ and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Conclusions Mental health nurses’ responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. Relevance to clinical practice There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working with patients with borderline personality disorder.

Teaching boys in neoliberal and postfeminist times: Feminization and the question of re-masculinization in the education system and policy field

This paper focuses on teaching boys, male teachers and the question of gendered pedagogies in neoliberal and postfeminist times of the proliferation of new forms of capitalism, multi-mediated technologies and the influence of globalization. It illustrates how a politics of re-masculinization and its reconstitution needs to be understood as set against changing economic and social conditions in which gender equity comes to be re-focused on boys as the ‚new disadvantaged‘. This re-framing of gender equity, it is argued, has been fuelled by both a media-inspired backlash discourse about ‚failing boys‘ and a neo-positivist emphasis on numbers derived primarily from standardized testing regimes at both global and national levels. A media-focused analysis of the proliferation of discourses about ‚failing boys‘ vis-a-vis the problem of encroaching feminization in the school system is provided to illuminate how certain truths about the influence of male teachers come to define how the terms of ensuring gender equity are delimited and reduced to a question of gendered pedagogies as grounded in sexed bodies. Historical accounts of the feminization of teaching in the North American context are also provided as a basis for building a more informed understanding of the present, particularly as it relates to the contextualization of policy articulation and enactment regarding the problem of teaching boys. In light of such historically informed and critical media analysis, it is argued that what is needed is a more informed, evidenced based policy articulation of the problem of teaching boys and a more gender sensitive reflection on the politics of masculinities in postfeminist times. (DIPF/Orig.)

New clinical practice guideline on enteral feeding in very low birth weight infants: first part

Introduction: The nutrition of very low birth weight (VLBW) infants is aimed at promoting a similar growth to that occurring in the uterus. However, in practice this is difficult to achieve and extrauterine growth restriction is frequent. The current tendency is to avoid this restriction by means of early parenteral and enteral nutrition. Nonetheless, uncertainty about many of the practices related with nutrition has resulted in a great variation in the way it is undertaken. In 2009 and 2011 in our hospital there was an unexpected increase in necrotizing enterocolitis. To check to see whether our nutrition policy was involved, we undertook a systematic review and drew up clinical practice guidelines (CPG) about enteral feeding in VLBW infants. New considerations about the duration of the fortification and the use of probiotics have led to an update of these CPG. Methods: A total of 21 clinical questions were designed dealing with the type of milk, starting age, mode of administration, rate and volume of the increments, fortification, use of probiotics and protocol. After conducting a systematic search of the available evidence, the information was contrasted and summarized in order to draw up the recommendations. The quality of the evidence and the strength of the recommendations were determined from the SIGN scale Comment: These CPG aim to help physicians in their decision making. The protocolized application of well-proven measurements reduces the variation in clinical practice and improves results.

New clinical practice guideline on enteral feeding in very low birth weight infants: second part

Introduction: The nutrition of very low birth weight (VLBW) infants is aimed at promoting a similar growth to that occurring in the uterus. However, in practice this is difficult to achieve and extrauterine growth restriction is frequent. The current tendency is to avoid this restriction by means of early parenteral and enteral nutrition. Nonetheless, uncertainty about many of the practices related with nutrition has resulted in a great variation in the way it is undertaken. In 2009 and 2011 in our hospital there was an unexpected increase in necrotizing enterocolitis. To check to see wether our nutrition policy was involved, we underlook a systematic review and drewup clinical practice guidelines (CPG) about enteral feeding in VLBW infants. New considerations about the duration of the fortification and the use of probiotics have led to an update of these CPG. Methods: A total of 21 clinical questions were designed dealing with the type of milk, starting age, mode of administration, rate and volume of the increments, fortification, use of probiotics and protocol. Afete conducting a systematic search of the available evidence, the information was contrasted and summarized in order to draw up the recommendations. The quality of the evidence and the strength of the recommendations were determined from the SIGN scale. Comment: These CPG aim to help physicians in their decision making. The protocolized application of well-proven measurements reduces the variation in clinical practice and improves results.

The age of studies and reports: selected elements concerning the background of encounters defining the power of education

In the present paper, we discuss the time before the “age of reports”. Besides the Coleman Report in the period of Coleman, the Lady Plowden Report also appeared, while there were important studies in France (Bourdieu & Passeron, 1964; Peyre, 1959) and studies that inaugurated comprehensive education in Nordic countries. We focus on the period after the World War II, which was marked by rising economic nationalism, on the one hand, and by the second wave of mass education, on the other, bearing the promise of more equality and a reduction of several social inequalities, both supposed to be ensured by school. It was a period of great expectations related to the power of education and the rise of educational meritocracy. On this background, in the second part of the paper, the authors attempt to explore the phenomenon of the aforementioned reports, which significantly questioned the power of education and, at the same time, enabled the formation of evidence-based education policies. In this part of the paper, the central place is devoted to the case of socialist Yugoslavia/Slovenia and its striving for more equality and equity through education. Through the socialist ideology of more education for all, socialist Yugoslavia, with its exaggerated stress on the unified school and its overemphasised belief in simple equality, overstepped the line between relying on comprehensive education as an important mechanism for increasing the possibility of more equal and just education, on the one hand, and the myth of the almighty unified school capable of eradicating social inequalities, especially class inequalities, on the other. With this radical approach to the reduction of inequalities, socialist policy in the then Yugoslavia paradoxically reduced the opportunity for greater equality, and even more so for more equitable education. (DIPF/Orig.)

Evaluation use within a humanitarian non-governmental organization’s health care user-fee exemption program in West Africa

L’évaluation de l’action humanitaire (ÉAH) est un outil valorisé pour soutenir l’imputabilité, la transparence et l’efficience de programmes humanitaires contribuant à diminuer les inéquités et à promouvoir la santé mondiale. L’EAH est incontournable pour les parties prenantes de programme, les bailleurs de fonds, décideurs et intervenants souhaitant intégrer les données probantes aux pratiques et à la prise de décisions. Cependant, l’utilisation de l’évaluation (UÉ) reste incertaine, l’ÉAH étant fréquemment menée, mais inutilisé. Aussi, les conditions influençant l’UÉ varient selon les contextes et leur présence et applicabilité au sein d’organisations non-gouvernementales (ONG) humanitaires restent peu documentées. Les évaluateurs, parties prenantes et décideurs en contexte humanitaire souhaitant assurer l’UÉ pérenne détiennent peu de repères puisque rares sont les études examinant l’UÉ et ses conditions à long terme. La présente thèse tend à clarifier ces enjeux en documentant sur une période de deux ans l’UÉ et les conditions qui la détermine, au sein d’une stratégie d’évaluation intégrée au programme d’exemption de paiement des soins de santé d’une ONG humanitaire. L’objectif de ce programme est de faciliter l’accès à la santé aux mères, aux enfants de moins de cinq ans et aux indigents de districts sanitaires au Niger et au Burkina Faso, régions du Sahel où des crises alimentaires et économiques ont engendré des taux élevés de malnutrition, de morbidité et de mortalité. Une première évaluation du programme d’exemption au Niger a mené au développement de la stratégie d’évaluation intégrée à ce même programme au Burkina Faso. La thèse se compose de trois articles. Le premier présente une étude d’évaluabilité, étape préliminaire à la thèse et permettant de juger de sa faisabilité. Les résultats démontrent une logique cohérente et plausible de la stratégie d’évaluation, l’accessibilité de données et l’utilité d’étudier l’UÉ par l’ONG. Le second article documente l’UÉ des parties prenantes de la stratégie et comment celle-ci servit le programme d’exemption. L’utilisation des résultats fut instrumentale, conceptuelle et persuasive, alors que l’utilisation des processus ne fut qu’instrumentale et conceptuelle. Le troisième article documente les conditions qui, selon les parties prenantes, ont progressivement influencé l’UÉ. L’attitude des utilisateurs, les relations et communications interpersonnelles et l’habileté des évaluateurs à mener et à partager les connaissances adaptées aux besoins des utilisateurs furent les conditions clés liées à l’UÉ. La thèse contribue à l’avancement des connaissances sur l’UÉ en milieu humanitaire et apporte des recommandations aux parties prenantes de l’ONG.

Home and group-based implementation of the "Growing Up Happily in the Family" program in at-risk psychosocial contexts

"Growing Up Happily in the Family" is a program to prevent child maltreatment targeted at parents of children aged 0-5 years old in at-risk psychosocial contexts. The program is delivered via either a group-based or a home-visit format. The objective of this study was to evaluate the impact of various implementation components in the home and group versions on changes in parental attitudes about child development and education. At-risk and non at-risk parents participated in the group-based (196 participants in 26 groups) and home-visit (95 participants) versions of the program delivered through local social services. We analyzed program adherence, adaptations, participant responsiveness, quality of delivery, and implementation barriers as predictors of changes in parental attitudes. The results showed that greater program adherence, better quality of delivery and participant responsiveness, and positive climate predicted changes in parental attitudes in both formats. Therefore, it is important to take into account the quality of the implementation process when testing the effectiveness of early group-based and home-visit interventions in at-risk families.

Evidence in promoting positive parenting through the Program-Guide to Develop Emotional Competences

This study aims at providing evidence of the effectiveness of the Program-Guide to Develop Emotional Competences in promoting positive parenting. Contextual, institutional, methodological and professional issues were taken into account to develop a social innovation experience to support parenting as a preventive measure to family conflicts. The study describes both the contents of the Program-Guide and the methodological and evaluation issues that trained professionals need to consider when delivering the Program-Guide to families in natural contexts. Information was gathered and analyzed from 259 parents with children of ages 1-18 who participated in 26 parent training groups. A pre- and post-test design showed that after finishing the sessions parents perceived themselves more competent as parents according to the five dimensions of parenting competences considered: (1) emotional self-regulation abilities; (2) self-esteem and assertiveness; (3) communication strategies; (4) strategies to solve conflicts and to negotiate; and (5) strategies to establish coherent norms, limits and consequences to promote positive discipline. The study presents a discussion on these results from evidence-based parenting programs, as well as some strengths and limitations of the study, together with some suggestions for further research.