scholarly journals The Maldistribution of Pediatric Providers as a Potential Driver of Reduced Educational Outcomes

2021 ◽  
Author(s):  
Jessica C Boyle ◽  
Ben W Domingue
Keyword(s):  
Child Health ◽  
National Level ◽  
Family Physicians ◽  
District Level ◽  
Health Access ◽  
Future Research ◽  
Physician Supply ◽  
Achievement Data ◽  
Uninsured Children ◽  
Child Health Access

Objective Despite evidence of a strong bidirectional connection between educational achievement and health, few studies have examined the link between these intertwining forces on a national level. This study takes advantage of a new population-level dataset to explicitly link child health access to academic outcomes in nearly every U.S. school district. Methods National data were used to construct and link district-level measures of child health access to district-level measures of third-grade achievement. Specifically, location data for over 256,000 practicing pediatricians and family physicians were linked to achievement data from 12,296 school districts. We include district-level rates of uninsured children as an additional measure of child health access. Results First, physician supply is unequally distributed across districts and their student populations. Second, districts that had higher physician supply tended to have higher test scores. This relationship is most pronounced for districts with relatively few pediatricians and family physicians. While the rate of uninsured children is largely correlated with community socioeconomic status, physician supply appears to operate independently of this measure. Conclusion Early childhood health and wellbeing are linked to cognitive performance and achievement in school. We provide evidence to illustrate an aspect of this relationship: children with less access to healthcare providers also do less well in school. The specific patterning of this finding suggests a need to reconsider how availability and access to pediatricians and family physicians is currently configured. Future research should examine whether a redistribution of the existing physician workforce could result in a net academic benefit for students.

scholarly journals Does the Narrative About the Use of Evidence in Priority Setting Vary Across Health Programs Within the Health Sector: A Case Study of 6 Programs in a Low-Income National Healthcare System

2020 ◽  
Author(s):  
Lydia Kapiriri
Keyword(s):  
Child Health ◽  
Healthcare System ◽  
Low Income ◽  
Priority Setting ◽  
National Level ◽  
District Level ◽  
Health Programs ◽  
Policy Makers ◽  
The Impact ◽  
And Child Health

Background: There is a growing body of literature on evidence-informed priority setting. However, the literature on the use of evidence when setting healthcare priorities in low-income countries (LICs), tends to treat the healthcare system (HCS) as a single unit, despite the existence of multiple programs within the HCS, some of which are donor supported. Objectives: (i) To examine how Ugandan health policy-makers define and attribute value to the different types of evidence; (ii) Based on 6 health programs (HIV, maternal, newborn and child health [MNCH], vaccines, emergencies, health systems, and non- communicable diseases [NCDs]) to discuss the policy-makers’ reported access to and use of evidence in priority setting across the 6 health programs in Uganda; and (iii) To identify the challenges related to the access to and use of evidence. Methods: This was a qualitative study based on in-depth key informant interviews with 60 national level (working in 6 different health programs) and 27 sub-national (district) level policy-makers. Data were analysed used a modified thematic approach. Results: While all respondents recognized and endeavored to use evidence when setting healthcare priorities across the 6 programs and in the districts; more national level respondents tended to value quantitative evidence, while more district level respondents tended to value qualitative evidence from the community. Challenges to the use of evidence included access, quality, and competing values. Respondents from highly politicized and donor supported programs such as vaccines, HIV and maternal neonatal and child health were more likely to report that they had access to, and consistently used evidence in priority setting. Conclusion: This study highlighted differences in the perceptions, access to, and use of evidence in priority setting in the different programs within a single HCS. The strong infrastructure in place to support for the access to and use of evidence in the politicized and donor supported programs should be leveraged to support the availability and use of evidence in the relatively under-resourced programs. Further research could explore the impact of unequal availability of evidence on priority setting between health programs within the HCS.

scholarly journals A gold mine, but still no Klondike: Nordic register data in health inequalities research

2019 ◽  
Vol 47 (6) ◽  
pp. 618-630 ◽  
Author(s):  
Kjetil A. Van Der Wel ◽  
Olof Östergren ◽  
Olle Lundberg ◽  
Kaarina Korhonen ◽  
Pekka Martikainen ◽  
...  
Keyword(s):  
National Level ◽  
Data Access ◽  
Register Data ◽  
Future Research ◽  
Gold Mine ◽  
Birth Cohorts ◽  
Policy And Practice ◽  
Research Papers ◽  
Processing Times ◽  
Acquisition Processes

Aims: Future research on health inequality relies on data that cover life-course exposure, different birth cohorts and variation in policy contexts. Nordic register data have long been celebrated as a ‘gold mine’ for research, and fulfil many of these criteria. However, access to and use of such data are hampered by a number of hurdles and bottlenecks. We present and discuss the experiences of an ongoing Nordic consortium from the process of acquiring register data on socio-economic conditions and health in Denmark, Finland, Norway and Sweden. Methods: We compare experiences of data-acquisition processes from a researcher’s perspective in the four countries and discuss the comparability of register data and the modes of collaboration available to researchers, given the prevailing ethical and legal restrictions. Results: The application processes we experienced were time-consuming, and decision structures were often fragmented. We found substantial variation between the countries in terms of processing times, costs and the administrative burden of the researcher. Concerned agencies differed in policy and practice which influenced both how and when data were delivered. These discrepancies present a challenge to comparative research. Conclusions: We conclude that there are few signs of harmonisation, as called for by previous policy documents and research papers. Ethical vetting needs to be centralised both within and between countries in order to improve data access. Institutional factors that seem to facilitate access to register data at the national level include single storage environments for health and social data, simplified ethical vetting and user guidance.

scholarly journals A Regional Review of Genetic Resource Access and Benefit Sharing – Key Issues and Research Gaps

2021 ◽  
pp. 1-24
Author(s):  
Clare Morrison ◽  
Fran Humphries ◽  
Charles Lawson
Keyword(s):  
Intellectual Property ◽  
Traditional Knowledge ◽  
Biological Diversity ◽  
National Level ◽  
Sustainable Use ◽  
Benefit Sharing ◽  
Comparative Approach ◽  
Future Research ◽  
Access And Benefit Sharing ◽  
Legal Mechanism

Countries are increasingly using access and benefit sharing (ABS) as a legal mechanism to support the conservation and sustainable use of the world’s biological diversity. ABS regulates collection and/or use of genetic resources/traditional knowledge and sharing benefits from their use with the provider. The purpose of this review is to assess the trends, biases and gaps of ABS literature using a regional comparative approach about the key topics of concern between each region. It analyses four key topic groupings: (1) implementation of international, regional and national ABS policy and law; (2) intellectual property and ABS; (3) traditional knowledge; and (4) research, development and commercialisation. Findings included gaps in: (1) analysing effectiveness of national level implementation; (2) addressing apparent conflicts between support for intellectual property promoting exclusivity for traditional knowledge and challenges to intellectual property exclusivity for patents; (3) examining traditional knowledge of local communities (in contrast to Indigenous Peoples); and (4) lack of practical examples that quantify benefit sharing from research and commercialisation outcomes. We conclude that future research addressing the identified gaps and biases can promote more informed understanding among stakeholders about the ABS concept and whether it is capable of delivering concrete biological conservation, sustainable use and equity outcomes.

scholarly journals Association of child health and household amenities in high focus states in India: a district-level analysis

BMJ Open ◽  
2015 ◽  
Vol 5 (5) ◽  
pp. e007589-e007589 ◽  
Author(s):  
J. Gouda ◽  
A. K. Gupta ◽  
A. K. Yadav
Keyword(s):  
Child Health ◽  
District Level ◽  
Level Analysis

“They Need More Training!” A National Level Analysis of Police Academy Basic Training Priorities

2021 ◽  
pp. 109861112110133
Author(s):  
John J. Sloan III ◽  
Eugene A. Paoline III
Keyword(s):  
Core Curriculum ◽  
National Level ◽  
Secondary Data ◽  
Future Research ◽  
Police Academy ◽  
Basic Training ◽  
The Hours ◽  
Contact Hours ◽  
Mean Differences ◽  
New Recruits

Recurring incidents of Black citizens killed or injured during interactions with police has led to calls for “more training” of officers, including new recruits. Prior research on academy-based police recruit training has centered on evaluation and heavily relied on case studies. The current study overcomes these limitations by analyzing the structure and content of academy-based basic training using secondary data collected from the population (N = 591) of U.S. police academies. Although we found significant mean differences across academies in total required contact hours needed to graduate and with how the hours were distributed across training areas, we also found academies adopted the same core curriculum consisting of six major “themes” and topics (n = 39) comprising them. We also found academies prioritized core areas of training in certain areas, while requiring far fewer hours in others. Implications of our results for basic training of recruits and suggestions for future research are then presented.

scholarly journals Evaluating the national multisite implementation of dialectical behaviour therapy in a community setting: A mixed methods approach

2019 ◽  
Author(s):  
Daniel Flynn ◽  
Mary Joyce ◽  
Conall Gillespie ◽  
Mary Kells ◽  
Michaela Swales ◽  
...  
Keyword(s):  
Mixed Methods ◽  
National Level ◽  
Team Leader ◽  
Barriers And Facilitators ◽  
Future Research ◽  
Evidence Based ◽  
Community Settings ◽  
Team Leaders ◽  
Implementation Framework ◽  
Mixed Methods Approach

Abstract Background The implementation of evidence-based interventions for borderline personality disorder in community settings is important given that individuals with this diagnosis are often extensive users of both inpatient and outpatient mental health services. Although work in this area is limited, previous studies have identified facilitators and barriers to successful DBT implementation. This study seeks to expand on previous work by evaluating a coordinated implementation of DBT in community settings at a national level. The Consolidated Framework for Implementation Research (CFIR) [1] provided structural guidance for this national level coordinated implementation.Methods A mixed methods approach was utilised to explore the national multi-site implementation of DBT from the perspective of team leaders and therapists who participated in the coordinated training and subsequent implementation of DBT. Qualitative interviews with DBT team leaders ( n = 8) explored their experiences of implementing DBT in their local service and was analysed using content analysis. Quantitative surveys from DBT therapists ( n = 74) examined their experience of multiple aspects of the implementation process including orienting the system, and preparations and support for implementation. Frequencies of responses were calculated. Written qualitative feedback was analysed using content analysis.Results Five themes were identified from the interview data: team formation, implementation preparation, client selection, service level challenges and team leader role. Participants identified team size and support for the team leader as key points for consideration in DBT implementation. Key challenges encountered were the lack of system support to facilitate phone coaching and a lack of allocated time to focus on DBT. Implementation facilitators included having dedicated team members and support from management.Conclusions The barriers and facilitators identified in this study are broadly similar to those reported in previous research. Barriers and facilitators were identified across several domains of the CFIR and are consistent with a recently published DBT implementation Framework [2]. Future research should pay particular attention to the domain of characteristics of individuals involved in DBT implementation. The results highlight the importance of a mandated service plan for the coordinated implementation of an evidence-based treatment in a public health service.

scholarly journals A More Perfect Union? Christian Nationalism and Support for Same-Sex Unions

2019 ◽  
Author(s):  
Andrew L Whitehead ◽  
Samuel Perry
Keyword(s):  
Political Ideology ◽  
Sense Of Self ◽  
National Level ◽  
Future Research ◽  
Same Sex ◽  
Religious Identities ◽  
Same Sex Marriage ◽  
Civil Unions ◽  
Social Identity Complexity ◽  
Christian Nationalism

How do overlapping social identities shape Americans’ views toward contemporary social and moral issues? Drawing upon national-level data and employing the theoretical construct of social identity complexity, we examine the link between Christian nationalism–representing a convergence of national and religious identities–and Americans’ views toward same-sex marriage and civil unions. Multivariate analyses reveal that greater adherence to Christian nationalism is strongly and negatively related to support for both same-sex marriage and civil unions, even after controlling for political ideology, religious controls, attribution of homosexuality, and other relevant correlates. We argue that Christian nationalists, who by definition internalize a high degree of overlap between political and religious identities, are more likely to see gays and lesbians as out-groups and same-sex unions as a threat to their sense of self and community. We conclude by discussing the implications of this study for future research on political and religious identities and intolerance toward socially marginalized populations.

scholarly journals Understanding Agenda Setting in State Educational Policy: An Application of Kingdon’s Multiple Streams Model to the Formation of State Reading Policy

2010 ◽  
Vol 18 ◽  
pp. 15 ◽  
Author(s):  
Tamara Viola Young ◽  
Thomas V. Shepley ◽  
Mengli Song
Keyword(s):  
Public Schools ◽  
Agenda Setting ◽  
National Level ◽  
State Level ◽  
Executive Branch ◽  
The State ◽  
Multiple Streams ◽  
Reading Policy ◽  
Achievement Data ◽  
Multiple Streams Model

Drawing on interview data from reading policy actors in California, Michigan, and Texas, this study applied Kingdon's (1984, 1995) multiple streams model to explain how the issue of reading became prominent on the agenda of state governments during the latter half of the 1990s. A combination of factors influenced the status of a state's reading policy agenda, including feedback from parents, teachers, and business groups; student achievement data; political pressure from the state administration; regional and national interest; a pervasive belief that reading is a building block for student success; and a widespread perception that the decline in reading achievement was symbolic of the failure of public schools. In addition, governors promoted reading to high agenda prominence by influencing which issues were placed on the decision agenda (agenda setting) and which alternatives were given serious attention (alternative specification). Finally, the findings suggest that the applicability of Kingdon's national-level model to the state level may depend on both the issue being examined and the participation of the state executive branch.

scholarly journals The Museum System of Modern Kazakhstan: Classification and Typology of Museums

2021 ◽  
Vol 9 (2) ◽  
pp. 79-89
Author(s):  
Abay Satubaldin ◽  
Kunikey Sakhiyeva
Keyword(s):  
National Level ◽  
Regional Level ◽  
District Level ◽  
Soviet System ◽  
Provincial Level ◽  
The Past ◽  
System A ◽  
The Subject ◽  
First Time

This article discusses the museum system of modern Kazakhstan and offers, for the first time ever, a classification and typology of the country’s museums.In recent years in independent Kazakhstan, on the basis of the Soviet system, a modern museum network has been formed which currently lists 250 museums. Among them are 17 national-level museums, 54 at the regional level, 73 at the provincial level, 103 branches of regional- and district-level museums and four private museums.The purpose of this article is to analyse the museum system of modern Kazakhstan and develop a classification and typology of the country’s museums.In the course of the study, conducted in 2017–2018, data was collected on the activities of museums at the national, regional and district levels over the past seven years. From the results of this investigation, the museums of Kazakhstan were systematized according to the subject or topic of the museum (e.g. history, art, scientific), its affiliation (national, regional district), and by size, measured by number of employees.

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