Family social support, community “social capital” and adolescents’ mental health and educational outcomes: a longitudinal study in England

Purpose To examine the associations between family social support, community “social capital” and mental health and educational outcomes. Methods The data come from the Longitudinal Study of Young People in England, a multi-stage stratified nationally representative random sample. Family social support (parental relationships, evening meal with family, parental surveillance) and community social capital (parental involvement at school, sociability, involvement in activities outside the home) were measured at baseline (age 13–14), using a variety of instruments. Mental health was measured at age 14–15 (GHQ-12). Educational achievement was measured at age 15–16 by achievement at the General Certificate of Secondary Education. Results After adjustments, good paternal (OR = 0.70, 95% CI 0.56–0.86) and maternal (OR = 0.65, 95% CI 0.53–0.81) relationships, high parental surveillance (OR = 0.81, 95% CI 0.69–0.94) and frequency of evening meal with family (6 or 7 times a week: OR = 0.77, 95% CI 0.61–0.96) were associated with lower odds of poor mental health. A good paternal relationship (OR = 1.27, 95% CI 1.06–1.51), high parental surveillance (OR = 1.37, 95% CI 1.20–1.58), high frequency of evening meal with family (OR = 1.64, 95% CI 1.33–2.03) high involvement in extra-curricular activities (OR = 2.57, 95% CI 2.11–3.13) and parental involvement at school (OR = 1.60, 95% CI 1.37–1.87) were associated with higher odds of reaching the educational benchmark. Participating in non-directed activities was associated with lower odds of reaching the benchmark (OR = 0.79, 95% CI 0.70–0.89). Conclusions Building social capital in deprived communities may be one way in which both mental health and educational outcomes could be improved. In particular, there is a need to focus on the family as a provider of support

La estrategia Educativa 2020 o las limitaciones del Banco Mundial para promover el "aprendizaje para todos"

La nueva Estrategia Educativa 2020 del Banco Mundial establece las prioridades de reforma educativa en paises en vias de desarrollo para la decada siguiente. El titulo explicito de la estrategia, Aprendizaje para Todos, es un claro reconocimiento de que, mas alla de politicas centradas en el acceso, se debe hacer algo mas para asegurar que la educacion derive en experiencias positivas de aprendizaje. Sin embargo, como este articulo sostiene, las opciones de politicas explicitas y latentes en la Estrategia 2020 no son las mas adecuadas para lograr el Aprendizaje para Todos. El articulo desarrolla tres tipos de argumentos al respecto. El primero se refiere al fuerte apego del Banco a un conocimiento disciplinario y un enfoque metodológico que es insufi ciente para entender lo que aprenden los niños en la escuela y por que. El segundo argumento se refiere al sesgo pro-mercado de la Estrategia por lo que respecta a la reforma del sector publico y a nuevas formas de oferta educativa. En tercer lugar, el articulo senala las principales ausencias de la Estrategia, con especial atencion a las omisiones relacionadas con la compleja relación entre educación y pobreza.The World Bank's 2020 Education Strategy establishes the new education priorities in developing countries for the next decade. Its title, Learning for All, clearly recognizes that, beyond policies focusing on access, something else must be done to ensure that schooling involves positive learning experiences. However, as this paper argues, the 2020 Strategy explicit and latent policy options might not be adequate to achieve Learning for All. This paper develops three arguments on that matter. The fi rst one refers to the Bank's strong attachment to a disciplinary knowledge and a methodological approach that do not suffi ce to understand what children learn at school and why. The second one addresses its pro-market bias when it approaches the public sector reforms and the new forms of providing education. The last argument points out the main omissions of this Strategy, especially in what regards the complex relation between education and poverty

When Incentives Work too well: Locally Implemented Pay for Performance (P4P) and Adverse Sanctions towards Home Birth in Tanzania - A Qualitative Study.

Despite limited evidence of its effectiveness, performance-based payments (P4P) are seen by leading policymakers as a potential solution to the slow progress in reaching Millennium Development Goal 5: improved maternal health. This paper offers insights into two of the aspects that are lacking in the current literature on P4P, namely what strategies health workers employ to reach set targets, and how the intervention plays out when implemented by local government as part of a national programme that does not receive donor funding. A total of 28 in-depth interviews (IDIs) with 25 individuals were conducted in Mvomero district over a period of 15 months in 2010 and 2011, both before and after P4P payments. Seven facilities, including six dispensaries and one health centre, were covered. Informants included 17 nurses, three clinical officers, two medical attendants, one lab technician and two district health administrators. Health workers reported a number of strategies to increase the number of deliveries at their facility, including health education and cooperation with traditional health providers. The staff at all facilities also reported that they had told the women that they would be sanctioned if they gave birth at home, such as being fined or denied clinical cards and/or vaccinations for their babies. There is a great uncertainty in relation to the potential health impacts of the behavioural changes that have come with P4P, as the reported strategies may increase the numbers, but not necessarily the quality. Contrary to the design of the P4P programme, payments were not based on performance. We argue that this was due in part to a lack of resources within the District Administration, and in part as a result of egalitarian fairness principles. Our results suggest that particular attention should be paid to adverse effects when using external rewards for improved health outcomes, and secondly, that P4P may take on a different form when implemented by local implementers without the assistance of professional P4P specialists

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Vocationalizing education : an international perspective

Meeting: Vocationalization of Education, 1986, London, G