Environmental Education: A Potential Foundation for Sustaining our Society

There is an ever-increasing need for sufficient environmental literacy instruction, especially for the contemporary generation of young people. The accruing complications of climate change due to anthropogenic activity will most affect the upcoming generation of students; therefore, it is paramount that they are sufficiently taught about the processes of climate change, human-nature relations, and the responsibility that we all have in remedying environmental degradation. Throughout the entire document, I call for explicit and consistent environmental and sustainability education for K-12 students: a necessary concentration that ought to be taught in all schools in Texas. I define the specific environmental and sustainability education that should be included in Texas curriculum, and identify the benefits for students, the environment, and their school and local communities. I also examine Texas’s Environmental Literacy Plan, and compare it to current Texas K-12 learning standards to assess whether Texas is honoring its commitment to environmental literacy in the most effective manner. I present Washington and Oregon’s environmental education learning standards as examples for Texas teachers, the State Board of Education, the Texas Education Agency, and policy makers to draw from for inspiration. Lastly, I reveal the challenges and barriers to individual Texas teachers taking on the responsibility of independently teaching environmentalism and sustainability, and implore Texas policy makers and affiliates to redesign K-12 learning standards with a uniform and specific inclusion of these topics.Plan II Honors Progra

A university system’s approach to enhancing the educational mission of health science schools and institutions: the University of Texas Academy of Health Science Education

Background: The academy movement developed in the United States as an important approach to enhance the educational mission and facilitate the recognition and work of educators at medical schools and health science institutions. Objectives: Academies initially formed at individual medical schools. Educators and leaders in The University of Texas System (the UT System, UTS) recognized the academy movement as a means both to address special challenges and pursue opportunities for advancing the educational mission of academic health sciences institutions. Methods: The UTS academy process was started by the appointment of a Chancellor’s Health Fellow for Education in 2004. Subsequently, the University of Texas Academy of Health Science Education (UTAHSE) was formed by bringing together esteemed faculty educators from the six UTS health science institutions. Results: Currently, the UTAHSE has 132 voting members who were selected through a rigorous, system-wide peer review and who represent multiple professional backgrounds and all six campuses. With support from the UTS, the UTAHSE has developed and sustained an annual Innovations in Health Science Education conference, a small grants program and an Innovations in Health Science Education Award, among other UTS health science educational activities. The UTAHSE represents one university system’s innovative approach to enhancing its educational mission through multi- and interdisciplinary as well as inter-institutional collaboration. Conclusions: The UTAHSE is presented as a model for the development of other consortia-type academies that could involve several components of a university system or coalitions of several institutions

Evidence for models of diagnostic service provision in the community: literature mapping exercise and focused rapid reviews

Background Current NHS policy favours the expansion of diagnostic testing services in community and primary care settings. Objectives Our objectives were to identify current models of community diagnostic services in the UK and internationally and to assess the evidence for quality, safety and clinical effectiveness of such services. We were also interested in whether or not there is any evidence to support a broader range of diagnostic tests being provided in the community. Review methods We performed an initial broad literature mapping exercise to assess the quantity and nature of the published research evidence. The results were used to inform selection of three areas for investigation in more detail. We chose to perform focused reviews on logistics of diagnostic modalities in primary care (because the relevant issues differ widely between different types of test); diagnostic ultrasound (a key diagnostic technology affected by developments in equipment); and a diagnostic pathway (assessment of breathlessness) typically delivered wholly or partly in primary care/community settings. Databases and other sources searched, and search dates, were decided individually for each review. Quantitative and qualitative systematic reviews and primary studies of any design were eligible for inclusion. Results We identified seven main models of service that are delivered in primary care/community settings and in most cases with the possible involvement of community/primary care staff. Not all of these models are relevant to all types of diagnostic test. Overall, the evidence base for community- and primary care-based diagnostic services was limited, with very few controlled studies comparing different models of service. We found evidence from different settings that these services can reduce referrals to secondary care and allow more patients to be managed in primary care, but the quality of the research was generally poor. Evidence on the quality (including diagnostic accuracy and appropriateness of test ordering) and safety of such services was mixed. Conclusions In the absence of clear evidence of superior clinical effectiveness and cost-effectiveness, the expansion of community-based services appears to be driven by other factors. These include policies to encourage moving services out of hospitals; the promise of reduced waiting times for diagnosis; the availability of a wider range of suitable tests and/or cheaper, more user-friendly equipment; and the ability of commercial providers to bid for NHS contracts. However, service development also faces a number of barriers, including issues related to staffing, training, governance and quality control. Limitations We have not attempted to cover all types of diagnostic technology in equal depth. Time and staff resources constrained our ability to carry out review processes in duplicate. Research in this field is limited by the difficulty of obtaining, from publicly available sources, up-to-date information about what models of service are commissioned, where and from which providers. Future work There is a need for research to compare the outcomes of different service models using robust study designs. Comparisons of ‘true’ community-based services with secondary care-based open-access services and rapid access clinics would be particularly valuable. There are specific needs for economic evaluations and for studies that incorporate effects on the wider health system. There appears to be no easy way of identifying what services are being commissioned from whom and keeping up with local evaluations of new services, suggesting a need to improve the availability of information in this area. Funding The National Institute for Health Research Health Services and Delivery Research programme

Thousands of domestic and public supply wells face failure despite groundwater sustainability reform in California’s Central Valley

Abstract Across the world, declining groundwater levels cause wells to run dry, increase water and food insecurity, and often acutely impact groundwater-dependent communities. Despite the ubiquity and severity of these impacts, groundwater research has primarily focused on economic policy instruments for sustainable management or the quantification of groundwater depletion, rather than assessing the impacts of management decisions. In particular, how definitions of groundwater sustainability shape the fate of resource users remains unexplored. Here, we examine one of the world’s largest-scale environmental sustainability reforms, the California Sustainable Groundwater Management Act (SGMA), and estimate the impact of sustainability definitions proposed in groundwater sustainability plans (GSPs) on well failure. We show that locally-proposed sustainability criteria are consistent with business as usual groundwater level decline, and if reached, could impact over 9000 domestic wells and around 1000 public supply wells. These findings highlight the necessity of careful and critical evaluation of locally-developed sustainability definitions and their implementation to prevent detrimental impacts, such as threats to household and municipal water supply