Evaluating the Impact of Health Programmes

This paper has two broad objectives. The first objective is broadly methodological and deals with some of the more pertinent estimation issues one should be aware of when studying the impact of health status on economic outcomes. We discuss some alternatives for constructing counterfactuals when designing health program evaluations such as randomization, matching and instrumental variables. Our second objective is to present a review of the existing evidence on the impact of health interventions on individual welfare.

Lifelong Learning and the Legacy of Social Purpose

This paper explores the implications for current lifelong learning research and practice of the historically privileged relationship claimed for radical adult education and movements for social change rooted in class, gender, anti-racist and community politics. The trajectory this relationship follows, in research, policy and practice, is complex, with phases of expansion and retrenchment, in the social movements and adult education, which do not always map straightforwardly against each other. The traditions, for they are importantly distinct within themselves, are also always found in relation to other traditions and purposes for adult education. “Complex and contested”, as Richard Taylor describes them (Taylor 2000, p.69), but there is nevertheless a clearly identifiable, if historically varied, set of values, sites and practices which share a commitment to an educational pedagogy and purpose rooted in social and transformative, rather than individual and conformist, aspirations. This tradition, like the social movements and political cultures with which it has been aligned, has foundered in the last decade under the combined impact and discontents of the radical right, de-industrialisation and globalisation. In Britain, especially in Scotland, in recent years there are signs of a revived interest in questions of social purpose, popular social movements and their relation to lifelong learning. Some commentators have explored and debated the extent of the tradition’s radicalism, less in the spirit of revisionism and more as a warning against the backward construction of a golden age against which to measure the shortcomings of the present (Chase 1995; Thompson 1996; Andrews, Keane and Thompson 1999). Others have engaged with and developed critiques of the shift from adult education to lifelong learning in terms of the opportunities and obstacles this presents radical adult educators (Foley 2001; Thompson 1997, 2000; Crowther, Martin and Shaw 1999; Field and Leicester 2000; Johnson 1999) while others have considered the debate in terms of changes within higher education as a whole (Scott 1995, 2000; Schuller 1995; Coffield and Williamson 1997; Watson and Taylor 1998). We explore the legacy of social purpose in lifelong learning from our shared positioning as researchers, teachers and providers who were formed in the older, radical tradition of adult education and are now seeking ways to integrate its first principles in a very different social, political and educational order. The paper has four sections. We begin with an overview of how the sites and preoccupations of an earlier generation of radical adult educators fared in the new times of post thatcherism and new labour. As part of this section we track the response and implications of the “call to arms” Jane Thompson extended through her 1993 article ‘Learning, liberation and maturity: an open letter to whoever’s left’ in Adults Learning (Thompson 1993). Next, through a comparative analysis of proceedings from the Standing Conference on University Teaching and Research in Education and its sister organisations in North America, Canada, Australasia and Europe, we consider the extent to which these concerns have shaped and informed the research agenda for adult education. We then discuss the nature of a range of contemporary social movements, of the right as well as the left, and discuss the extent to which they engage with and utilise forms of lifelong learning. Finally, in considering the implications for teaching and research into lifelong learning, we argue for the importance of constructing and inhabiting positions within lifelong learning which are both critical and active, that is they are for, as well as against, things

Evaluating the Impact of Health Programmes on Productivity

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96396/1/1467-8268.12002.pd

An investigation of theory-practice gap in undergraduate paramedic education

<p>Abstract</p> <p>Background</p> <p>Bachelor of Emergency Health (Paramedic) (BEH) students at Monash University undertake clinical placements to assist with the transition from student to novice paramedic. Anecdotally, students report a lack of opportunity to practise their clinical skills whilst on placements. The barriers to participation and the theory-practice gap have not been previously documented in Australian paramedic literature. The purpose of this study was to investigate the theory-practice gap for paramedic students by linking education and skill level to case exposure and skills praxis during clinical placements.</p> <p>Methods</p> <p>A cross-sectional retrospective study using a convenience sample of second and third year BEH undergraduate students. Ethics approval was granted.</p> <p>Results</p> <p>Eighty four second and third year BEH students participated. 59.5% were female (n = 50), 40.5% were male (n = 34). Overall, students most commonly reported exposure to cardiac and respiratory cases and were satisfied with the number of cases encountered during placement. However, over half (n = 46) reported being exposed to < 50% of cases that allowed skills praxis. The most common barrier to participation (34.5%) was the opportunity to participate in patient care and 68% of student's were unsure if paramedics understood their role during clinical placements.</p> <p>Conclusion</p> <p>This study demonstrates that the majority of students were satisfied with their clinical placement experience; even though they were exposed to < 50% of cases that allowed skills practice. Identifying these educational barriers will assist in improving the quality and theory-practice gap of paramedic clinical education.</p

Examining inhibition during spoken word production in aphasia

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Frontline over ivory tower: key competencies in community-based curricula

Background: The Royal College of Physicians and Surgeons of Canada mandates that community experiences be incorporated into medicine-based specialties.  Presently there is wide variability in community endocrine experiences across Canadian training programs.  This is complicated by the paucity of literature providing guidance on what constitutes a ‘community’ rotation.Method: A modified Delphi technique was used to determine the CanMEDS competencies best taught in a community endocrinology curriculum. The Delphi technique is a qualitative-research method that uses a series of questionnaires sent to a group of experts with controlled feedback provided by the researchers after each survey round.  The experts in this study included endocrinology program directors, community endocrinologists, endocrinology residents and recent endocrinology graduates.Results: Thirty four out of 44 competencies rated by the panel were deemed suitable for a community curriculum.  The experts considered the “Manager” role best taught in the community, while they considered the community least suitable to learn the “Medical Expert” competency.Conclusions: To our knowledge, this is the first time the content of a community-based subspecialty curriculum was determined using the Delphi process in Canada.  These findings suggest that community settings have potential to fill in gaps in residency training in regards to the CanMEDS Manager role.  The results will aid program directors in designing competency-based community endocrinology rotations and competency-based community rotations in other medical subspecialty programs

Differences in the pregnancy gestation period and mean birth weights in infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK: a retrospective analysis of routinely collected data

Objective To compare mean birth weights and gestational age at delivery of infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK. Design Retrospective analysis using routinely recorded secondary data in Ciconia Maternity information System, between 2008 and 2013. Setting Luton, UK. Participants Mothers whose ethnicity was recorded as white British, Bangladeshi, Pakistani or Indian and living in Luton, aged over 16, who had a live singleton birth over 24 weeks of gestation were included in the analysis (n=14 871). Outcome measures Primary outcome measures were mean birth weight and gestational age at delivery. Results After controlling for maternal age, smoking, diabetes, gestation age, parity and maternal height and body mass index at booking, a significant difference in infants’ mean birth weight was found between white British and Indian, Pakistani and Bangladeshi infants, F(3, 12 287)=300.32, p Conclusions Results show important differences in adjusted mean birth weight between Indian, Pakistani, Bangladeshi and white British women. Moreover, an association was found between primipara Indian mothers and preterm delivery, when compared with Pakistani, Bangladeshi and white British women.</p

Loss of testosterone impairs anti-tumor neutrophil function.

In men, the incidence of melanoma rises rapidly after age 50, and nearly two thirds of melanoma deaths are male. The immune system is known to play a key role in controlling the growth and spread of malignancies, but whether age- and sex-dependent changes in immune cell function account for this effect remains unknown. Here, we show that in castrated male mice, neutrophil maturation and function are impaired, leading to elevated metastatic burden in two models of melanoma. Replacement of testosterone effectively normalized the tumor burden in castrated male mice. Further, the aberrant neutrophil phenotype was also observed in prostate cancer patients receiving androgen deprivation therapy, highlighting the evolutionary conservation and clinical relevance of the phenotype. Taken together, these results provide a better understanding of the role of androgen signaling in neutrophil function and the impact of this biology on immune control of malignancies

The accumulation economy of private schools : extraction, mystification and depletion

Too few studies of elite private schools consider how they derive power and prestige from their relationships and interactions with other social and political groups and institutions, including the State. This paper contributes to elite school studies by examining the relationality between the Australian State and private sector schools around how government funds public and private education. Of all Australian students, 35.5% attend private schools. All private schools, including elite schools, receive significant amounts of taxpayers’ money. After explaining the complex policy architecture of this funding regime, this paper offers a fresh set of conceptual resources to help deepen the analysis of this situation. We argue that the whole Australian private school sector operates as an accumulation economy, essentially utilising public sector resources to enlarge, enrich and sustain itself. This happens via three dynamics–accumulation by extraction, by mystification and by depletion. We show how elite schools are part of, and benefit from, each.Peer reviewe