979 research outputs found

    Examining systemic and dispositional factors impacting historically disenfranchised schools across North Carolina

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    This mixed method sequential explanatory study provided analysis of North Carolina (NC) school leaders’ dispositions in eliminating opportunity gaps, outlined in NC’s strategic plan. The study’s quantitative phase used descriptive and correlation analysis of eight Likert subscales around four tenets of transformative leadership (Shields, 2011) and aspects of critical race theory (Bell, 1992; Ladson-Billings, 1998; Ladson-Billings & Tate, 2006) to understand systemic inequities and leadership attitudes. The qualitative phase comprised three analyses of education leadership dispositions and systemic factors in NC schools. The first analysis of State Board of Education meeting minutes from 2018–2023 quantified and analyzed utterances of racism and critical race, outlined the sociopolitical context of such utterances, and identified systemic patterns and state leader dispositions. The second analysis of five interviews of K–12 graduates identified persistent and systemic factors influencing NC education 3 decades after Brown v. Board of Education (1954) and within the context of Leandro v. State of NC (1997), where the NC Supreme Court recognized the state constitutional right for every student to access a “sound basic education.” The final qualitative analysis consisted of five interviews of current NC public school system leaders, for personal narratives of the state of NC schools compared to patterns from lived experiences of NC K–12 graduates. The study’s findings suggested NC school and state education leaders experience a racialized dichotomy between willingness for change (equity intentions) and execution of transformative action (practice). Although leaders at the board and school levels recognize the need for inclusivity and equity, a struggle to transcend systemic challenges, especially rooted in racial biases and power dynamics is evident. This study may identify leadership qualities needed for change in NC to address systemic inequities for improving educational access and inform policy to uphold all students’ constitutional right to a sound, basic education

    Journal of Early Hearing Detection and Intervention: Volume 8 Issue 1, pages 1-68

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    Optimising delivery of the Childsmile nursery supervised toothbrushing programme in Scotland

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    Background. Supervised toothbrushing in nurseries, delivered as a component of Childsmile, Scotland’s national oral health improvement programme for children, is associated with reduced caries experience and cost savings in prevented dental treatments. There is also evidence that it is effective in reducing oral health inequalities, with greater improvements in oral health observed among children living in the most deprived areas. However Childsmile process evaluation data indicate that the nursery supervised toothbrushing programme does not take place as intended in all nursery settings. This highlighted the need to undertake further research to optimise its delivery, to maximise the gains for children’s oral health and contribute to reducing oral health inequalities. Aims: The overarching aim of the research is to optimise delivery of the nursery supervised toothbrushing programme, which is achieved by: further developing its Theory of Change; assessing the fidelity of its implementation compared with the Theory of Change; identifying the barriers and facilitators to its implementation; and identifying implementation strategies to overcome those barriers. It is intended that findings will be fed back into the Childsmile programme to inform ongoing improvement of the nursery supervised toothbrushing programme component. Methods: The research was framed within the paradigm of pragmatism and utilised a mixed-methods approach, informed by a programme theory approach and implementation science methods, making it the first study of its kind to utilise this approach to investigate the implementation of a complex toothbrushing intervention delivered in educational settings. The researcher explicated the programme’s Theory of Change via documentary review, to identify its key components (the inputs, activities and outcomes); and qualitative interviews and focus groups with programme stakeholders, to discuss and agree the Theory of Change, which was depicted in a logic model. Using a mixed methods approach, the researcher undertook national, crosssectional surveys of nurseries, qualitative interviews with programme stakeholders and extracted data from ongoing Childsmile process evaluation, to assess fidelity of implementation and identify barriers and facilitators to delivery. Delivery-in-reality was assessed in comparison with the intended model (per the logic model developed in the previous stage of the research). The researcher used the Consolidated Framework for Implementation Research to categorise the barriers and facilitators identified and mapped these to the Expert Recommendations for Implementing Change compilation of implementation strategies to identify potential methods and techniques to overcome barriers to programme delivery. Results: This novel study identified that optimising the Childsmile nursery supervised toothbrushing programme requires a shared vision to be developed and strengthened among partners involved in its implementation, supported by developing a formal implementation blueprint and further work to increase nursery staff’s buy-in, such as local champions and enhanced training. The fidelity of programme delivery should continue to be monitored and evaluated using the methodology and logic model developed via this research. The inputs, activities and outcomes comprising the Theory of Change of the nursery supervised toothbrushing programme were specified, with consensus on those reached among programme stakeholders. This included stating the primary aim of the programme: 100% of children brush their teeth in nursery, every day they attend. However, national survey results showed that this target was not met, with 92% of eligible children brushing in nurseries on the day of the survey and variation in percentages of children brushing across geographical health boards. Nurseries with 100% toothbrushing rates were more likely to have fewer children attending, only have a single age group attending and were situated in certain geographical health board areas and not others. Using a mixed methods approach highlighted inconsistencies between these quantitative data on nurseries’ participation and qualitative findings on stakeholders’ perceptions about nurseries’ participation. There were variations between health boards in the extent to which delivery-in-reality matched what was intended. This included the content and frequency of training provided to nursery staff to support their delivery of the programme, with no standardised training package available nationally. Relationships between Childsmile teams and local authorities’ education departments were identified as important although these required careful management and communication. Barriers and facilitators influencing programme implementation before and during the Covid19 pandemic were identified and the Consolidated Framework for Implementation Research provided good coverage of these (encompassing all five domains and 14 out of 26 constructs associated with intervention implementation). Relevant constructs included: ‘Complexity’, in relation to fitting toothbrushing in to nursery routines and perceptions about it being too time-consuming; ‘Patient Needs and Resources’, in terms of children’s ability to perform the required actions as well as their reluctance to participate in toothbrushing instead of other available activities; and ‘External Policies and Incentives’, which related to the interpretation of early years policies which conflicted with directing children to participate in activities, including toothbrushing. An overarching theme related to the prioritisation of the nursery supervised toothbrushing programme by nursery staff, including the extent to which other activities were given precedence over it; and nursery staff’s willingness to accommodate toothbrushing flexibly within nursery schedules. The Covid-19 pandemic disrupted delivery of the programme due to nursery closures in 2020 and 2021, as well as creating additional pressures for nursery staff once establishments reopened. This affected the extent to which they engaged with efforts to restart the toothbrushing programme. Conclusions: This research has explicated the Theory of Change for Childsmile’s nursery supervised toothbrushing programme, from the perspective of programme stakeholders. There is scope for further specification of core, ‘essential’ programme components and adaptable, peripheral components, to identify an acceptable level of delivery which will allow progress towards outcomes. There are also opportunities to work with stakeholders from other organisations, aside from Childsmile, to identify changes to the Theory of Change to enhance its fit with their needs and priorities. In assessing the fidelity of programme implementation, it was found that aspects were delivered as intended; however, most logic model activities had components that were not being delivered with fidelity, including that less than 100% of children brushed their teeth every day they attended nursery. It was identified that the nursery context in which the programme is delivered was complex and fluctuating, with competing demands on nursery staff’s time. This indicated a need to accept that the programme has to fit within overall nursery provision, to ensure it is given enough priority. This requires identifying implementation strategies to find ways to help it fit alongside other priorities, including strategies to enhance engagement among nursery staff while taking their perspectives into account. A number of recommendations are made to support and optimise programme delivery going forward. These include supplementing the programme’s ongoing work in fostering relationships with partners with a focused communications campaign, targeted at stakeholders in individual nurseries and local authority education departments, which demonstrates how the programme fits within the wider nursery curriculum and its contribution to children’s health and wellbeing alongside information (tailored to stakeholders’ roles) that clarifies what is involved in programme delivery. It is also recommended that a knowledge exchange and support network should be established among nurseries, led by champions (invited to undertake this role among nursery staff with an interest in oral health working in nurseries identified to deliver the programme well) who support and mentor their peers to overcome challenges to delivering the toothbrushing programme. This could include enhanced training, tailored to individual nurseries’ needs, to provide practical solutions to overcome challenges encountered. To encourage participation among local authorities’ education departments and individual establishments’ head teachers and managers, it is recommended that further, supportive dialogue takes place between the Childsmile programme, the Scottish Government and local authority education departments

    Towards a Digital Capability Maturity Framework for Tertiary Institutions

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    Background: The Digital Capability (DC) of an Institution is the extent to which the institution's culture, policies, and infrastructure enable and support digital practices (Killen et al., 2017), and maturity is the continuous improvement of those capabilities. As technology continues to evolve, it is likely to give rise to constant changes in teaching and learning, potentially disrupting Tertiary Education Institutions (TEIs) and making existing organisational models less effective. An institution’s ability to adapt to continuously changing technology depends on the change in culture and leadership decisions within the individual institutions. Change without structure leads to inefficiencies, evident across the Nigerian TEI landscape. These inefficiencies can be attributed mainly to a lack of clarity and agreement on a development structure. Objectives: This research aims to design a structure with a pathway to maturity, to support the continuous improvement of DC in TEIs in Nigeria and consequently improve the success of digital education programmes. Methods: I started by conducting a Systematic Literature Review (SLR) investigating the body of knowledge on DC, its composition, the relationship between its elements and their respective impact on the Maturity of TEIs. Findings from the review led me to investigate further the key roles instrumental in developing Digital Capability Maturity in Tertiary Institutions (DCMiTI). The results of these investigations formed the initial ideas and constructs upon which the proposed structure was built. I then explored a combination of quantitative and qualitative methods to substantiate the initial constructs and gain a deeper understanding of the relationships between elements/sub-elements. Next, I used triangulation as a vehicle to expand the validity of the findings by replicating the methods in a case study of TEIs in Nigeria. Finally, after using the validated constructs and knowledge base to propose a structure based on CMMI concepts, I conducted an expert panel workshop to test the model’s validity. Results: I consolidated the body of knowledge from the SLR into a universal classification of 10 elements, each comprising sub-elements. I also went on to propose a classification for DCMiTI. The elements/sub-elements in the classification indicate the success factors for digital maturity, which were also found to positively impact the ability to design, deploy and sustain digital education. These findings were confirmed in a UK University and triangulated in a case study of Northwest Nigeria. The case study confirmed the literature findings on the status of DCMiTI in Nigeria and provided sufficient evidence to suggest that a maturity structure would be a well-suited solution to supporting DCM in the region. I thus scoped, designed, and populated a domain-specific framework for DCMiTI, configured to support the educational landscape in Northwest Nigeria. Conclusion: The proposed DCMiTI framework enables TEIs to assess their maturity level across the various capability elements and reports on DCM as a whole. It provides guidance on the criteria that must be satisfied to achieve higher levels of digital maturity. The framework received expert validation, as domain experts agreed that the proposed Framework was well applicable to developing DCMiTI and would be a valuable tool to support TEIs in delivering successful digital education. Recommendations were made to engage in further iterations of testing by deploying the proposed framework for use in TEI to confirm the extent of its generalisability and acceptability

    Analysis and forecasting of asset quality, risk management and financial stability for the Greek banking system

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    The increase in non-performing loans (NPLs) during the financial crisis of 2008, which has been converted into a fiscal crisis, as well as the risk of a medium-term increase due to the COVID-19 pandemic has put into question the robustness of many banks and the financial stability of the whole sector. As far as the banking sector is concerned, the management of non-performing loans represents the most significant challenge as their stock reached unprecedented levels, with the deterioration in asset quality being widespread. Addressing the problem of non-performing loans with the assistance of credit risk modeling is important from both a micro and a macro-prudential perspective, since it would not only improve the financial soundness and the capital adequacy of the banking sector, but also free-up funds to be directed to other more productive sectors of the economy. This Thesis extends earlier research by employing a short-term monitoring system with the aim to forecast “failures” i.e. NPL creation. The creation of such a monitoring system allows the risk of a “failure” to change over time, measuring the likelihood of “failure” given the survival time and a set of explanatory variables. The application of Cox proportional hazards models and survival trees to forecast NPLs can be usefully employed in the Greek corporate sectors. The research aim of this thesis consists of two domains: The first aim is the investigation of the determinants that contribute to the NPLs formation. Two GAMLSS models are being tested, a linear GAMLSS model and a nonlinear semi-parametric GAMLSS model which includes smoothing functions that capture potential nonlinear relationships between the explanatory variables to model the parameters favorably. The explanatory variables of the models consist of credit risk variables, macroeconomic variables, bank-specific variables and supervisory and market variables, while the response variable is the non-performing loans. The second aim is to provide answers on whether proportional hazards Cox models and survival tree models can forecast NPLs of loans that are provided in specific corporate sectors in Greece by the use of the most granular data set of corporate borrowers. By evaluating a series of Cox models, a short-term monitoring system has been created with the aim to forecast “failures” i.e. NPL creation. The Cox proportional hazards regression models are incorporating time-to-event, involving a timeline, described by the survival function, indicating the probability that a loan becomes an NPL until time t. The time period counts from the origination of the loan until the “death” of the loan, i.e. its termination, incorporating an “in between” observation point. The event is when the loan is initially being “infected”, i.e. has become NPL. Regarding survival trees, the data set was divided into more subsets, which are easier to model separately and hence yield an improved overall performance. Such models are then beneficial to implement with different machine learning techniques. Predictors (or covariates) are defined as the sectors of the Greek economy and the model is fitted both for the whole sample and for the sample of early terminated loans. The Thesis is organized as follows: Chapter 1 - Introduction addresses the role of banks in financial intermediation, the evolution of credit risk and some issues regarding the Greek banking sector. Chapter 2 constitutes a literature review on research focused on improving the predictive performance of different credit risk assessment methods. Chapter 3 outlines the competitive conditions in the banking sector to demonstrate whether the increase in concentration had affected the competitive conditions in the Greek banking system. In Chapter 4, the funding and the liquidity conditions in the Greek banking sector are being addressed. Chapter 5 contains the selection of aggregate sample, results and analysis of GAMLSS models that have been used for determining NPLs. Chapter 6 provides an introduction to the granular database on Large Exposures, which is used for deriving the panel sample of corporate borrowers whereby models of forecasting and prediction are being employed. Chapter 7 contains the application of Cox models and decision trees, the estimation procedure, parameters, model fit, estimation results and empirical findings. Chapter 8 provides an evaluation and applicability of models as well as the implications for further research. Finally, a conclusion is provided by summarizing my contribution to the research community and my recommendations to the banking industr

    Uncovering the Myths of Shared Reading English Picture Books for Chinese Families: A Narrative Inquiry

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    This doctoral research explored the experiences of Chinese parents in parent-child shared reading on English picture books (EPBs). It was unique in its approach, taking the perspective and standpoint of the parents as the research stance, and was one of the few studies in the existing literature to do so. The Narrative Inquiry proposed by Polkinghorne (1995) was adopted to explore Chinese parents\u27 voices, especially the unspoken ones. The study aimed to learn from Chinese parents\u27 experiences, provided valuable insights into their reflections and expectations of their family literacy activities, and contributed to the limited research on English family literacy in the Chinese context. The findings of this study suggest that, in the current Chinese context, parent-child shared reading practices on EPBs were influenced by their beliefs about literacy, which were highly shaped by their own literacy experiences, as well as the socio-cultural environment, SES, and educational level in which they were situated. The results contributed to a better understanding of how Chinese parents explore their literacy beliefs to reflect their experience of the parent-child shared EPBs reading by making these activities unique, relevant, and meaningful. In addition, the study revealed that these parents showed open-mindedness and inclusiveness towards topics, such as language skills and pedagogical framework, related to shared reading and had a solid learning awareness and motivation to implement family literacy practices. However, the study also highlighted the deficiencies in their socialized family literacy support system. And the impact of the unregulated commercialized environment of education on their implementation of English family literacy activities. The study provided more background literature for future research on English family literacy in China and further insight into future exploration of parent-child shared reading on EPBs and English family literacy in the Chinese context

    Persons with autism and persons with ADHD : the need to understand and improve services for families in Malta

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    Persons diagnosed with autism, or Autism Spectrum Disorder (ASD) and/or Attention Deficit Hyperactivity Disorder (ADHD) are often reported to perform significantly low in overall wellbeing when compared to their neurotypical counterparts (van Heijst & Geurts, 2015; Meier et al., 2011). With active participation in society considered to be a key factor surrounding wellbeing (Askari et al., 2015), it comes as no surprise therefore that the reduced levels of involvement reported in areas such as social engagement, education, and leisure may be major contributors to this (Deserno et al, 2016). Over the years, Malta has made considerable shifts towards the recognition of certain rights when it comes to disability, although negative attitudes still exist, both from the general public, as well as professionals (Cardona, 2013). This study therefore sought to understand the experiences of those living with autism and/or ADHD in the local scenario, looking into how current support structures impact their livelihood. Using a mixed-method approach involving quantitative and qualitative data collection strategies, this study sought to highlight insider voices, attempting to ‘take stock’ of the status of the evidence base, listening to the voices of those concerned and their experiences with local services and within the wider local community as a whole, identifying any gaps in services or data along the way. The findings of this study indicate that locally, persons living with autism and/or ADHD, encounter challenges throughout their development from children into adulthood which considerably impact their performance and consequently their wellbeing. A number of areas for development were identified. The services surrounding the attainment of a diagnosis for instance, were found to be typically carried out professionally in the case of those flagged at early years, however, were severely lacking when it came to adults. Moreover, a vast majority (80%) of adult service user participants in the study had received their diagnosis during adulthood, exposing a local picture where diagnoses are not being made early enough, leading to individuals facing foundation schooling and critical years without the necessary support. Although services users who are being diagnosed as adults may have faced a different situation when they were of school age, since these conditions were less known and there was less awareness, nevertheless, caregivers are still reporting that there are instances where they know that there is a condition but find it hard to access a diagnosis as they are told to wait until the child is older. Support services and referrals for treatment offered following diagnosis were also found to be severely lacking, with 91% of service user respondents and 6 82% of caregiver participants not having received any services or information after receiving their diagnosis. Encouraging achievements within the educational and employment realm were observed, however areas for improvement still remain, with finding indicating this may be more so the case for those living with autism. Levels of dissatisfaction with services were reported across large numbers of participants with the highest ranked dissatisfaction expressed towards how well services were connected amongst each other, followed by access to services following diagnosis. Several lamented long waiting lists, lack of trained professionals and infrequency and inconsistency across public services provided. In addition to this, over 70% of participants reported being dissatisfied with the prospects for lifelong fulfilment, accompanied by concerns about services not catering for different age groups, particularly adolescence and even more so adulthood. These findings were also echoed in data gathered from service providers, who in the larger part, shared that there were waiting lists associated with the provision of their services – in some cases, of even more than 13 months. A review of the services provided amongst participating service providers also reflected the critical reduction in services available for adults when compared to younger ages. Amongst service providers, the largest challenge in offering services both for ASD and ADHD was lack of trained professionals. These include a range of services, such as occupational therapy, speech therapy, behaviour specialists, health and educational services as well as social services, amongst others. Over the years, valuable developments have been achieved when it comes to Malta catering for the needs of all of its citizens, including those living with ADHD or ASD. The views and experiences discussed in this study have brought several commendations for milestones reached and have also highlighted several others that still need to be worked as a society towards. Ultimately, awareness and understanding across the different strata and branches of society is at the base of making these developments possible. The study concludes with a list of recommendations proposed for the enhanced wellbeing of those living with these conditions and society at large. These include, amongst others, recommendations for policy, such as the creation of a one-stop shop for provision of services, the introduction of quiet rooms in places such as hospitals and schools, the incentivising of youngsters to undertake studies related to disability in order to enrich the local pool of professionals, and the involvement of diagnosed individuals in decision-making processes. Recommendations for further research are also laid out, such as investigating gender differences related to ASD and ADHD, where females are typically underdiagnosed, or further examining the findings of this study by looking into ASD and ADHD separately to bring more insight into, for instance, findings related to the educational and employment attainments for these groupsnon peer-reviewe

    Behavior quantification as the missing link between fields: Tools for digital psychiatry and their role in the future of neurobiology

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    The great behavioral heterogeneity observed between individuals with the same psychiatric disorder and even within one individual over time complicates both clinical practice and biomedical research. However, modern technologies are an exciting opportunity to improve behavioral characterization. Existing psychiatry methods that are qualitative or unscalable, such as patient surveys or clinical interviews, can now be collected at a greater capacity and analyzed to produce new quantitative measures. Furthermore, recent capabilities for continuous collection of passive sensor streams, such as phone GPS or smartwatch accelerometer, open avenues of novel questioning that were previously entirely unrealistic. Their temporally dense nature enables a cohesive study of real-time neural and behavioral signals. To develop comprehensive neurobiological models of psychiatric disease, it will be critical to first develop strong methods for behavioral quantification. There is huge potential in what can theoretically be captured by current technologies, but this in itself presents a large computational challenge -- one that will necessitate new data processing tools, new machine learning techniques, and ultimately a shift in how interdisciplinary work is conducted. In my thesis, I detail research projects that take different perspectives on digital psychiatry, subsequently tying ideas together with a concluding discussion on the future of the field. I also provide software infrastructure where relevant, with extensive documentation. Major contributions include scientific arguments and proof of concept results for daily free-form audio journals as an underappreciated psychiatry research datatype, as well as novel stability theorems and pilot empirical success for a proposed multi-area recurrent neural network architecture.Comment: PhD thesis cop
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