Using Boundary Changes to Estimate the Impact of School Competition on Test Scores

We study the impact of school choice on test score outcome. It has generally proved difficult to isolate exogenous differences in the degree of competition faced by schools. We run a difference-in-difference analysis, exploiting a local government reorganisation to provide identification. This reorganisation changed the boundaries of education markets. We analyse one cohort of children passing through secondary school before the change, and one afterwards, both for the treated (re-organised) area and for similar control areas. Our point estimates suggest that the fall in competition experienced reduced test scores, but the estimates are not statistically significant.School choice, school competition, educational outcomes

Do teachers matter? Measuring the variation in teacher effectiveness in England

Using a unique primary dataset for the UK, we estimate the effect of individual teachers on student outcomes, and the variability in teacher quality. This links over 7000 pupils to the individual teachers who taught them, in each of their compulsory subjects in the high-stakes exams at age 16. We use point-in-time fixed effects and prior attainment to control for pupil heterogeneity. We find considerable variability in teacher effectiveness, a little higher than the estimates found in the few US studies. We also corroborate recent findings that observed teachers’ characteristics explain very little of the differences in estimated effectiveness.education, test scores, teacher effectiveness

Who wins and who loses from school accountability? The distribution of educational gain in English secondary schools

In 1988 the UK government introduced greater accountability into the English state school sector. But the information that schools are required to make public on their pupil achievement is only partial. The paper examines whether accountability measures based on a partial summary of student achievement influence the distribution of student achievement. Since school ratings only incorporate test results via pass rates, schools have incentives to improve the performance of students who are on the margin of meeting these standards, to the detriment of very low achieving or high achieving pupils. Using pupil level data for a cohort of all students in secondary public sector schools in England, we find that this policy reduces the educational gains and exam performance in high stakes exams of very low ability students.school accountability, high stakes exams, educational value added

School Choice in England: Background Facts

There is considerable debate on the merits of extending and strengthening school choice. In England, the controversial Education and Inspections Bill, published on the 28 February 2006, contains a prominent role for ‘school choice’. But the debate lacks some basic information on these issues, and this paper provides some background facts to fill this gap. We first consider the transport issue and ask how many pupils have choice of schools. We report the distance of school commutes for various breakdowns of LEA and school type, and for sub-groups of pupils. We also turn the question around and tabulate the proportion of pupils who have 3 schools within 2km of their home, and within 5km and 8km. The conclusion from all this is that most pupils do have considerable choice of school (as defined here). We also address a specific issue about school access ? which pupils attend their nearest school. We show that only about a half of pupils attend their nearest school, and 30% do not attend one of their nearest three schools. We investigate this to understand which pupils attend their local school, and the role played by the quality of that local school.school choice; school commute; ethnicity and education

The Future of Work in Africa: Implications for Secondary Education and TVET Systems

The objective of this background paper is to try to determine, in light of the likely disruptive evolution of technology and global trade and urbanization, what African countries should do to provide productive jobs for their large and fast-growing youth population. The focus is on secondary education, including both academic-oriented secondary schools (both lower and higher) and vocational training institutes (TVETs). This review aims to answer the following questions:- What are the jobs that are likely to be available or the jobs that African countries should target in the future?- What growth strategies should African countries adopt to pursue these job opportunities?- What changes should African countries make to the secondary level education systems to prepare graduates to successfully take advantage of the productive opportunities, including the informal sector and agriculture, in the face of an evolving landscape?The study is largely based on an extensive desk review, with two case studies including Ghana and Senegal

Suppression of neointima formation by targeting β-catenin/TCF pathway

Coronary artery disease is treated by vein grafting and stent implantation. Late vein graft failure and restenosis of stented arteries reduce the success rates of these approaches and are caused by neointima formation. We have previously shown that Wnt proteins are up-regulated during intimal thickening, and have speculated that these lead to activation of downstream genes with β-catenin/T-cell factor (TCF)-responsive promoters. In the present study, we aimed to provide evidence that β-catenin/TCF signalling promotes neointima formation and assess whether targeting this pathway has potential for reducing neointima formation. We utilized a gene therapy approach selectively targeting cells in which the β-catenin/TCF pathway is activated by using a recombinant adenovirus Ad-TOPTK, which carries a herpes simplex virus thymidine kinase (HSV-TK) gene under the control of a β-catenin/TCF-response promoter. Cells with activated β-catenin will therefore be selectively killed. Ad-TOPTK and ganciclovir (GCV) treatment significantly suppressed the growth of the neointima in a murine model of left carotid artery ligation. In summary, we demonstrated that Wnt/β-catenin/TCF signalling promotes neointima formation, by showing that the selective death of cells with activated β-catenin suppressed neointima formation. This highlights the therapeutic potential for reducing late vein graft failure and in-stent restenosis by targeting β-catenin/TCF signalling

Models of Care for musculoskeletal health: Moving towards meaningful implementation and evaluation across conditions and care settings

Models of Care (MoCs) are increasingly recognised as a system-level enabler to translate evidence for ‘what works’ into policy and, ultimately, clinical practice. MoCs provide a platform for a reform agenda in health systems by describing not only what care to deliver but also how to deliver it. Given the enormous burden of disease associated with musculoskeletal (MSK) conditions, system-level (macro) reform is needed to drive downstream improvements in MSK healthcare – at the health service (meso) level and at the clinical interface (micro) level. A key challenge in achieving improvements in MSK healthcare is sustainable implementation of reform initiatives, whether they be macro, meso or micro level in scope. In this chapter, we introduce the special issue of the Journal dedicated to implementation of MSK MoCs. We provide a contextual background on MoCs, a synthesis of implementation approaches across care settings covered across the chapters in this themed issued, and perspectives on the evaluation of MoCs

Neuropathic Pain Components Are Common in Patients With Painful Cervical Radiculopathy, but Not in Patients With Nonspecific Neck-Arm Pain

Objectives: The aim of this study was to investigate, using quantitative sensory testing (QST) parameters and the painDETECT (PD-Q) screening questionnaire, the presence of neuropathic pain (NeP) in patients with unilateral painful cervical radiculopathy (CxRAD) and in patients with unilateral nonspecific neck-arm pain associated with heightened nerve mechanosensitivity (NSNAP). Methods: All patients completed the PD-Q before QST. QST was performed bilaterally in the maximal pain area and the affected dermatome in 23 patients with painful C6 or C7 radiculopathy and in 8 patients with NSNAP following a C6/7 dermatomal pain distribution.Results: Patients with CxRAD demonstrated a significant loss of sensory function in mechanical (P≤0.021) and vibration sense (P≤0.003) on the symptomatic side compared with the asymptomatic side in both tested body regions and in the dermatome reduced cold detection (P=0.021) and pressure pain sensitivity (P=0.005), findings consistent with nerve root damage. These sensory alterations in the maximal pain area/symptomatic side are confirmative for the presence of NeP. In contrast to these QST data, only 30% of patients with CxRAD demonstrated a NeP component according to the PD-Q score. In patients with NSNAP, a significant side-to-side difference was demonstrated for warm detection threshold in the dermatome (P=0.030). The PD-Q score indicated that NeP components were unlikely in this group. Discussion: QST data suggest that NeP is likely to be observed in patients with painful CxRAD, but not in patients with NSNAP

The role of sensory parameters in predicting clinical outcome after lumbar discectomy

Background: Lumbar discectomy is considered a safe, efficacious and cost-effective treatment for selected cases of patients with leg pain associated with the presence of a disc protrusion. But despite technically successful surgery, 30 % of patients complain of persistent pain on long-term follow up. Identification of possible predictors for a negative outcome is important, in the search for appropriate pre- and/or post-operative care and prevention of persistent disability. There is some evidence in the literature that quantitative sensory testing (QST) measures may play a role in prediction of patients’ pain persistency, however, this has never been investigated in patients undergoing lumbar discectomy. Objective: The aim of this study is to determine the predictive value of QST parameters, in combination with previously documented predictor variables such as medical/psychological/cognitive behavioural factors, in patients with lumbar radiculopathy and/or radicular pain, for predicting patients’ clinical outcome after lumbar discectomy. Method: Participants with radiculopathy and/or radicular pain and confirmed imaging diagnosis of nerve root compression will be recruited from the elective surgery waitlist at one hospital. All participants will undergo lumbar discectomy performed by one neurosurgeon. A standardized QST protocol comprising all of the somatosensory sub-modalities that are mediated by different primary afferents (C-, Aδ-, Aβ-) will be performed prior to surgery. QST will be conducted in the patients’ main pain area and contralateral side, in the affected dermatome and at a remote control site. The presence of other predictor variables will be captured by questionnaires. Follow-up at 3 months will include QST and measurements of pain intensity, pain descriptors, functional status, health related quality of life, return to work and health care utilisation. A further 1-year follow-up will include the same measurements except QST. Results/Conclusions: Identification of new predictor variables may assist in the development of pre-surgical screening methods and in targeted pre- and/or post-operative patient care, with the potential to improve patients’ functional status, quality of life, work capacity whilst also reducing health care costs associated with persistent disability

Societal beliefs about pain may be more balanced than previously thought:Results of the Guernsey pain survey

Musculoskeletal pain is multidimensional and associated with significant societal impact. Persistent or chronic pain is a public health priority. A step towards high-value care is a contemporary understanding of pain. While pain-related knowledge has been examined in specific conditions (e.g. neck pain) knowledge of the public's broader understanding regarding musculoskeletal pain per se, warrants investigation. This study examined the public's knowledge and beliefs regarding musculoskeletal pain and pain management. This observational cohort study was conducted in Guernsey (January 2019-February 2020). Participants (n = 1656; 76.0% female) completed an online questionnaire capturing: demographics, pain experience, work absenteeism, understanding of pain and pain management, multidimensional influences, physical activity, pain catastrophising and healthcare decision-making. Statements were deemed true/false/equivocal and mapped to biopsychosocial/biomedical/neutral perspectives based upon contemporary literature. Descriptive statistics were analysed for each statement. Participants' responses were examined for alignment to a contemporary viewpoint and themes within responses derived using a semi-quantitative approach modelled on direct content analysis. Comparisons between participants with/without pain were examined (χ -squared/Wilcoxon Rank Sum test). Within the cohort 83.6% reported currently experiencing pain. The overarching theme was perspectives that reflected both biomedical and contemporary, multidimensional understandings of pain. Sub-themes included uncertainty about pain persistence and evidence-based means to reduce recurrence, and reliance upon healthcare professionals for guiding decision-making. Compared to those with pain, those without had a greater belief that psychological interventions may help and lower pain catastrophising. Participants' understanding of pain demonstrated both biomedical and multidimensional pain understanding consistent with elements of a contemporary understanding of pain. [Abstract copyright: © 2024. The Author(s).