4,728 research outputs found
Variations in amenable mortality--trends in 16 high-income nations.
BACKGROUND: There has been growing interest in the comparison of health system performance within and between countries, using a range of different indicators. This study examines trends in amenable mortality, as one measure of health system performance, in sixteen high-income countries. METHODS: Amenable mortality was defined as premature death from causes that should not occur in the presence of timely and effective health care. We analysed age-standardised rates of amenable mortality under age 75 in 16 countries for 1997/1998 and 2006/2007. RESULTS: Amenable mortality remains an important contributor to premature mortality in 16 high-income countries, accounting for 24% of deaths under age 75. Between 1997/1998 and 2006/2007, amenable mortality fell by between 20.5% in the US and 42.1% in Ireland (average decline: 31%). In 2007, amenable mortality in the US was almost twice that in France, which had the lowest levels. CONCLUSIONS: Amenable mortality continues to fall across high-income nations although the USA is lagging increasingly behind other high income countries. Despite its many limitations, amenable mortality remains a useful indicator to monitor progress of nations
How authentic should a learning context be? Using real and simulated profiles in a classroom intervention to improve safety on social network sites
With the rise of social network sites (SNSs), there is an increasing need for safety education within the current cyber society. To this end, a variety of educational materials have been developed to prepare children to be vigilant when interacting on such sites. However, little is known about the critical design aspects necessary to make these materials effective. In this study, we build on the results of two previous studies, in which we found that general instructional principles drawn from constructivism, such as collaborative learning, are not always appropriate to teach children how to behave safely online. This study therefore focuses on the importance of authentic learning and active learning as critical design features. A quasi-experimental study was conducted in secondary schools in order to compare the impact of two classroom interventions about the risks on SNSs. As part of the intervention, students were presented scaffolds towards different risks related to an SNS-profile through a series of questions. In the control condition, these questions concerned a simulated SNS-profile on paper containing signs of many risks. In the experimental condition, students had to answer the same questions about their own SNS-profile on a computer. It was hypothesized that the simulated profile would not be experienced as realistic, and that students would have difficulties identifying with it. On the other hand, teenagers were expected to be able to recognize more risks on the simulated âworst-case scenarioâ profile than on their own profile, which would facilitate the scaffolding process in the control condition. The results of the study mostly confirmed these hypotheses. Furthermore, the question arose as to whether the intervention based on the studentâs own rea listic profile was educationally more valuable than the intervention based on the simulated profile, but no such added value was found. On the contrary, the scaffolding questions about the simulated profile were found to be more effective in teaching the teenagers about the different categories of risks that were tackled. Based on these findings, the importance of an authentic setting was put into perspective. Within the context of a classroom intervention to promote safety on SNSs, the exercise based on the simulated SNS-profile is put forward as the more effective teaching strategy
On the Role of Mechanics in Chronic Lung Disease.
Progressive airflow obstruction is a classical hallmark of chronic lung disease, affecting more than one fourth of the adult population. As the disease progresses, the inner layer of the airway wall grows, folds inwards, and narrows the lumen. The critical failure conditions for airway folding have been studied intensely for idealized circular cross-sections. However, the role of airway branching during this process is unknown. Here, we show that the geometry of the bronchial tree plays a crucial role in chronic airway obstruction and that critical failure conditions vary significantly along a branching airway segment. We perform systematic parametric studies for varying airway cross-sections using a computational model for mucosal thickening based on the theory of finite growth. Our simulations indicate that smaller airways are at a higher risk of narrowing than larger airways and that regions away from a branch narrow more drastically than regions close to a branch. These results agree with clinical observations and could help explain the underlying mechanisms of progressive airway obstruction. Understanding growth-induced instabilities in constrained geometries has immediate biomedical applications beyond asthma and chronic bronchitis in the diagnostics and treatment of chronic gastritis, obstructive sleep apnea and breast cancer
Developing educational materials about risks on social network sites: a design based research approach
Nearly all of todayâs Western teenagers have a profile on a social network site (SNS). As many risks have been reported, researchers and governments have emphasized the role of school education to teach teenagers how to deal safely with SNSs. However, little is known about the specific characteristics which would make interventions effective. Therefore, the overall objective of this research aims to propose a list of validated theoretical design principles for future development of educational materials about risks on SNSs. This research goal was pursued through a design-based research procedure. Thereby targeting teenagers of secondary education in 8 separate studies, the different steps of the design-based research procedure have iteratively been completed. Firstly, a problem analysis was executed through 3 explorative studies, including an observational study, a theoretical evaluation of existing materials and a survey study. Secondly, initial solutions were developed and evaluated in practice through 5 quasi-experimental intervention studies. Thirdly, we reflected upon all the previous results to produce design principles. Finally, we conclude with an analysis of the design-based research methodology
Son, are you on Facebook? The impact of parental involvement in school interventions about E-safety
Media literacy interventions in secondary education typically have a limited impact on the participantsâ behavior. Therefore, we developed a new e-safety intervention using a design-based research methodology. In the current study, it was verified whether involving parents actively in this intervention was helpful to decrease unsafe behavior on social network sites, or at least the intentions to behave unsafely. A quasi-experimental study with pre- and post-test measures in secondary education (n=207) showed that parental involvement was beneficial to change the intentions to engage in certain unsafe behavior, and to reduce existing problematic
behavior, particularly for boys. These findings have important implications for research and practice, guiding us toward more effective e-safety interventions
Understanding the Value of Backbone Organizations in Collective Impact
Effective backbone support is a critical condition for collective impact. In fact, it is the number one reason that collective impact initiatives fail. In this publication, we provide communities and organizations engaged in collective impact with guidance on the role of the backbone and how to understand and support its effectiveness.In the Greater Cincinnati region, collective impact has become the "new normal," and The Greater Cincinnati Foundation (GCF) has made a commitment to support the infrastructure of collective impact - the backbone organization itself - in an effort to sustain and scale long-term systemic change and impact in the community. However, the role of the backbone organization in collective impact is complex and can be difficult to explain.In early 2012, The Greater Cincinnati Foundation and FSG began a partnership to define the value of backbone organizations and better understand back-bone effectiveness by working with six local backbone organizations and collective impact initiatives
Manifestations of Tibetan Buddhism in Pudacuo National Park and its Effectiveness as an Environmental Education Tool
Pudacuo National Park in Shangri-la, Yunnan is mainland Chinaâs first national park and comprehensive conservation and eco-tourism attempt. The Nature Conservancy worked with Yunnan provincial government to establish park guidelines and advocate for certain conservation measures. One of the important guidelines that The Nature Conservancy included was local cultural preservation. A primary goal of this experiment in US-modeled national parks is to ensure the longevity of traditional values and beliefs in the parkland area. Pudacuo National Park is not only attempting to conserve the local Tibetan Buddhist tradition but also is attempting to capitalize on the uniqueness of the experience by providing environmental education revolving around the belief system. This paper synthesizes Pudacuo National Parkâs use of Tibetan Buddhism to promote environmental education by looking at the inclusion of Tibetan Buddhism in all aspects of the Pudacuo visitorâs typical experience. This paper will go on to show via an environmental education study that Pudacuo National Parkâs use of Tibetan Buddhism on signs is an effective way to educate visitors
Structures Serving the Visibly Homeless: An Emergency Shelter Response in Charleston, South Carolina
This thesis is an architectural exploration into how to partially address the housing crisis affecting the visibly homeless population of Charleston, South Carolina. Thousands of men, women, and children in the United States are homeless in Charleston there is a significant and increasing number of visibly homeless. Those who sleep outside shelters are generally known as the \u27visibly homeless\u27 or street homeless. The visibly homeless is the most underserved group within the entire homeless population and is composed of those who sleep in places not intended for human habitation, such as bus stations, subway trains, automobiles, doorways, and abandoned buildings. These individuals exist at the threshold of meeting their basic physiological needs such as warmth, food, clothing, security and shelter. Shelter as a necessity rather than as a negotiated commodity is the reality of a homeless person. Shelter that strives to satisfy basic physiological, social, safety, and self-esteem needs and utilizes affordable construction strategies can best support the visibly homeless in Charleston. The issues and complexities of homelessness and mental health will drive this thesis investigation. An architecture is proposed to meet the basic needs of Charleston\u27s most exposed and critical population--the visibly homeless. This thesis first identifies homelessness as a housing emergency and examines the causes and effects of homelessness. This visibly homeless population is very difficult to obtain an accurate count or profile, but through informal personal interviews with the test population, greater insight was gained about their living situation and resultant mental stability. Secondly, this thesis examines the hierarchy of needs, formulated by Abraham Maslow. This hierarchy identifies the needs that we as a civilization must satisfy to survive and that require fulfillment to become the individuals we are all capable of becoming. Research also examined Oscar Newman\u27s defensible space principles, which attempt to deter crime through the physical environment. Crime deterrence is essential when addressing the visibly homeless--a population who is vulnerable and regularly victimized. Lastly, this thesis explores the relief efforts offered for those who have suddenly become homeless due to natural causes and compares those to the efforts taken to those who are homeless due to a complex set of circumstances, some innate and some contracted. The design principles and strategies employed in the creation of relief housing for the victims of the Kosovo war were examined and adapted. Housing relief efforts should be responsive to homelessness with the same level of urgency and intensity as those measures taken with victims of natural disasters. This research led to the formation of design principles that can appropriately accommodate the housing needs of the visibly homeless in Charleston. Structures serving the visibly homeless must respond to personal selection of site whenever applicable and appropriate. The siting of these structures and the dwelling units themselves must provide defensible space through territoriality and surveillance opportunities that support personal space. These structures must also allow for universal and flexible living which support personalization and varying levels of privacy. Lastly, structures serving the homeless must utilize affordable construction methods, materials, and labor which respond to the limited financial resources available to the homeless and their supportive organizations. These design principles will aid in the creation of an architectural response. The test site for this thesis has been self-designated by the local homeless population itself, as it is in close proximity to the existing homeless shelter. The residents of the site have chosen to, or have been forced, to live outside the existing shelter, but still require the services provided by the shelter including mental health counseling, food services, and medical attention. This urban campground is designed as a supplement and as an alternative to the traditional shelter model existing in Charleston. The strategy of this thesis is to create shelter that supports well-being and mental health through spaces that accommodate basic needs and create defensible space
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