899 resultados para Willingness-to-pay


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On formal credit markets, access to formal credit and reasonable credit terms of smallholder farmers
in rural sub-Saharan Africa is limited due to adverse selection. Financial institutions operating in
rural areas often cannot distinguish between borrowers (farmers) that are creditworthy and those that
are not, thus, allocate limited resource to agriculture to reduce credit risk. In the presence of limited business quality signaling by smallholder farmers, financial institutions shall demand for collateral and/or offer unfavorable contract terms. Moreover, agricultural productivity of rural sub-Saharan
Africa, dominated by subsistence or small-scale farmers, is also negatively impacted by the adverse
effect of climate change. A strategy that may make the farming practices of smallholder farmer’s
climate resilient and profitable may also improve smallholder farmer's access to formal credit. This
study investigates to what extent participating in ecosystem and extension services (EES) programs
signals business quality of smallholders, thus granting them credit accessibility. We collected data
on 210 smallholder farmers in 2013, comprising farmers that receive payments for ecosystem
services (PES) and farm management training from the International Small Group Tree Planting
Program (TIST) Kenya to test the aforementioned theory empirically. We use game theory,
particularly a screening and sorting model, to illustrate the prospects for farmers with EES to access
formal credit and to improve their credit terms given that they receive PES and banking services
training. Furthermore, the PES’ long term duration (10 – 30 years) generates stable cash-flow which
may be perceived as collateral substitute. Results suggest that smallholder farmers in the TIST
program were less likely to be credit constraint compared to non-TIST farmers. Distance to market,
education, livestock and farm income are factors that determine access to credit from microfinance
institutions in rural Kenya. Amongst farmers that have obtained loans, those keeping business records
enjoy more favorable formal credit conditions. These farmers were observed to pay ca. 5 percent less
interest rate in microfinance charges. For TIST farmers, this type of farm management practices may
be attributed to the banking services and other training they receive within the program. While the
availability of classical collateral (farmlands) and PES may reduce interest rate, the latter was found
to be statistically insignificant. This research underlines the importance of an effective extension
services in rural areas of developing countries and the need to improve gains from conservation
agriculture and ensuing PES. The benefits associated with EES and PES may encompass agricultural
financing.

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Since 11 September 2001, the religious dimension of conflict has been the focus of increasing attention. In The Clash of Civilizations, Huntington has identified the West in religious-cultural terms, as Christian with a dominant democratic culture emphasizing tolerance, moderation and consensus. The persistence of conflict in Northern Ireland among 'White' Protestant and Catholic Christians undermines this simplistic argument and demands a more subtle understanding of the role of religion and fundamentalism in contemporary conflict. Modernization theory - which is echoed among some theorists of globalization - had predicted the declining importance of religion as the world became industrialized and increasingly interconnected. This is echoed by those who argue that the Northern Ireland conflict is 'ethno-national' and dismiss the role of religion. On the other hand, others have claimed that the conflict is religious and stress the role of Protestant fundamentalism. This article draws on new evidence from Northern Ireland of the complex and subtle ways in which religion impacts on the conflict there, incorporating insights about the pragmatism of fundamentalist Protestants and how religious actors are contributing to conflict transformation. This analysis leads to three broader conclusions about understanding conflicts with religious dimensions. First, the complexity of religion must be understood, and this includes a willingness to recognize the adaptability of fundamentalisms to particular contexts. Second, engaging with fundamentalists and taking their grievances seriously opens up possibilities for conflict transformation. Third, governments and religious actors within civil society can play complementary roles in constructing alternative (religious) ideologies and structures as part of a process of transformation. In a world in which the impact of religion is persistent, engaging with the religious dimension is a vital part of a broader-based strategy for dealing with conflict. © 2008 Journal of Peace Research.

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Compassion is at the forefront of national and international healthcare policy, practice and educational debates as a result of a series of recent reports (Mid Staffordshire NHS Foundation Trust Inquiry, 2010, Lown et al 2011, Mannion, 2014). Arguably, this emphasis on compassion is in juxtaposition to an increasingly complex technological healthcare system focused upon outcomes, efficiency, productivity and competence. Within this fast paced and time pressured environment innovative strategies are required to cultivate and sustain compassion among healthcare professionals.

Understanding the person’s experience of illness and making an emotional connection are key processes in cultivating compassion (Dewar, 2013). The exponential growth in unsolicited patient narratives has the potential to provide invaluable insight into what matters to patients and their experience of illness. For many patients these stories ‘reclaim’ their illnesses from the traditional biomedical model of disease and reveal otherwise hidden aspects of their experience. The content though freely accessible, is however unedited and lacks safeguards in relation to the quality or accuracy of the information provided. Despite these concerns, healthcare professionals are now challenged to pay attention to these unsolicited patient stories and to consider how they can inform and improve patient care.

This paper discusses the use of online patient narratives in undergraduate nurse education to cultivate compassion. Critical analysis of online patient narratives is advocated as a potential educational strategy to cultivate compassion among future health care professionals.

References
Dewar,B. (2013) Cultivating compassionate care Nursing Standard 27, (34) 48-55

Lown B, Rosen J, Martilla J.(2011) An agenda for improving compassionate care: a survey shows about half of patients say such care is missing. Health Affairs (Millwood) 30, 1772–8.
Mannion,R. (2014) Enabling compassionate healthcare: perils, prospects and perspectives International Journal of Health Policy and Management 2, 115-7
Mid Staffordshire NHS Foundation Trust Inquiry (2010). Independent Inquiry into care provided by Mid Staffordshire NHS Foundation London: Stationery Office.

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A series of ‘traditional values’ resolutions, passed by the UN Human Rights Council in 2009, 2011, and 2012, were the result of a highly controversial initiative spearheaded by Russia. Do these ‘traditional values’ underpin human rights? If not, why are religious traditions or, indeed, any traditional values worth preserving at all? Why are they valuable from the point of view of adherents to that tradition? Should the larger society take into account the fact that a practice is based on tradition in deciding whether or not to override it in the name of human rights? Put more technically, in what does the normativity of tradition lie, for adherents and non-adherents of that tradition? These are the questions that this essay explores, in the context of the recent debates over the scope and meaning of human rights stimulated by the Human Rights Council Resolutions. Much of the support for the Resolutions comes from what can broadly be called the global South. In several books, particularly Human Rights, Southern Voices, and General Jurisprudence: Understanding Law from a Global Perspective William Twining has explored the question of how to reconcile human rights norms and belief systems embedded in the global South (including ‘traditional values’), and in doing so has drawn particular attention to intellectuals from that part of the world, in particular Francis Deng, Yash Ghai, Abdullahi An-Na’im, and Upendra Baxi. I suggest that those concerned to recognize the legitimate concerns that significant sections of the global South have about the human rights project, concerns reflected in the ‘traditional values’ Resolutions would do well to pay more attention to the ‘Southern voices’ on whom Twining rightly focuses attention.

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Using the contingent valuation method, this study investigates the preferences of local people for a wind farm that is planned in the Province of Rome. We estimate the reductions in their bimonthly electrical bills over a period of time that respondents are willing to accept as compensation for the installation of the wind farm. Our results suggest that respondents who perceive that the wind farm generates substantial negative impacts on landscape beauty ask higher reductions than others, while respondents who believe that the wind farm produces economic benefits for local communities ask lower reductions than others. Finally, we find that the demand for compensative measures is influenced particularly by socio-economic factors such as age and education.

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The continued use of traditional lecturing across Higher Education as the main teaching and learning approach in many disciplines must be challenged. An increasing number of studies suggest that this approach, compared to more active learning methods, is the least effective. In counterargument, the use of traditional lectures are often justified as necessary given a large student population. By analysing the implementation of a web based broadcasting approach which replaced the traditional lecture within a programming-based module, and thereby removed the student population rationale, it was hoped that the student learning experience would become more active and ultimately enhance learning on the module. The implemented model replaces the traditional approach of students attending an on-campus lecture theatre with a web-based live broadcast approach that focuses on students being active learners rather than passive recipients. Students ‘attend’ by viewing a live broadcast of the lecturer, presented as a talking head, and the lecturer’s desktop, via a web browser. Video and audio communication is primarily from tutor to students, with text-based comments used to provide communication from students to tutor. This approach promotes active learning by allowing student to perform activities on their own computer rather than the passive viewing and listening common encountered in large lecture classes. By analysing this approach over two years (n = 234 students) results indicate that 89.6% of students rated the approach as offering a highly positive learning experience. Comparing student performance across three academic years also indicates a positive change. A small data analytic analysis was conducted into student participation levels and suggests that the student cohort's willingness to engage with the broadcast lectures material is high.

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Objective: To understand the knowledge and attitudes of rural Chinese physicians, patients, and village health workers (VHWs) toward diabetic eye disease and glaucoma. Methods: Focus groups for each of the 3 stakeholders were conducted in 3 counties (9 groups). The focus groups were recorded, transcribed, and coded using specialized software. Responses to questions about barriers to compliance and interventions to remove these barriers were also ranked and scored. Results: Among 22 physicians, 23 patients, and 25 VHWs, knowledge about diabetic eye disease was generally good, but physicians and patients understood glaucoma only as an acutely symptomatic disease of relatively low prevalence. Physicians did not favor routine pupillary dilation to detect asymptomatic disease, expressing concerns about workflow and danger and inconvenience to patients. Providers believed that cost was the main barrier to patient compliance, whereas patients ranked poorly trained physicians as more important. All 3 stakeholder groups ranked financial interventions to improve compliance (eg, direct payment, lotteries, and contracts) low and preferred patient education and telephone contact by nurses. All the groups somewhat doubted the ability of VHWs to screen for eye disease accurately, but patients were generally willing to pay for VHW screening. The VHWs were uncertain about the value of eye care training but might accept it if accompanied by equipment. They did not rank payment for screening services as important. Conclusions: Misconceptions about glaucoma's asymptomatic nature and an unwillingness to routinely examine asymptomatic patients must be addressed in training programs. Home contact by nurses and patient education may be the most appropriate interventions to improve compliance.

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PURPOSE: To assess determinants of spectacle acceptance and use among rural Chinese children. METHODS: Children with uncorrected acuity < or = 6/12 in either eye and whose presenting vision could be improved > or = 2 lines with refraction were identified from a school-based sample of 1892 students. Information on obtaining glasses and the benefits of spectacles was provided to children, families, and teachers. Purchase of new spectacles and reasons for nonpurchase were assessed by direct inspection and interview 3 months later. RESULTS: Among 674 (35.6%) children requiring spectacles (mean age, 14.7 +/- 0.8 years), 597 (88.6%) were followed up. Among 339 children with no glasses at baseline, 30.7% purchased spectacles, whereas 43.2% of 258 children with inaccurate glasses replaced them. Most (70%) subjects paid US$13 to $26. Among children with bilateral vision < or = 6/18, 45.6% bought glasses. In multivariate models, presenting vision < 6/12 (P < 0.009), refractive error < -2.0 D (P < 0.001), and amount willing to pay for glasses (P = 0.01) were predictors of purchase. Reasons for nonpurchase included satisfaction with current vision (78% of those with glasses at baseline, 49% of those without), concerns over price or parental refusal (18%), and fear glasses would weaken the eyes (13%). Only 26% of children stated that they usually wore their new glasses. CONCLUSIONS: Many families in rural China will pay for glasses, though spectacle acceptance was < 50%, even among children with poor vision. Acceptance could be improved by price reduction, education showing that glasses will not harm the eyes, and parent-focused interventions.

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AIM: To study patient sources of knowledge about cataract surgical services, and strategies for financing surgery in rural China. DESIGN: Cross-sectional case series. METHODS: Patients undergoing cataract surgery by local surgeons in a government, village-level facility in Sanrao, Guangdong between 8 August and 31 December 2005 were examined and had standardised interviews an average of 12 months after surgery. RESULTS: Of 313 eligible patients, 239 (76%) completed the questionnaire. Subjects had a mean (SD) age of 69.9 (10.2) years, 36.4% (87/239) were male, and 87.0% (208/239) had been blind (presenting visual acuity < or = 6/60) before surgery. Word-of-mouth advertising was particularly important: 198 (85.0%) of the subjects knew a person who had undergone cataract surgery, of whom 191 (96.5%) had had cataract surgery at Sanrao itself. Over 70% of subjects (166/239) watched TV daily, whereas 80.0% (188/239) "never" read the newspaper. Nearly two-thirds of suggestions from participants (n = 211, 59.6%) favoured either TV advertisements or word-of-mouth to publicise the programme. While the son or daughter had paid for surgery in over 70% of cases (164/233), the patient's having paid without help was the sole predictor of undergoing second-eye surgery (OR 2.27 (95% CI 1.01 to 5.0, p = 0.04)). DISCUSSION: Strategies to increase uptake of cataract surgery in rural China may benefit from enhancing word-of-mouth advertising (such as with pseudophakic motivators), using television advertising where affordable, and micro-credit or other programmes to enable patients to pay their own fees, thus increasing uptake of second-eye surgery.

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BACKGROUND: To evaluate cataract surgical outcomes in four rural districts of Ha Tinh Province, Vietnam. DESIGN: Cross-sectional study. PARTICIPANTS: Post-cataract surgery patients sampled randomly from facilities in four rural districts of Ha Tinh Province >3 months after surgery. MAIN OUTCOME MEASURES: Postoperative visual acuity (VA), visual function and quality of life. RESULTS: Among 412 patients, the mean age was 74.5 ± 9.4 years, 67% (276) were female, and 377 (91.5%) received intraocular lenses (IOL). Nearly two-thirds of patients had no postoperative visits after discharge. Postoperatively, more than 40% of eyes had presenting VA <6/18, while 20% remained <6/60. The mean self-reported visual function and quality of life for all patients were 68.7 ± 23.8 and 73.8 ± 21.6, respectively. Most patients (89.5%) were satisfied with surgery and the majority (94.4%) would recommend surgery to others. One-third of patients paid ≥$US50 for surgery. In multiple regression modelling, older age (P < 0.01), intraoperative complications (P < 0.01) and failure to receive an IOL (P < 0.01) were associated with postoperative VA <6/60. CONCLUSION: Satisfaction with surgery was high, and many patients were willing to pay for their operations. Poor visual outcomes were common; however, and better surgical training is needed to reduce complications and their impact on visual outcomes. More intensive postoperative follow-up may also be beneficial. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

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Background: Cachexia has been defined as an on-going loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support. It can be found in up to 80% of patients with advanced cancer and has profound psycho-social consequences for patients and their families. There is a paucity of studies examining the role and experience of healthcare professionals in relation to cachexia and existing studies suggest that professional staff have limited understanding and do not intervene effectively.
Aim: To identify barriers and facilitators to good practice in cachexia care in order to inform future developments in service provision.
Design: An exploratory qualitative study was conducted employing semi-structured interviews with a range of healthcare professionals recruited purposefully from an Australian hospital. Interviews were conducted in private rooms within the hospital.
Setting/participants: A range of healthcare professionals responsible for cancer care were recruited from a large Australian teaching hospital.
Results: Interviews were conducted with 8 healthcare professionals responsible for delivering cancer care. Four themes were identified: formal and informal education, knowledge and understanding, truth telling in cachexia and palliative care, and, a multi-disciplinary approach. Findings show how improved knowledge and understanding across a staff body can lead to improved staff confidence and a willingness to address cancer cachexia and its consequences with patients and their families.
Conclusion: Comparison with previous studies illustrates the importance of improving knowledge and understanding about cachexia and how this can contribute to staff having the skills and experience necessary to address cachexia and provide an improved care experience for patients and carers.

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Willingness to lay down one’s life for a group of non-kin, well documented in the
historical and ethnographic records, represents an evolutionary puzzle. Here we
present a novel explanation for the willingness to fight and die for a group, combining evolutionary theorizing with empirical evidence from real-world human groups. Building on research in social psychology, we develop a mathematical model showing how conditioning cooperation on previous shared experience can allow extreme (i.e., life-threatening) pro-social behavior to evolve. The model generates a series of predictions that we then test empirically in a range of special sample populations (including military veterans, college fraternity/sorority members, football fans, martial arts practitioners, and twins). Our results show that sharing painful experiences produces “identity fusion” – a visceral sense of oneness – more so even than bonds of kinship, in turn motivating extreme pro-group behavior, including willingness to fight and die for the group. These findings have theoretical and practical relevance. Theoretically, our results speak to the origins of human cooperation, as we offer an explanation of extremely costly actions left unexplained by existing models.
Practically, our account of how shared dysphoric experiences produce identity fusion, which produces a willingness to fight and die for a non-kin group, helps us better understand such pressing social issues as suicide terrorism, holy wars, sectarian violence, gang-related violence, and other forms of intergroup conflict.

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Relatório de estágio para a obtenção do grau de Mestre em educação pré-escolar e em ensino do 1.º ciclo do ensino básico

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A presente dissertação teve como linha de rumo a questão de partida: De que forma é que a existência de ambientes de aprendizagem não formal e informal no território/comunidade pode enquadrar e reforçar as aprendizagens formais e a relação com a escola? Através duma abordagem teórica que inclui uma revisão bibliográfica e a análise de normativos legais que abordam e regulamentam a área em que decorre o nosso estudo, procurámos dar resposta aos seguintes objectivos: a) efectuar a cartografia institucional do território educativo do Agrupamento de Escolas nº4 de Évora; b) conhecer o potencial educativo existente nas associações e instituições localizadas no território; c) identificar instituições que possibilitem novas ofertas educativas e possam promover e potenciar o sucesso educativo, d) avaliar a oferta local de ambientes de aprendizagem e a sua disponibilidade para a promoção de parcerias educativas. Ao nível do estudo empírico e como forma de dar resposta às questões da investigação, optámos por uma metodologia mista (quantitativa/qualitativa), numa aproximação conceptual ao estudo de caso, tendo recorrido ao inquérito por questionário, aplicado como técnica de recolha de dados. Após a apresentação dos dados disponíveis, sua análise e interpretação, apurámos as seguintes conclusões: a) as instituições objecto do nosso estudo constituem um recurso do qual este Agrupamento não pode prescindir para a prossecução da sua acção educativa; b) estas instituições desenvolvem no seu seio uma considerável quantidade de actividades que envolvem aprendizagens; c) estas instituições estão receptivas à promoção de parcerias com o Agrupamento; d) estas instituições, pela área de actividade desenvolvida e pelo desenvolvimento de actividades com aprendizagem, podem potenciar novas ofertas educativas; e) estão reunidas as condições, nesta comunidade educativa, para a construção duma Carta Educativa de Agrupamento envolvendo todos os ambientes de aprendizagem disponíveis. No final da nossa dissertação expressámos as recomendações e sugestões que possam potenciar futuras investigações ABSTRACT; The following dissertation had, has a basis, the starting question (How can the existence of formal and informal environments in the territory/community regulate and reinforce the formal apprenticeships and the relationship with the school?). Through a theoretical approach and bibliographical and an analysis of legislation concerning to the area of our study we have tried to answer to the following objectives: a) create an institutional map of the educative territory of 4th Group of Schools of Évora) understand the educational potential of the institutions and associations in the territory; c) identify the institutions that may offer new educational offers that promote and may increase the educational success and d) evaluate the local offer of apprenticeship environments and their willingness to promote educational partnerships. ln terms of empirical study and as a way to answer the questions of our investigation we have opted to use a mixed quantitative/qualitative methodology in a conceptual approach to the case study having used a survey by questionnaire which was used as a technique for data collection. After the presentation of the available data, we have analyzed and interpreted it and got to the following conclusions: a) the institutions that we have studied are a resource that our Group of Schools must use to fulfill its educational action; b) these institutions create inside themselves a considerable amount of activities that involve apprenticeships; c) these institutions are receptive to the creation of partnerships with the group; d) these institutions may create new educational offers because of their activity area and their development of apprenticeship activities; e) there are conditions, in this educational community for the creation of a real Educational Chart for the 4th Group of Schools concerning all the learning environments. At the end of our dissertation we express our recommendations and suggestions that may help in future investigations

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A Formação Continuada de Professores de Ciências assume-se como uma via capaz de ajudar os alunos a desenvolver competências, como as de resolução de problemas. Nesta perspetiva, a Educação em Ciências deve visar o desenvolvimento de cidadãos cada vez mais participativos, responsáveis, capazes de tomar decisões conscientes, exigindo-se o desenvolvimento da literacia científica como uma meta a alcançar pelas escolas. Uma das estratégias considerada como potenciadora do desenvolvimento de tais competências é o trabalho experimental desenvolvido com os alunos, durante as aulas de Ciências de 2.º CEB. Neste contexto, desenvolveu-se um Programa de Formação Continuada de Professores em Ensino Experimental das Ciências no 2.º CEB, procurando-se avaliar o seu impacte nas conceções e práticas de índole experimental de quatro professores. Assim, formularam-se as seguintes questões de investigação: Qual o impacte do Programa de Formação para uma Educação em Ciências de base experimental: a) na (re)construção das conceções dos professores do 2.º CEB acerca do Trabalho Experimental?; b) e na promoção intencional, por parte dos professores envolvidos, de práticas didático-pedagógicas de base experimental no 2.º CEB? De forma a dar resposta às questões formuladas, desenvolveu-se uma investigação de natureza qualitativa, que pretendeu contribuir para a compreensão da relação entre a formação continuada de professores e as conceções e práticas de índole experimental desenvolvidas na disciplina de Ciências da Natureza, do 2.º CEB. O planeamento escolhido foi o de estudo de caso com quatro professoras participantes na formação continuada, tendo-se recorrido a várias técnicas e instrumentos de recolha e análise de dados. Para a caraterização das conceções das professoras sobre trabalho experimental foi utilizada a entrevista semi-estruturada, o Diário do Investigador e as transcrições das aulas destas professoras, bem como a reflexão oral nas sessões de acompanhamento com a Formadora. Este último instrumento também foi usado para a caracterização das práticas das professoras, assim como o Instrumento de Caraterização das Práticas Didático-Pedagógicas de índole experimental, desenvolvido para o presente estudo. Utilizou-se ainda um Questionário de Avaliação do Programa de Formação e os Portefólios das quatro professoras do estudo, para se obter a avaliação destas docentes acerca do Programa de Formação frequentado. Os resultados parecem indicar que, antes do Programa de Formação, apenas a Professora D apresentava conceções acerca de trabalho experimental, em sintonia com a perspetiva defendida na revisão de literatura. Após o Programa de Formação as quatro professoras revelaram conceções mais realistas acerca de trabalho experimental. Relativamente às práticas de índole experimental, antes do Programa de Formação, nenhuma das professoras colaboradoras do estudo implementava esta estratégia com os alunos. Após o Programa de Formação, todas as docentes passaram a contemplar nas suas práticas o trabalho experimental. De uma maneira geral, no que concerne à avaliação do Programa de Formação, as quatro docentes consideram que este teve impacte quer nas suas conceções quer nas suas práticas de índole experimental, destacando a importância do contributo das sessões de acompanhamento em sala de aula, com a Formadora, para a implementação efetiva do trabalho experimental nas suas práticas. A partir dos resultados obtidos, concluiu-se que o Programa de Formação contribuiu para que as quatro professoras colaboradoras do estudo (re) construíssem as suas conceções sobre trabalho experimental e para que o privilegiassem efetivamente nas suas aulas. O presente estudo visou contribuir para o desenvolvimento da formação de professores em ensino experimental das ciências, no que respeita à clarificação de conceções sobre o trabalho experimental e sua implementação efetiva com os alunos, dando-lhes autonomia e apelando ao desenvolvimento das suas capacidades de pensamento, relacionadas, por exemplo, com a identificação e controlo de variáveis.