208 research outputs found

    Student Choice in Higher Education—Reducing or Reproducing Social Inequalities?

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    A hallmark of recent higher education policy in developed economies is the move towards quasi-markets involving greater student choice and provider competition, underpinned by cost-sharing policies. This paper examines the idealizations and illusions of student choice and marketization in higher education policy in England, although the overall conclusions have relevance for other countries whose higher education systems are shaped by neoliberal thinking. First, it charts the evolution of the student-choice rationale through an analysis of government commissioned reports, white papers, and legislation, focusing on policy rhetoric and the purported benefits of increasing student choice and provider competition. Second, the paper tests the predictions advanced by the student-choice rationale—increased and wider access, improved institutional quality, and greater provider responsiveness to the labour market—and finds them largely not met. Finally, the paper explores how conceptual deficiencies in the student-choice model explain why the idealization of student choice has largely proved illusionary. Government officials have narrowly conceptualized students as rational calculators primarily weighing the economic costs and benefits of higher education and the relative quality of institutions and programs. There is little awareness that student choices are shaped by several other factors as well and that these vary considerably by social background. The paper concludes that students’ choices are socially constrained and stratified, reproducing and legitimating social inequality

    Implementation of College In-State Tuition for Undocumented Immigrants in New York

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    This qualitative case study explored how New York’s in-state tuition policy is being implemented for undocumented immigrants at two community colleges within the City University of New York (CUNY) system. This investigation discovered that CUNY has devoted its own resources in the development of workshops, training sessions, manuals, and centers to assist in the implementation of this measure. Also, this study found that — while these colleges and CUNY overall have made a commitment towards the successful implementation of this policy — undocumented immigrants still face barriers in obtaining in-state tuition rates. The objective of this investigation is to under-stand how New York’s in-state tuition policy is being implemented for undocumented immi-grants. To explore this phenomenon, two groups of individuals were interviewed, state-3Spring 2010 NYLARNet 9 level officials6 and local-level officials.7 While no undocumented immigrants were requested to participate, the perception of that group was gathered from local-level officials. The in-sights of both sets of officials will provide a glimpse into how each has been involved with or affected by the manner in which this policy has been shaped and implemented for this specific population

    Duplex ultrasound imaging alone is sufficient for midterm endovascular aneurysm repair surveillance: A cost analysis study and prospective comparison with computed tomography scan

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    ObjectiveEarly in our experience with endovascular aortic aneurysm repair (EVAR) we performed both serial computed tomography scans and duplex ultrasound (DU) imaging in our post-EVAR surveillance regimen. Later we conducted a prospective study with DU imaging as the sole surveillance study and determined cost savings and outcome using this strategy.MethodsFrom September 21, 1998, to May 30, 2008, 250 patients underwent EVAR at our hospital. Before July 1, 2004, EVAR patients underwent CT and DU imaging performed every 6 months during the first year and then annually if no problems were identified (group 1). We compared aneurysm sac size, presence of endoleak, and graft patency between the two scanning modalities. After July 1, 2004, patients underwent surveillance using DU imaging as the sole surveillance study unless a problem was detected (group 2). CT and DU imaging charges for each regimen were compared using our 2008 health system pricing and Medicare reimbursements. All DU examinations were performed in our accredited noninvasive vascular laboratory by experienced technologists. Statistical analysis was performed using Pearson correlation coefficient.ResultsDU and CT scans were equivalent in determining aneurysm sac diameter after EVAR (P < .001). DU and CT were each as likely to falsely suggest an endoleak when none existed and were as likely to miss an endoleak. Using DU imaging alone would have reduced cost of EVAR surveillance by 29% (534,356)ingroup1.Costsavingsof534,356) in group 1. Cost savings of 1595 per patient per year were realized in group 2 by eliminating CT scan surveillance. None of the group 2 patients sustained an adverse event such as rupture, graft migration, or limb occlusion as a result of having DU imaging performed as the sole follow-up modality.ConclusionSurveillance of EVAR patients can be performed accurately, safely, and cost-effectively with DU as the sole imaging study
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