Self-Efficacy and Engagement as Predictors of Student Programming Performance

Programming is a core subject introduced in the first year of an Undergraduate Computer Science programme. Since programming is a core subject, it is a major concern that high attrition and failure rates continue to be reported in such courses. Evidence from the literature suggests that programming is cognitively demanding, and the solutions proposed have had minimal impact on students in introductory programming courses. However, in the literature on learning theory, there is evidence suggesting that the self-efficacy beliefs of students affect their engagement, and that their engagement affects their performance. In the literature on introductory programming courses, there is a lack of research examining the effect of self-efficacy on engagement, and the effect of engagement on the programming performance of students. This leaves a gap in programming research that this research seeks to fill. Based on student engagement frameworks in the literature on learning theory, a conceptual model was developed. To operationalise and validate the conceptual model within the context of learning programming, a study consisting of focus group interviews and a survey on students in introductory programming courses is proposed. The results of the survey will be analysed using structural equation modelling (SEM) techniques

Effect of Self-efficacy and Emotional Engagement on Introductory Programming Students

Today organisations both in the private and public sectors rely on Information Technology (IT) solutions and continue to make significant investments enabling business via IT. The increase in investment in IT is due to the demand for more efficient and cost-effective delivery of products and services. The dependency on IT and the increased level of investment in IT have both motivated a wider accountability focus on strategic technology initiatives, and a complex mix of political, organisational, technical and cultural shifts requiring far-sighted management and governance of IT. Throughout the last decade, systems, processes, standards and best practice frameworks have been developed to facilitate effective IT governance. However, a large number of IT initiatives fail to deliver. Getting value from technology deployment via effective IT governance remains a key concern of management. This paper presents the outcome of the analysis of four IT deployment cases studies. The analysis of the four case studies demonstrated a strong connection between project failures and inadequate governance practices

Variations in Performance of Mental Health Providers in the English NHS : An Analysis of the Relationship Between Readmission Rates and Length-of-Stay

Length-of-stay (LOS) for inpatient mental health care is a major driver of variation in resource use internationally. We explore determinants of LOS in England, focusing on the impact of emergency readmission rates which can serve as a measure of the quality of care. Data for 2009/2010 and 2010/2011 are analysed using hierarchical and non-hierarchical models. Unexplained residual variation among providers is quantified using Empirical Bayes techniques. Diagnostic, treatment and patient-level demographic variables are key drivers of LOS. Higher emergency readmission rates are associated with shorter LOS. Ranking providers by residual variation reveals significant differences, suggesting some providers can improve performance

Examining equity in the utilisation of psychiatric inpatient care among patients with severe mental illness (SMI) in Ontario, Canada

BACKGROUND: Severe mental illness (SMI) comprises a range of chronic and disabling conditions, such as schizophrenia, bipolar disorder and other psychoses. Despite affecting a small percentage of the population, these disorders are associated with poor outcomes, further compounded by disparities in access, utilisation, and quality of care. Previous research indicates there is pro-poor inequality in the utilisation of SMI-related psychiatric inpatient care in England (in other words, individuals in more deprived areas have higher utilisation of inpatient care than those in less deprived areas). Our objective was to determine whether there is pro-poor inequality in SMI-related psychiatric admissions in Ontario, and understand whether these inequalities have changed over time. METHODS: We selected all adult psychiatric admissions from April 2006 to March 2011. We identified changes in socio-economic equity over time across deprivation groups and geographic units by modeling, through ordinary least squares, annual need-expected standardised utilisation as a function of material deprivation and other relevant variables. We also tested for changes in socio-economic equity of utilisation over years, where the number of SMI-related psychiatric admissions for each geographic unit was modeled using a negative binomial model. RESULTS: We found pro-poor inequality in SMI-related psychiatric admissions in Ontario. For every one unit increase in deprivation, psychiatric admissions increased by about 8.1%. Pro-poor inequality was particularly present in very urban areas, where many patients with SMI reside, and very rural areas, where access to care is problematic. Our main findings did not change with our sensitivity analyses. Furthermore, this inequality did not change over time. CONCLUSIONS: Individuals with SMI living in more deprived areas of Ontario had higher psychiatric admissions than those living in less deprived areas. Moreover, our findings suggest this inequality has remained unchanged over time. Despite the debate around whether to make more or less use of inpatient versus other care, policy makers should seek to address suboptimal supply of primary, community or social care for SMI patients. This may potentially be achieved through the elimination of barriers to access psychiatrist care and the implementation of universal coverage of psychotherapy

Determinants of hospital length of stay for people with serious mental illness in England and implications for payment systems: a regression analysis

BackgroundSerious mental illness (SMI), which encompasses a set of chronic conditions such as schizophrenia, bipolar disorder and other psychoses, accounts for 3.4 m (7 %) total bed days in the English NHS. The introduction of prospective payment to reimburse hospitals makes an understanding of the key drivers of length of stay (LOS) imperative. Existing evidence, based on mainly small scale and cross-sectional studies, is mixed. Our study is the first to use large-scale national routine data to track English hospitals’ LOS for patients with a main diagnosis of SMI over time to examine the patient and local area factors influencing LOS and quantify the provider level effects to draw out the implications for payment systems.MethodsWe analysed variation in LOS for all SMI admissions to English hospitals from 2006 to 2010 using Hospital Episodes Statistics (HES). We considered patients with a LOS of up to 180 days and estimated Poisson regression models with hospital fixed effects, separately for admissions with one of three main diagnoses: schizophrenia; psychotic and schizoaffective disorder; and bipolar affective disorder. We analysed the independent contribution of potential determinants of LOS including clinical and socioeconomic characteristics of the patient, access to and quality of primary care, and local area characteristics. We examined the degree of unexplained variation in provider LOS.ResultsMost risk factors did not have a differential effect on LOS for different diagnostic sub-groups, however we did find some heterogeneity in the effects. Shorter LOS in the pooled model was associated with co-morbid substance or alcohol misuse (4 days), and personality disorder (8 days). Longer LOS was associated with older age (up to 19 days), black ethnicity (4 days), and formal detention (16 days). Gender was not a significant predictor. Patients who self-discharged had shorter LOS (20 days). No association was found between higher primary care quality and LOS. We found large differences between providers in unexplained variation in LOS.ConclusionsBy identifying key determinants of LOS our results contribute to a better understanding of the implications of case-mix to ensure prospective payment systems reflect accurately the resource use within sub-groups of patients with SMI

Risk of Care Home Placement following Acute Hospital Admission:Effects of a Pay-for-Performance Scheme for Dementia

IntroductionThe Quality and Outcomes Framework, or QOF, rewards primary care doctors (GPs) in the UK for providing certain types of care. Since 2006, GPs have been paid to identify patients with dementia and to conduct an annual review of their mental and physical health. During the review, the GP also assesses the carer's support needs, including impact of caring, and ensures that services are co-ordinated across care settings. In principle, this type of care should reduce the risk of admission to long-term residential care directly from an acute hospital ward, a phenomenon considered to be indicative of poor quality care. However, this potential effect has not previously been tested.MethodsUsing English data from 2006/07 to 2010/11, we ran multilevel logit models to assess the impact of the QOF review on the risk of care home placement following emergency admission to acute hospital. Emergency admissions were defined for (a) people with a primary diagnosis of dementia and (b) people with dementia admitted for treatment of an ambulatory care sensitive condition. We adjusted for a wide range of potential confounding factors.ResultsOver the study period, 19% of individuals admitted to hospital with a primary diagnosis of dementia (N = 31,120) were discharged to a care home; of those admitted for an ambulatory care sensitive condition (N = 139,267), the corresponding figure was 14%. Risk factors for subsequent care home placement included older age, female gender, vascular dementia, incontinence, fall, hip fracture, and number of comorbidities. Better performance on the QOF review was associated with a lower risk of care home placement but only when the admission was for an ambulatory care sensitive condition.ConclusionsThe QOF dementia review may help to reduce the risk of long-term care home placement following acute hospital admission.</p

The relationship between social care resources and healthcare utilisation by older people in England : an exploratory investigation

Background Since 2010, adult social care spending has fallen significantly in real terms whilst demand has risen. Reductions in local authority (LA) budgets are expected to have had spill over effects on the demand for healthcare in the English NHS. Motivation If older people, including those with dementia, have unmet needs for social care, their use of healthcare may increase. Methods We assembled a panel dataset of 150 LAs, aggregating individual-level data where appropriate. We tested the impact of changes in LA social care resources, which was measured in two ways: expenditure and workforce. The effects on people aged 65+ were assessed on five outcomes. 1. Rates of emergency hospital admissions for falls in people with dementia aged 65 and over. 2. Rates of emergency hospital admissions for fractured neck of femur in people 65 and over. 3. Extended length of stay in people with dementia, 7 days and over 4. Extended length of stay in people with dementia, 21 days and over 5. Rates of NHS Continuing Healthcare (NHS CHC) Outcomes (utilisation) data were derived from the Hospital Episode Statistics (1, 2, 3 and 4), the Public Health Outcomes Framework (2), and publicly available datasets from NHS Digital (5). Datasets varied in the timeframes available for analysis. Planned analysis of the effects of social care cuts on delayed transfers of care in mental health trusts, and on deprivation of liberty safeguards were not undertaken because of data quality concerns. We tested the effect of two separate explanatory variables: adult social care gross current expenditure (per capita 65 and over) adjusted by area cost; and adult social care workforce staff (per capita 18 and over). Workforce measures distinguished LA and independent sector employees and included professional and non-professional staff providing direct social care. We ran negative binomial models and linear models, and controlled for a range of confounding factors, including deprivation, ethnicity, age, unpaid care, LA class and year effects. To account for potential endogeneity (‘reverse causality’), we also tested the Area Cost Adjustment (ACA) as an instrumental variable and ran dynamic panel models. Sensitivity analysis explored the effects of the additional effects of the Better Care Fund. Results The level of social care expenditure on older people was not significantly related to emergency admission rates for falls in people with dementia or for fractured neck of femur. Extended stays of 7 days or longer were significantly and positively related to the level of social care spend, but this association was no longer significant when additional spend from the Better Care Fund was taken into account. There was no significant relationship between the level of social care spend and hospital stays of 21 days or longer or between spend and uptake of NHS CHC. We also tested the effect of four social care workforce measures. LAs employing higher rates of social care staff (especially professional staff) had significantly higher levels of NHS CHC, but there was no significant relationship between LA staffing levels and the remaining four outcomes. LAs with higher levels of independent social care staffing had significantly lower rates of extended stays, but there was no association with either emergency admissions or on NHS CHC. The effect of ‘full time’ ii CHE Research Paper 174 unpaid care on outcomes was mixed, with tentative evidence of a protective effect on admissions for falls, and on extended stays of 21 days or longer. When the Area Cost Adjustment was used as an instrument in place of expenditure, results were largely consistent with the main analysis: there were negative effects on NHS CHC but no effect on any other outcome. The dynamic panel models found a positive relationship between spend and emergency admissions for falls, but the effect on other outcomes was statistically insignificant. Conclusions The study found no consistent evidence that reductions in social care budgets led to the expected rises in hospital admissions, hospital stays or uptake of NHS CHC. However, findings suggest that public sector staff providing direct social care, particularly professional staff, may be instrumental in facilitating access to NHS CHC. In addition, the study found tentative evidence that extended hospital stays are partially offset by social care provision by the independent sector and by unpaid carers providing intensive care. To test the validity and robustness of these findings, future research using linked individual-level health and social care data is needed

"There's not enough knowledge out there": examining older adults' perceptions of digital technology use and digital inclusion classes

Older adults' definitions of digital technology, and experiences of digital inclusion sessions, were examined using qualitative approaches. Seventeen older adults (aged between 54 and 85) participated in two focus groups that each lasted approximately 90 minutes to explore how older adults understood technology within their lived experience. Interpretative Phenomenological Analysis yielded two main themes: Thirst for knowledge and a wish list for digital technology sessions. A separate content analysis was performed to identify what technology older adults identified as digital technology. This analysis revealed that the older adults most frequently defined digital technology as computers and telephones. The findings support the conclusions that this group of older adults, some of whom were 'successful users', have a wide knowledge of digital technology, are interested in gaining more skills, and desire knowledge acquisition through personalised one-to-one learning sessions

Tuberculosis and gender in the Asia-Pacific region

We thank the NHMRC Tuberculosis Centre of Research Excellence, Australia, and Philippe Glaziou, Senior Epidemiologist, GTB/TME, WHO Headquarters, Geneva, Switzerlan

The impact of primary care quality on inpatient length of stay for people with dementia : An analysis by discharge destination

Dementia is a chronic and progressive condition involving memory loss, mood swings, and difficulties in communication, mobility, reasoning and self-care. Older people with dementia occupy up a quarter of NHS hospital beds and tend to have prolonged hospital stays. Being admitted to hospital can have a significant negative impact on the person’s physical and mental health, and have an emotional impact on carers. As part of a national scheme known as the Quality and Outcomes Framework (QOF), GPs are rewarded for providing an annual review for patients with dementia. In the review, the GP checks the patient’s physical and mental health, and the support needs of the patient and carer. The GP also ensures services are coordinated across different parts of the system, e.g. that the patient is linked to community mental health services who can support them at home after a hospital stay. So does the QOF dementia review help achieve timely discharge from hospital? We used several large linked datasets to answer this question, analysing data on around 36,700 people from 2006 to 2010. The analyses took account of the influence of the GP practice with which people were registered and adjusted for other factors that might shorten or lengthen hospital stay. On average, hospital stay for people with dementia was around 18 days but was longer for those who were subsequently discharged to a care home (33 days). The QOF review had little effect on length of stay, with slightly shorter stays achieved only for individuals discharged back into the community and slightly longer stays for those who were discharged to a care home. Older people tended to be discharged from hospital more quickly than younger people, and Sunday admissions were shorter than admissions initiated on other days of the week. Unsurprisingly, people with multiple conditions had longer stays. Better availability of social care options – care home beds, or local authority intermediate care facilities – was linked to shorter hospital stays, which suggests that these sorts of services can be used instead of hospital care if they can be accessed. Another finding was that intense levels of unpaid care are associated with longer hospital stays – so it’s particularly important that GPs make sure these types of carer are well supported