Acceptability and deliverability of an auditory rhythmical cueing (ARC) training programme for use at home and outdoors to improve gait and physical activity post-stroke

Background Although laboratory studies demonstrate that training programmes using auditory rhythmical cueing (ARC) may improve gait post-stroke, few studies have evaluated this intervention in the home and outdoors where deployment may be more appropriate. This manuscript reports stakeholder refinement of an ARC gait and balance training programme for use at home and outdoors, and a study which assessed acceptability and deliverability of this programme. Methods Programme design and content were refined during stakeholder workshops involving physiotherapists and stroke survivors. A two-group acceptability and deliverability study was then undertaken. Twelve patients post-stroke with a gait related mobility impairment received either the ARC gait and balance training programme or the gait and balance training programme without ARC. Programme provider written notes, participant exercise and fall diaries, adverse event monitoring and feedback questionnaires captured data about deliverability, safety and acceptability of the programmes. Results The training programme consisted of 18 sessions (six supervised, 12 self-managed) of exercises and ARC delivered by a low-cost commercially available metronome. All 12 participants completed the six supervised sessions and 10/12 completed the 12 self-managed sessions. Provider and participant session written records and feedback questionnaires confirmed programme deliverability and acceptability. Conclusion An ARC gait and balance training programme refined by key stakeholders was feasible to deliver and acceptable to participants and providers. Trial registration ISCTRN 12/03/2018.

Sustainable development in the design of online degree programmes for national cross-studies

This study examines the integration of sustainable development in the holistic design of higher education online degree programmes for national cross-studies in Finland. The methodology adopted is design-based research. The literature combines works from the fields of online degree programme design and sustainable development. The empirical data is collected from an Online Degree Working Group representing various online degree expertise in applied higher education. The results of this study highlight the importance of national level collaboration in efforts to reach sustainable development goals in online degree programmes for national cross-studies in higher education. Key sustainability competencies are combined into online degree programme design to reveal new considerations for sustainable development in the online degree education context. The results can be utilised by managers, administrators, and educators of online degree programmes in higher education organisations who are interested in implementing sustainable development in the design phase of the online degree programmes.

Decentralisation of Public Enterprises in federal countries

To bring concepts and knowledge to bear more effectively on policy analysis and programme design, a framework for analysis is needed that focuses on alternatives for organising and financing the State Owned Enterprises (SOEs). Whether the motivating force behind organisation of SOEs is political or economic, a developing country situation demands that the strategy be looked at from the perspective of the provision of the people’s needs. The paper looks at the forms of SOEs and the relevance of fiscal federalism in this context. Past experience has some lessons and a flawed policy can have unwelcome consequences. Keeping in view the different initial conditions, strategies need to be devised for organisation of SOEs.

Business accelerators as learning environments: A mixed methods investigation

<p>This thesis is a study of business accelerators, and the efficacy of accelerators as learning environments. Accelerators are increasingly becoming a popular strategy for delivering a more authentic entrepreneurial learning experience. Accelerators provide a time-bound suite of highly structured educational and business development activities that provide learning support to cohorts of competitively selected high-potential entrepreneurial teams. The participants face considerable uncertainty and are exposed to complex learning and business development processes associated with rapidly building, validating, and scaling investable business models. Intense mentorship and entrepreneurial education are core features by which accelerators support this journey. Thus, an implicit assumption embedded in accelerator programme logic is the accelerator learning environment positively shapes learning and development outcomes. Yet little research has investigated how accelerators influence participant learning and development. This gap motives the current research. A multilevel quantitative and qualitative mixed methods approach was adopted to examine participant learning and development at the three levels of participation embedded within accelerator programme design – cohort, team and participant. Concepts and measures from academic work on accelerators, learning agility, and individual performance behaviour were assembled into a coherent set of investigative tools and lenses. Taken together, they frame the accelerator learning environment as a whole system of actors and elements that operate both independently and interdependently. The research setting is a Global Accelerator Network affiliate programme based in New Zealand. Three strands of data were collected on 29 participants associated with 10 venture teams participating in a single accelerator programme cohort. Strand 1 applied a multiphase quantitative survey approach to capture a longitudinal understanding of how accelerators influence participant learning and development at the cohort level. Patterns of relationships between the key constructs were identified for each phase. Strand 2 utilised a qualitative observation method to investigate the quantitative findings through a team lens. This was done because of the central role teams play in the accelerator programme logic. Each of these stands occurred during the accelerator. Strand 3 used interviews to explore how the accelerator learning environment influenced learning and development at the level of individual participants. Interview data was collected six months after the accelerator to capture participant perceptions in retrospect. The research findings show accelerators do more than shelter emerging organisations; they actively support the development of the new venture, provide an authentic learning environment for the entrepreneurs, and they foster the development of entrepreneurship capacity. However, findings also suggest participant response to the learning environment is dynamic and unpredictable. Specifically, participants perceived the learning and development benefits they received from: a) mentors, as low across all phases; b) managers, as strongest during the middle and last phase of the programme; c) the cohort of participants, as very helpful during all three phases; and, d) accelerator instructional programming was tied closely to the relevance, quality and timing of the resources provided to them. Further, the evidence suggests team composition matters more than the team’s business idea, and task-oriented accelerator programme design negatively influences learning and development by limiting the amount of ‘free’ time participants have for creative interactions, experimentation and reflection. Thus, the availability of accelerator learning opportunities, such as education and mentorship, can both enable and hinder participant learning and development. This study provides insights for entrepreneurship research focused on supporting the development and success of early-stage enterprises. The presented findings and interpretations offer scholars, organisers and stakeholders a greater appreciation of the importance of participant learning and development in accelerators. They also suggest the utility of applying learning agility and individual performance concepts as lenses for understanding individual learning processes and their effects in entrepreneurial contexts beyond accelerators. Research limitations, implications for policy and practice, and future research are discussed.</p>

Business accelerators as learning environments: A mixed methods investigation

<p>This thesis is a study of business accelerators, and the efficacy of accelerators as learning environments. Accelerators are increasingly becoming a popular strategy for delivering a more authentic entrepreneurial learning experience. Accelerators provide a time-bound suite of highly structured educational and business development activities that provide learning support to cohorts of competitively selected high-potential entrepreneurial teams. The participants face considerable uncertainty and are exposed to complex learning and business development processes associated with rapidly building, validating, and scaling investable business models. Intense mentorship and entrepreneurial education are core features by which accelerators support this journey. Thus, an implicit assumption embedded in accelerator programme logic is the accelerator learning environment positively shapes learning and development outcomes. Yet little research has investigated how accelerators influence participant learning and development. This gap motives the current research. A multilevel quantitative and qualitative mixed methods approach was adopted to examine participant learning and development at the three levels of participation embedded within accelerator programme design – cohort, team and participant. Concepts and measures from academic work on accelerators, learning agility, and individual performance behaviour were assembled into a coherent set of investigative tools and lenses. Taken together, they frame the accelerator learning environment as a whole system of actors and elements that operate both independently and interdependently. The research setting is a Global Accelerator Network affiliate programme based in New Zealand. Three strands of data were collected on 29 participants associated with 10 venture teams participating in a single accelerator programme cohort. Strand 1 applied a multiphase quantitative survey approach to capture a longitudinal understanding of how accelerators influence participant learning and development at the cohort level. Patterns of relationships between the key constructs were identified for each phase. Strand 2 utilised a qualitative observation method to investigate the quantitative findings through a team lens. This was done because of the central role teams play in the accelerator programme logic. Each of these stands occurred during the accelerator. Strand 3 used interviews to explore how the accelerator learning environment influenced learning and development at the level of individual participants. Interview data was collected six months after the accelerator to capture participant perceptions in retrospect. The research findings show accelerators do more than shelter emerging organisations; they actively support the development of the new venture, provide an authentic learning environment for the entrepreneurs, and they foster the development of entrepreneurship capacity. However, findings also suggest participant response to the learning environment is dynamic and unpredictable. Specifically, participants perceived the learning and development benefits they received from: a) mentors, as low across all phases; b) managers, as strongest during the middle and last phase of the programme; c) the cohort of participants, as very helpful during all three phases; and, d) accelerator instructional programming was tied closely to the relevance, quality and timing of the resources provided to them. Further, the evidence suggests team composition matters more than the team’s business idea, and task-oriented accelerator programme design negatively influences learning and development by limiting the amount of ‘free’ time participants have for creative interactions, experimentation and reflection. Thus, the availability of accelerator learning opportunities, such as education and mentorship, can both enable and hinder participant learning and development. This study provides insights for entrepreneurship research focused on supporting the development and success of early-stage enterprises. The presented findings and interpretations offer scholars, organisers and stakeholders a greater appreciation of the importance of participant learning and development in accelerators. They also suggest the utility of applying learning agility and individual performance concepts as lenses for understanding individual learning processes and their effects in entrepreneurial contexts beyond accelerators. Research limitations, implications for policy and practice, and future research are discussed.</p>

Long-term effects of payment for performance on maternal and child health outcomes: evidence from Tanzania

BackgroundThe success of payment for performance (P4P) schemes relies on their ability to generate sustainable changes in the behaviour of healthcare providers. This paper examines short-term and longer-term effects of P4P in Tanzania and the reasons for these changes.MethodsWe conducted a controlled before and after study and an embedded process evaluation. Three rounds of facility, patient and household survey data (at baseline, after 13 months and at 36 months) measured programme effects in seven intervention districts and four comparison districts. We used linear difference-in-difference regression analysis to determine programme effects, and differential effects over time. Four rounds of qualitative data examined evolution in programme design, implementation and mechanisms of change.ResultsProgramme effects on the rate of institutional deliveries and antimalarial treatment during antenatal care reduced overtime, with stock out rates of antimalarials increasing over time to baseline levels. P4P led to sustained improvements in kindness during deliveries, with a wider set of improvements in patient experience of care in the longer term. A change in programme management and funding delayed incentive payments affecting performance on some indicators. The verification system became more integrated within routine systems over time, reducing the time burden on managers and health workers. Ongoing financial autonomy and supervision sustained motivational effects in those aspects of care giving not reliant on funding.ConclusionOur study adds to limited and mixed evidence documenting how P4P effects evolve over time. Our findings highlight the importance of undertaking ongoing assessment of effects over time.

Evaluating the impact of the first 10 years of the Cambridge Masters in Conservation Leadership

Conservation lacks sufficient well-trained leaders who are empowered to catalyse positive change for the natural world. Addressing this need, the University of Cambridge launched a Masters in Conservation Leadership in 2010. The degree includes several features designed to enhance its impact. Firstly, it recruits international, gender-balanced cohorts of mid-career professionals, building leadership capacity in the Global South and providing a rich environment for peer learning. Secondly, teaching includes applied leadership training in topics such as fundraising, leading people and networking, as well as interdisciplinary academic topics. Thirdly, the degree is delivered through the Cambridge Conservation Initiative, a partnership of international NGOs and networks, facilitating extensive practitioner-led and experiential learning. We present details of programme design and evaluate the impact of the Masters after 10 years, using data from course records, student and alumni perspectives, and interviews with key stakeholders. The course has broadly succeeded in its design and recruitment objectives. Self-assessed leadership capabilities, career responsibilities and the overall impact of alumni increased significantly 5 years after graduation. However, specific impacts of alumni in certain areas, such as on their professional colleagues, have been less clear. We conclude by outlining future plans for the Masters in light of growing demands on conservation leaders and the changing landscape of leadership capacity development. These include reforms to course structure and assessment, long-term support to the alumni network and developing a conservation leadership community of practice.

Effectiveness of Hospitality Programme Design in Developing Skills among the Graduates from Vocational Education and Training in Arusha Region, Tanzania

Tourism and hospitality sector in Tanzania contributes to 18 percent of the Gross Domestic Product (GDP) and about 10 percent employment rate in the country. However, industry professionals are complaining about the quality of human resource from training institutions. While some authors have addressed the quality of human resources in relation to graduates’ skills possession using the managers, trainers and the nature of services they render, the researcher could not find a study that has addressed the issue in relation to programme design from the trainers, heads of department and hotel managers. This study was set to answer the main research question: How is VET hospitality programme designed to contribute to skills development among the graduates in Arusha region? The study employed convergent design to assess VET hospitality programme design in developing skills among the graduates. Participants were obtained through simple random sampling of training institutions and purposive sampling of hotels belonging to HAT in Arusha region. Data were collected through semi structured interview with the hotel managers and heads of department, structured interview with the trainers and content analysis of programme document. Data were analyzed by transcription of data from the interviews. Programme activities were used to analyze the collected data and used for data interpretation. Interpretation and discussion of data analysis results were summarized and compared with the reviewed literature and theories. The findings for this study indicated that VET programme for Food and Beverages Service and Sales and Front Office Operations are well designed to enhance skills development among the graduates and if well implemented should lead to the acquisition of hospitality knowledge, skills, values and attitudes. English and communication skills, as a supporting course needs to be structured for implementers to understand designated learning outcomes, learning activities, teaching and training methods and assessment activities.

The role of nutrition and feeding in equine weight management

Increasing awareness of the prevalence of overweight and obese horses has shed light on to the importance of appropriate nutrition and feed management within weight loss programmes. The review presents a basic approach to weight loss programme design and appropriate feeding and shows that while there is sufficient information upon which to base weight loss programmes, the findings of recent research into compliance and communication is likely to improve future success. Further education for livery yards and establishments is also a pivotal piece of the weight loss puzzle. There is still ground with regard to the most appropriate conserved forage, and a shift in responsibilities and mindset when it comes to forage analysis may be required. Ultimately, success may lie in a multidisciplinary team approach to weight recognition and management, and the development of a framework for fostering and maintaining communication across paraprofessionals and owners is an essential first step.