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    Student enrollment data identified that Black students are learners in suburban schools. Data revealed that the academic achievement gap between Black and White students has been persistent in suburban schools. Effective central office leadership is essential to ensuring optimal student outcomes, which includes addressing racial academic achievement gaps. This case study explored central office leadership practices supporting a suburban high school that had documented academic achievement gaps between Black and White students. A single exploratory case study methodology was implemented to conduct this study. To ensure confidence in the study, the between-methods triangulation process of key informant interviews, direct observations, and document reviews was utilized. The data analysis phase consisted of transcribing and coding the data that were collected. The grouping of the codes led to the development of the broader categories of themes for answering the research questions. Findings indicated that central office leaders practiced top-down development strategies, engaged in joint work to gain buy-in and divide responsibilities, and inquired about school needs to facilitate solutions. The perceived strengths of central office practices were developing, brokering, and facilitating systemic solutions and academic supports. The perceived weaknesses of central office practices were the omission of explicit reference to the racial achievement gap between Black and White students in district and school level goals and strategies. Another factor that was perceived likely to have a negative impact on studentsā€™ academic achievement was inadequate attention to their social-emotional development combined with the overall well-being of teachers.Ed.D.EducationUniversity of Michigan-Flinthttps://deepblue.lib.umich.edu/bitstream/2027.42/156053/1/KennedyRogers2020.pdfDescription of KennedyRogers2020.pdf : thesi

    Drone Chic

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    Policy Recommendations: Within the UK there is currently a bias depicting drones as precise, clean and value free. Our recommendations question this. 1) Precision is a 'myth': We need to stop deceiving ourselves that progress is being made and costs are being avoided through precision. War is never cost-free. But it appears to be in most accounts of contemporary conflict. We term this 'Drone Chic'. The stories we tell ourselves deceive us. 2) No strategy: Drones are tactical devices and cannot substitute for an overarching and coherent national strategy. Yet we ignore the primacy of the tactical and celebrate false 'victories' through simply 'proportionate and discriminate' means. A form of Moralism has replaced Politics. 3) The Victims: It is not just 'death' on the receiving end of the drone that demands attention. There are profound consequences for those living under the ever present and seemingly omnipotent machines hovering in the sky above. Drones are, we believe, 'disheartening'. They change cultural practices and cause psychological damage. 4) 'Where are the women?': More investigation is needed as to the gendered effects of drones and drone killing on the ground. What are the hard socioeconomic implications for families when the men are killed? What are the psychological implications for those who witness drone strikes? Can the rise in female suicide rates in places such as Afghanistan be attributed in part to an increase in drone strikes? 5) The Veterans: One of the important 'stories' we are told about drones is that they are accurate and precise. Yet the mounting evidence points, on numerous occasions, in 'precisely' the opposite direction. Do drone pilots 'suffer' trauma and PTSD from their duties? 6) Future concerns: As drones continue to proliferate into the hands of both state and non-state actors, we must realize that drones can be used in a multitude of ways which may compromise our safety

    Long-term condition self-management support in online communities. A meta-synthesis of qualitative papers

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    Background: Recent years have seen an exponential increase in people with a long-term condition (LTC) using the internet for information and support. Prior research has examined support for LTC self-management (SM) through the provision of illness, every day and emotional work in the context of traditional offline communities. However, less is known about how communities hosted in digital spaces contribute through the creation of social ties and the mobilisation of an online illness ā€˜workforceā€™. Objectives: To understand the negotiation of LTC illness work in patient online communities and how such work may assist the SM of LTCs in daily life. Methods: A systematic search of qualitative papers was undertaken using AMED, CINAHL, Cochrane Database, Delphis, Embase, International Bibliography of Social Sciences, Medline, PsychInfo, Scopus, Sociological Abstracts and Web of Science for papers published since 2004. 21 papers met the inclusion criteria of using qualitative methods and examined the use of peer-led online communities in those with a LTC. A qualitative meta-synthesis was undertaken and the review followed a line of argument synthesis. Results: The main themes identified in relation to the negotiation of Self-Management Support (SMS) were: 1) Redressing offline experiential information and knowledge deficits; 2) The influence of modelling and learning behaviours from others on SM; 3) Engagement which validates illness and negates offline frustrations; 4) Tie formation and community building; 5) Narrative expression and cathartic release; 6) Dissociative anonymity and invisibility. These translated into a line of argument synthesis in which four network mechanisms for SMS in patient online communities were identified. These were collective knowledge and identification through lived experience; support, information and engagement through readily accessible gifting relationships; sociability that extends beyond illness; and online disinhibition as a facilitator in the negotiation of SMS. Conclusion: Social ties forged in online spaces provide the bases for performing relevant SM work that can improve an individualā€™s illness experience, tackling aspects of SM that are particularly difficult to meet offline. Membership of online groups can provide those living with a LTC with ready access to a SMS illness ā€˜workforceā€™ and illness and emotional support. The substitutability of offline illness work may be particularly important to those whose access to support offline is either limited or absent. Furthermore, such resources require little negotiation online, since information and support is seemingly gifted to the community by its members. <br/

    The UK and the Arctic: Forward defence

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    The United Kingdom (UK) is not an Arctic state, but over the past decade its policies towards the region have developed in significant ways. Since 2013 the British Government has published two Arctic Policy Frameworks, setting out commitments to working cooperatively with the Arctic states and other stakeholders to ensure that as climate change occurs the region remains peaceful. In 2019, the Ministry of Defence (MOD) committed to publishing an Arctic Defence Strategy, that would ā€œput the Arctic and the High North central to the security of the United Kingdomā€. This article examines the evolution of UK defence interests in the Arctic, whilst also highlighting the emergence of a significant Scottish dimension in UK Arctic affairs.</div

    Achieving change in primary careā€”causes of the evidence to practice gap : systematic reviews of reviews

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    Acknowledgements The Evidence to Practice Project (SPCR FR4 project number: 122) is funded by the National Institute of Health Research (NIHR) School for Primary Care Research (SPCR). KD is part-funded by the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Research and Care West Midlands and by a Knowledge Mobilisation Research Fellowship (KMRF-2014-03-002) from the NIHR. This paper presents independent research funded by the National Institute of Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Funding This study is funded by the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR).Peer reviewedPublisher PD

    Commissioning of self-management support for people with long-term conditions: an exploration of commissioning aspirations and processes

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    Objectives: To explore how self-management support (SMS) is considered and conceptualised by Clinical Commissioning Groups (CCGs) and whether this is reflected in strategic planning and commissioning. SMS is an essential element of long-term condition (LTC) management and CCGs are responsible for commissioning services that are coordinated, integrated and link into patient's everyday lives. This focus provides a good test and exemplar for how commissioners communicate with their local population to find out what they need.Design: A multisite, quasi-ethnographic exploration of 9 CCGs.Setting: National Health Service (NHS) CCGs in southern England, representing varied socioeconomic status, practice sizes and rural and urban areas.Data collection/analysis: Content analysis of CCG forward plans for mention of SMS. Semistructured interviews with commissioners (n=10) explored understanding of SMS and analysed thematically. The practice of commissioning explored through the observations of Service User Researchers (n=5) attending Governing Body meetings (n=10, 30?hours).Results: Observations illuminate the relative absence of SMS and gateways to active engagement with patient and public voices. Content analysis of plans point to tensions between local aspirations and those identified by NHS England for empowering patients by enhancing SMS services (ā€˜person-centredā€™, whole systems). Interview data highlight disparities in the process of translating the forward plans into practice. Commissioners reference SMS as a priority yet details of local initiatives are notably absent with austerity (cost-containment) and nationally measured biomedical outcomes taking precedence.Conclusions: Commissioners conceptualise locally sensitive SMS as a means to improve health and reduce service use, but structural and financial constraints result in prioritisation of nationally driven outcome measures and payments relating to biomedical targets. Ultimately, there is little evidence of local needs driving SMS in CCGs. CCGs need to focus more on early strategic planning of lay involvement to provide an avenue for genuine engagement, so that support can be provided for communities and individuals in a way people will engage with.<br/

    Metabolic Requirements of Farmers/Ranchers Performing Simulated Occupational Tasks: Recommendations for Cardiovascular Rehabilitation

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    Current ACSM guidelines for cardiac rehabilitation (rehab) return to work state that exercise training should mimic the muscle groups, movements, and energy systems utilized in a patientā€™s occupational tasks. The aims of this study were to evaluate the metabolic costs of typical farming/ranching tasks, determine the pattern of movement and muscle groups involved in these tasks, and determine the approximate duration of these tasks. Methods: Participants (n=29) were employed in the farming/ranching field and ranged in aged from 18-57 years. The participants performed four tasks: loading 10 hay bales, digging a fence post hole, filling eight seed hoppers, and shoveling grain. Results: Ranges for mean metabolic equivalent (MET) levels of the tasks were 5.9-7.6 while respiratory exchange ratio (RER) values ranged from .85-.93. Mean times (min:sec) for task duration were 1:42-3:34. Conclusion: MET levels recorded in this study are in agreement with the Compendium of Physical Activities for farming tasks and meet the standard requirements for cardiovascular training in cardiac rehab (~ 8 METS). However, these tasks are of high intensity and require an exercise prescription based on specificity of training for the muscle groups and energy systems involved. In accordance to ACSM guidelines, this study includes recommendations for exercise prescription specific to supervised resistance training appropriate for a farmer/rancher population in cardiac rehab settings

    Assessing the implementability of telehealth interventions for self-management support: a realist review.

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    BACKGROUND: There is a substantial and continually growing literature on the effectiveness and implementation of discrete telehealth interventions for health condition management. However, it is difficult to predict which technologies are likely to work and be used in practice. In this context, identifying the core mechanisms associated with successful telehealth implementation is relevant to consolidating the likely elements for ensuring a priori optimal design and deployment of telehealth interventions for supporting patients with long-term conditions (LTCs). METHODS: We adopted a two-stage realist synthesis approach to identify the core mechanisms underpinning telehealth interventions. In the second stage of the review, we tested inductively and refined our understanding of the mechanisms. We reviewed qualitative papers focused on COPD, heart failure, diabetes, and behaviours and complications associated with these conditions. The review included 15 papers published 2009 to 2014. RESULTS: Three concepts were identified, which suggested how telehealth worked to engage and support health-related work. Whether or not and how a telehealth intervention enables or limits the possibility for relationships with professionals and/or peers. Telehealth has the potential to reshape and extend existing relationships, acting as a partial substitute for the role of health professionals. The second concept is fit: successful telehealth interventions are those that can be well integrated into everyday life and health care routines and the need to be easy to use, compatible with patients' existing environment, skills, and capacity, and that do not significantly disrupt patients' lives and routines. The third concept is visibility: visualisation of symptoms and feedback has the capacity to improve knowledge, motivation, and a sense of empowerment; engage network members; and reinforce positive behaviour change, prompts for action and surveillance. CONCLUSIONS: Upfront consideration should be given to the mechanisms that are most likely to ensure the successful development and implementation of telehealth interventions. These include considerations about whether and how the telehealth intervention enables or limits the possibility for relationships with professionals and peers, how it fits with existing environment and capacities to self-manage, and visibility-enabling-enhanced awareness to self and others
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