For the Welfare of Children: Lessons Learned from Class Action Litigation

ERIC Educational Resources Information Center

Meltzer, Judith, Ed.; Joseph, Rachel Molly, Ed.; Shookhoff, Andy, Ed.

2012-01-01

This series of papers brings together distinguished experts writing on the use of class action litigation to reform public child welfare systems. It is an effort to tease out of four decades of experience in this work, the factors that increase the likelihood that litigation will result in successful system reform. This publication is an outgrowth…

Family planning and sexual health organizations: management lessons for health system reform.

PubMed

Ambegaokar, Maia; Lush, Louisiana

2004-10-01

Advocates of health system reform are calling for, among other things, decentralized, autonomous managerial and financial control, use of contracting and incentives, and a greater reliance on market mechanisms in the delivery of health services. The family planning and sexual health (FP&SH) sector already has experience of these. In this paper, we set forth three typical means of service provision within the FP&SH sector since the mid-1900s: independent not-for-profit providers, vertical government programmes and social marketing programmes. In each case, we present the context within which the service delivery mechanism evolved, the management techniques that characterize it and the lessons learned in FP&SH that are applicable to the wider debate about improving health sector management. We conclude that the FP&SH sector can provide both positive and negative lessons in the areas of autonomous management, use of incentives to providers and acceptors, balancing of centralization against decentralization, and employing private sector marketing and distribution techniques for delivering health services. This experience has not been adequately acknowledged in the debates about how to improve the quality and quantity of health services for the poor in developing countries. Health sector reform advocates and FP&SH advocates should collaborate within countries and regions to apply these management lessons. Copyright 2004 Oxford University Press

Lessons Learned from Developing and Implementing the Qatar Student Assessment System. Research Brief

ERIC Educational Resources Information Center

Gonzalez, Gabriella; Le, Vi-Nhuan; Broer, Markus; Mariano, Louis T.; Froemel, J. Enrique; Goldman, Charles A.; DaVanzo, Julie

2009-01-01

Analysis of Qatar's standards-based student assessment system, the first in the region, offers several lessons for other nations instituting similar reforms. These include the need to coordinate on standards and assessment development, allow sufficient time for a fully aligned assessment, and communicate about the purposes and uses of testing.…

Lessons Learned in Systemic District Reform: A Cross-District Analysis from the Comprehensive Aligned Instructional System (CAIS) Benchmarking Study

ERIC Educational Resources Information Center

Waters, Louise Bay; Vargo, Merrill

2008-01-01

Urban district reform has been hampered by the challenge of understanding and supporting the tremendous complexity of district change. Improving this understanding through actionable, practice-based research is the purpose of this study. The authors began the study with the hypothesis that achieving districts both align their instructional systems…

Lessons learned from health sector reform: a four-country comparison.

PubMed

Talukder, Md Noorunnabi; Rob, Ubaidur; Mahabub-Ul-Anwar, Md

Various reforms have been undertaken to improve the functioning of health systems in developing countries, but there is limited comparative analysis of reform initiatives. This article discusses health sector reform experiences of four developing countries and identifies the lessons learned. The article is based on the review of background papers on Bangladesh, Pakistan, Indonesia, and Tanzania prepared as part of a multi-country study on health sector reform. Findings suggest that decentralization works effectively while implementing primary and secondary health programs. Decentralization of power and authority to local authorities requires strengthening and supporting these units. Along with the public sector, the private sector plays an effective role in institutional and human resources development as well as in improving service delivery. Community participation facilitates recruitment and development of field workers, facility improvement, and service delivery. For providing financial protection to the poor, there is a need to review user fees and develop affordable health insurance with an exemption mechanism. There is no uniform health sector reform approach; therefore, the experiences of other countries will help countries undertake appropriate reforms. Here, it is important to examine the context and determine the reform measures that constitute the best means in terms of equity, efficiency, and sustainability.

School-Based Management and Arts Education: Lessons from Chicago

ERIC Educational Resources Information Center

Fitzpatrick, Kate R.

2012-01-01

School-based management, or local school control, is an organizational school reform effort aimed at decentralizing school decision-making that has become prevalent in districts throughout the United States. Using the groundbreaking Chicago system of local school control as an exemplar, this article outlines the implications of such reform efforts…

The Indiana Science Initiative: Lessons from a Classroom Observation Study

ERIC Educational Resources Information Center

Cook, Nicole D.; Walker, William S.; Weaver, Gabriela C.; Sorge, Brandon H.

2015-01-01

The Indiana Science Initiative (ISI) is a systemic effort to reform K-8 science education. The program provides teachers with professional development, reform-oriented science modules, and materials support. To examine the impact of the initiative's professional development, a participant observation study was conducted in the program's pilot…

Final Report on the Study of the Impact of the Statewide Systemic Initiatives. Lessons Learned about Designing, Implementing, and Evaluating Statewide Systemic Reform. WCER Working Paper No. 2003-12

ERIC Educational Resources Information Center

Heck, Daniel J.; Weiss, Iris R.; Boyd, Sally E.; Howard, Michael N.; Supovitz, Jonathan A.

2003-01-01

This document represents the first of two volumes presented in "Study of the Impact of the Statewide Systemic Initiatives Program" (Norman L. Webb and Iris R. Weiss). In an effort to evaluate the impact of the Statewide Systemic Initiatives (SSIs) on student achievement and the lessons that could be learned from the National Science…

Synthesis of Findings from 15?years of Educational Reform in Thailand: Lessons on Leading Educational Change in East Asia

ERIC Educational Resources Information Center

Hallinger, Philip; Bryant, Darren A.

2013-01-01

The past two decades have been a period of active education reform throughout much of the world, and East Asia is no exception. This paper synthesizes findings from a series of empirical studies of educational reform in Thailand where an ambitious educational reform law was adopted in 1999. The purpose is to identify lessons learned about…

Urban School Systems and Education Reform: Key Lessons From a Case Study of Large Urban School Systems

ERIC Educational Resources Information Center

Snipes, Jason C.; Casserly, Michael D.

2004-01-01

Foundations for Success, a study conducted by MDRC for the Council of the Great City Schools, examined the reform efforts of 3 large urban school districts and a portion of a 4th that had been successful in improving student achievement and reducing racial achievement gaps. This article summarizes the key findings of the study and discusses the…

Organizational Change in the Russian Airborne Forces: The Lessons of the Georgian Conflict

DTIC Science & Technology

2011-12-01

with Georgia, the general pace of Russian military reform —which had, prior to the conflict, been moving at a glacial pace—increased exponentially...Training and Troop Service Directorate. 44. Dale Herspring and Roger McDermott, “Serdyukov Pro- motes Systemic Russian Military Reform ,” Orbis, Vol. 54, No

New York City's Children First: Lessons in School Reform

ERIC Educational Resources Information Center

Kelleher, Maureen

2014-01-01

Under Mayor Michael Bloomberg, New York City's education system embarked on a massive change effort, known as Children First, that produced significant results: new and better school options for families, more college-ready graduates, and renewed public confidence in New York City's schools. New York City's reform effort has also produced…

Advancing universal coverage of healthcare in China: translating political will into policy and practice.

PubMed

Tang, Shenglan; Brixi, Hana; Bekedam, Henk

2014-01-01

China launched its new health system reform plan in 2009 to advance its universal coverage of healthcare, after more than 4 years' consultations and discussions with various stakeholders including the public. This paper aims to introduce and discuss the context and process of China's current health system reform and analyse how political will in China has been translated into policy practice over the past decade. The paper also shares the insights of World Health Organization's contribution to China's health system reform, as the authors advised the Chinese government on the reform options and process. Furthermore, the paper describes and discusses key challenges in the implementation of the reform plan over the past 3 years and draws lessons for other countries. Copyright © 2013 John Wiley & Sons, Ltd.

Pharmaceutical reform in South Korea and the lessons it provides.

PubMed

Kim, Hak-Ju; Ruger, Jennifer Prah

2008-01-01

Through implementation of its 2000 pharmaceutical reform, the South Korean government expected to reduce the cost of medications and improve service levels, medical appropriateness of care, and drug effectiveness. However, despite the reform's lofty goals, unintended consequences have distorted the supply of medical services and spending. These consequences have included increasing the use of uninsured services, prescribing high-price drugs, and a growing market share for multinational drug companies. Further reforms are needed to reduce the measure's adverse effects. This paper examines the Korean mandatory prescription system and offers an analysis of Korea's reforms.

School Reform in Chicago: Lessons in Policy and Practice

ERIC Educational Resources Information Center

Russo, Alexander, Ed.

2004-01-01

"School Reform in Chicago" shares the lessons learned from the city of Chicago's school reform efforts over the past two decades, the most ambitious in history, becoming a huge laboratory for innovations in areas such as school governance, leadership, accountability, and community involvement. In 1987, The U.S. Secretary of Education…

Steering without navigation equipment: the lamentable state of Australian health policy reform

PubMed Central

2009-01-01

Background Commentary on health policy reform in Australia often commences with an unstated logical error: Australians' health is good, therefore the Australian Health System is good. This possibly explains the disconnect between the options discussed, the areas needing reform and the generally self-congratulatory tone of the discussion: a good system needs (relatively) minor improvement. Results This paper comments on some issues of particular concern to Australian health policy makers and some areas needing urgent reform. The two sets of issues do not overlap. It is suggested that there are two fundamental reasons for this. The first is the failure to develop governance structures which promote the identification and resolution of problems according to their importance. The second and related failure is the failure to equip the health services industry with satisfactory navigation equipment - independent research capacity, independent reporting and evaluation - on a scale commensurate with the needs of the country's largest industry. These two failures together deprive the health system - as a system - of the chief driver of progress in every successful industry in the 20th Century. Conclusion Concluding comment is made on the National Health and Hospitals Reform Commission (NHHRC). This continued the tradition of largely evidence free argument and decision making. It failed to identify and properly analyse major system failures, the reasons for them and the form of governance which would maximise the likelihood of future error leaning. The NHHRC itself failed to error learn from past policy failures, a key lesson from which is that a major - and possibly the major - obstacle to reform, is government itself. The Commission virtually ignored the issue of governance. The endorsement of a monopolised system, driven by benevolent managers will miss the major lesson of history which is illustrated by Australia's own failures. PMID:19948044

The Practice of School Reform: Lessons from Two Centuries

ERIC Educational Resources Information Center

Nehring, James

2009-01-01

Former high school teacher, school leader, activist, consultant, and now professor of education James Nehring combines vivid case studies with practical suggestions to describe how the system works to thwart good schools and what educators can do to improve them. In this book he paints the big picture of school reform in the United States, deftly…

Y&E Lessons in Learning: Youth and Education Program News, Summer 2003

ERIC Educational Resources Information Center

Cournoyer, David, Ed.

2003-01-01

This Summer 2003 issue of "Y&E Lessons in Learning" contains the following articles: (1) Playgrounds Where All Kids Are Able to Play; (2) Kellogg Foundation Promotes Youth Voices in Special Comic Book; (3) Families for Kids: A Powerful Approach to System Reform; (4) New Program Focuses Community Leaders on Educational Change; (5)…

The Health Care System Under French National Health Insurance: Lessons for Health Reform in the United States

PubMed Central

Rodwin, Victor G.

2003-01-01

The French health system combines universal coverage with a public–private mix of hospital and ambulatory care and a higher volume of service provision than in the United States. Although the system is far from perfect, its indicators of health status and consumer satisfaction are high; its expenditures, as a share of gross domestic product, are far lower than in the United States; and patients have an extraordinary degree of choice among providers. Lessons for the United States include the importance of government’s role in providing a statutory framework for universal health insurance; recognition that piecemeal reform can broaden a partial program (like Medicare) to cover, eventually, the entire population; and understanding that universal coverage can be achieved without excluding private insurers from the supplementary insurance market. PMID:12511380

Educating for Freedom and Responsibility: Lessons From the First Amendment Schools Project

ERIC Educational Resources Information Center

Mitchell, Cynthia

2016-01-01

The First Amendment Schools project holds rich lessons in how to change school cultures into "laboratories of democracy"--as well as in how to increase the odds of success for any school reform effort. School reform programs of any sort need to make sure to build in sustainability, to provide ways to spread their lessons beyond the…

Equity, governance and financing after health care reform: lessons from Mexico.

PubMed

Arredondo, Armando; Orozco, Emanuel

2008-01-01

To determine, from the perspective of providers, community leaders and users of health services, equity, governance and health financing outcomes of the Mexican health system reform.Cross-sectional study oriented towards the qualitative analysis of financing, governance and equity indicators for the uninsured population. Taking into account feasibility, as well as political and technical criteria, six Mexican states were selected as study populations and a qualitative research was conducted during 2004-2006. Two hundred and forty in-depth interviews were applied, in all selected states, to 60 decision-makers, including medical and administrative personnel; 60 service providers at health centres; 60 representatives of civil organizations, including municipal representatives and, finally, 60 members of health committees and users of services at second and first levels of care units. The analysis of interviews was performed using ATLAS-Ti software. An outcome mapping of health reform was developed. For political actors, Mexican health system reform has not modified dependence on the central level; ignorance about reform strategies and lack of participation in the search for financial resources to finance health systems were evidenced. Also, in all states under study, community leaders and users of services reported the need to improve an effective accountability system at both municipal and state levels. Health strategies for equity, governance and financing do not have adequate mechanisms to promote participation from all social actors. Improving this situation is a very important goal in the Mexican health democratization process, in the context of health care reform. There are relevant positive and negative effects of the reform on equity, governance and financing in health. Special emphasis is placed on the analysis of lessons learned in Mexico and the usefulness of the main strengths and weaknesses, as relevant evidences for other middle-income countries which are designing, implementing and evaluating reform strategies in order to achieve equity in resource allocation, good levels of governance and a greater financial protection in health.

Adequacy, accountability, autonomy and equity in a Middle Eastern school reform: The case of Qatar

NASA Astrophysics Data System (ADS)

Guarino, Cassandra M.; Tanner, Jeffery C.

2012-04-01

This study examines Qatar's recent and ambitious school reform in the early stages of its implementation against a set of four criteria for successful education systems drawn from guidelines developed by the international community: adequacy, accountability, autonomy and gender equity. We investigate both the initial structure of the reform and its sustainability in light of concerns that movements in these directions might be politically unfeasible. To some degree, these concerns are substantiated by the developments we trace. However, it is important to note that the reform has changed the landscape of primary and secondary education in Qatar and that many reform principles, though diluted, have been retained. This paper highlights lessons learned - both hopeful and cautionary - in the first few years of reform and presents a methodology for evaluating progress along key dimensions that can be applied to school systems in many nations.

Commentary: recent reforms in the British National Health Service--lessons for the United States.

PubMed Central

Holland, W W; Graham, C

1994-01-01

President Clinton recently announced his reform plan for health care in the United States. The United Kingdom, along with other countries, has already enacted reforms in an effort to overcome the basic problem of having insufficient funds to provide a health service to meet modern demands. This paper briefly describes the recent health reforms in the United Kingdom and highlights some lessons for the United States, which include the need to choose procedures that should be universally provided. Health reforms that involve some fundamental restructuring need to be evaluated everywhere and agreed to by the staff in advance. PMID:8296937

Pharmaceutical policy reform in Canada: lessons from history.

PubMed

Boothe, Katherine

2018-07-01

Canada is the only country with a broad public health system that does not include universal, nationwide coverage for pharmaceuticals. This omission causes real hardship to those Canadians who are not well-served by the existing patchwork of limited provincial plans and private insurance. It also represents significant forgone benefits in terms of governments' ability to negotiate drug prices, make expensive new drugs available to patients on an equitable basis, and provide integrated health services regardless of therapy type or location. This paper examines Canada's historical failure to adopt universal pharmaceutical insurance on a national basis, with particular emphasis on the role of public and elite ideas about its supposed lack of affordability. This legacy provides novel lessons about the barriers to reform and potential methods for overcoming them. The paper argues that reform is most likely to be successful if it explicitly addresses entrenched ideas about pharmacare's affordability and its place in the health system. Reform is also more likely to achieve universal coverage if it is radical, addressing various components of an effective pharmaceutical program simultaneously. In this case, an incremental approach is likely to fail because it will not allow governments to contain costs and realize the social benefits that come along with a universal program, and because it means forgoing the current promising conditions for achieving real change.

Indian University System: Revitalization and Reform.

ERIC Educational Resources Information Center

Mathur, M. V., Ed.; And Others

This book contains 35 papers on varying aspects of the Indian university system and strategies for its renewal. The papers are: (1) "Introduction: Imperatives of System Renewal" (Ramesh K. Arora and Meena Sogani; (2) "The Universities and the State: Global Experience and Lessons for India" (Malcolm S. Adiseshiah); (3)…

The Real Lessons in School Reform from Britain.

ERIC Educational Resources Information Center

Walford, Geoffrey

1993-01-01

John E. Chubb and Terry M. Moe's booklet "A Lesson in School Reform from Great Britain (Brookings, 1992) and Denis Lawton's book "Education and Politics in the 1990s: Conflict or Consensus?" (Falmer, 1992) attempt to evaluate effects of recent educational changes in England and Wales. Lawton's thoughtful, scholarly analysis of the…

Education Reforms: Lessons from History

ERIC Educational Resources Information Center

Hunt, Thomas C.

2005-01-01

Policy makers in education have long embraced reform. Unfortunately, education reforms have consistently been plagued by the reformers' lack of knowledge and appreciation of the history of education. Accordingly, the latest reform, touted as a panacea, meets with failure, and the search for the magic elixir begins anew. The ahistorical nature of…

Mount Sinai Hospital's approach to Ontario's Health System Funding Reform.

PubMed

Chalk, Tyler; Lau, Davina; Morgan, Matthew; Dietrich, Sandra; Beduz, Mary Agnes; Bell, Chaim M

2014-01-01

In April 2012, the Ontario government introduced Health System Funding Reform (HSFR), a transformational shift in how hospitals are funded. Mount Sinai Hospital recognized that moving from global funding to a "patient-based" model would have substantial operational and clinical implications. Adjusting to the new funding environment was set as a top corporate priority, serving as the strategic basis for re-examining and redesigning operations to further improve both quality and efficiency. Two years into HSFR, this article outlines Mount Sinai Hospital's approach and highlights key lessons learned. Copyright © 2014 Longwoods Publishing.

Student Loan Reform, Interest Subsidies and Costly Technicalities: Lessons from the UK Experience

ERIC Educational Resources Information Center

Johnston, Alison; Barr, Nicholas

2013-01-01

In this paper, we consider lessons for other countries about the design of student loans with income-contingent repayments (i.e. repayments calculated as "x" per cent of each borrower's subsequent income). Using a dataset of 20,000 simulated lifetime graduate earnings paths, we estimate the cost and distributional effects of reforms in…

Policy experimentation and innovation as a response to complexity in China's management of health reforms.

PubMed

Husain, Lewis

2017-08-03

There are increasing criticisms of dominant models for scaling up health systems in developing countries and a recognition that approaches are needed that better take into account the complexity of health interventions. Since Reform and Opening in the late 1970s, Chinese government has managed complex, rapid and intersecting reforms across many policy areas. As with reforms in other policy areas, reform of the health system has been through a process of trial and error. There is increasing understanding of the importance of policy experimentation and innovation in many of China's reforms; this article argues that these processes have been important in rebuilding China's health system. While China's current system still has many problems, progress is being made in developing a functioning system able to ensure broad population access. The article analyses Chinese thinking on policy experimentation and innovation and their use in management of complex reforms. It argues that China's management of reform allows space for policy tailoring and innovation by sub-national governments under a broad agreement over the ends of reform, and that shared understandings of policy innovation, alongside informational infrastructures for the systemic propagation and codification of useful practices, provide a framework for managing change in complex environments and under conditions of uncertainty in which 'what works' is not knowable in advance. The article situates China's use of experimentation and innovation in management of health system reform in relation to recent literature which applies complex systems thinking to global health, and concludes that there are lessons to be learnt from China's approaches to managing complexity in development of health systems for the benefit of the poor.

New Orleans Education Reform: A Guide for Cities or a Warning for Communities? (Grassroots Lessons Learned, 2005-2012)

ERIC Educational Resources Information Center

Buras, Kristen L.

2013-01-01

Louisiana Senator Mary Landrieu, co-chair of the Senate Public Charter School Caucus in Washington, DC, hosted a forum for education policymakers. It centered on "New Orleans-Style Education Reform: A Guide for Cities (Lessons Learned, 2004-2010)," a report published by the charter school incubator New Schools for New Orleans (NSNO).…

Enacting Curriculum Reform through Lesson Study: A Case Study of Mathematics Teacher Learning

ERIC Educational Resources Information Center

Ni Shuilleabhain, Aoibhinn; Seery, Aidan

2018-01-01

Based in a time of major curriculum reform, this article reports on a qualitative case study of teacher professional development (PD) in the Republic of Ireland (ROI). Five mathematics teachers in an Irish secondary school were introduced to and participated in successive cycles of school-based lesson study (LS) over the course of one academic…

Health sector reform in Argentina: a cautionary tale.

PubMed

Lloyd-Sherlock, Peter

2005-04-01

In November 2002 the World Bank published a report on the Argentine health sector. The report accurately portrays the complexity and severity of the problems facing the health care system. It stresses that these problems are not purely a product of the country's economic collapse, noting that the system has suffered from long-standing structural problems and inefficiencies. Curiously, the report makes no mention of the leading role played by the World Bank in health reform efforts during the 1990s. This paper demonstrates that these reforms did much to worsen pre-existing weaknesses of the sector. The paper criticises the content of the reform agenda and the manner in which it was produced, arguing that these were reforms in which considerations of public health were less significant than conformity to the wider model of neo-liberal social and economic development prevailing at the time. It also highlights problems of implementing the reform agenda, which reduced the coherency of the reforms. The paper goes on to examine the impact of the crisis, noting links with the preceding reforms. It identifies a number of insights and lessons of potential value to other countries which are pursuing similar policies.

Impacts of reform-based science in middle school classrooms

NASA Astrophysics Data System (ADS)

Ruth, Lisa Mccurry

2007-12-01

In the summer of 2005, the University of South Carolina offered a four week, summer professional development opportunity for middle school science teachers. In this institute, reform-based curricula and strategies were introduced to the teachers. Seven teachers were asked to participate in this study to assess the impacts of reformed curricula and pedagogy. Teachers administered standards-based pretests and posttests to their students before and after the specified unit of study. Teachers were videotaped teaching lessons included in the curriculum unit or teaching a lesson that addressed the same set of standards. Pretests and posttests were analyzed and effect sizes were calculated. Effect sizes ranged from a minimum of 0.57 to 3.18. Videotaped lessons were analyzed using the Reformed Teaching Observation Protocol (RTOP) developed by the Arizona Collaborative for Excellence in the Preparation of Teachers (ACEPT) project. The level of inquiry-based instruction was not found to be a primary predictor of student learning gains, but was found to be associated with teachers who implemented the curriculum and associated pedagogical techniques. Teachers who presented lessons considered highly reformed had effect sizes as high as or greater than those who continued to utilize more traditional methods of teaching, when student population differences are taken into account. These same teachers were highly successful in facilitating student-directed, scientific discussions in their classrooms as compared to teachers who did not utilize curriculum materials.

Financing reforms of public health services in China: lessons for other nations.

PubMed

Liu, Xingzhu; Mills, Anne

2002-06-01

Financing reforms of China's public health services are characterised by a reduction in government budgetary support and the introduction of charges. These reforms have changed the financing structure of public health institutions. Before the financing reforms, in 1980, government budgetary support covered the full costs of public health institutions, while after the reforms by the middle of the 1990s, the government's contribution to the institutions' revenue had fallen to 30-50%, barely covering the salaries of health workers, and the share of revenue generated from charges had increased to 50-70%. These market-oriented financing reforms improved the productivity of public health institutions, but several unintended consequences became evident. The economic incentives that were built into the financing system led to over-provision of unnecessary services, and under-provision of socially desirable services. User fees reduced the take-up of preventive services with positive externalities. The lack of government funds resulted in under-provision of services with public goods' characteristics. The Chinese experience has generated important lessons for other nations. Firstly, a decline in the role of government in financing public health services is likely to result in decreased overall efficiency of the health sector. Secondly, levying charges for public health services can reduce demand for these services and increase the risk of disease transmission. Thirdly, market-oriented financing reforms of public health services should not be considered as a policy option. Once this step is made, the unintended consequences may outweigh the intended ones. Chinese experience strongly suggests that the government should take a very active role in financing public health services.

Lessons Learned from a Tryout of Spanish and English Versions of a State Assessment.

ERIC Educational Resources Information Center

Stansfield, Charles W.; Kahl, Stuart R.

The Massachusetts Comprehensive Assessment System (MCAS) is the new Massachusetts state assessment program that is being implemented in response to state education reform legislation. The paper describes the early efforts of the state Department of Education (MDOE), its prime contractor for development of the MCAS (Advanced Systems in Measurement…

Strategic Leadership for Education Reform: Lessons from the Statewide Systemic Initiatives Program. CPRE Policy Briefs RB-41

ERIC Educational Resources Information Center

Heck, Daniel J.; Weiss, Iris R.

2005-01-01

In 1990, the National Science Foundation (NSF) created the Statewide Systemic Initiative Program. The solicitation issued by the Directorate for Science and Engineering Education sought proposals "for projects intended to broaden the impact, accelerate the pace, and increase the effectiveness of improvements in science, mathematics, and…

Design Principles for New Systems of Assessment

ERIC Educational Resources Information Center

Shepard, Lorrie A.; Penuel, William R.; Davidson, Kristen L.

2017-01-01

The Every Student Succeeds Act grants states new flexibility to create more balanced assessment systems with a greater role for formative assessment. Drawing on lessons learned over three decades of research and reform, we argue that state and local leaders should take the lead in designing new assessments guided by two core principles: First,…

Primary Health Care That Works: The Costa Rican Experience.

PubMed

Pesec, Madeline; Ratcliffe, Hannah L; Karlage, Ami; Hirschhorn, Lisa R; Gawande, Atul; Bitton, Asaf

2017-03-01

Long considered a paragon among low- and middle-income countries in its provision of primary health care, Costa Rica reformed its primary health care system in 1994 using a model that, despite its success, has been generally understudied: basic integrated health care teams. This case study provides a detailed description of Costa Rica's innovative implementation of four critical service delivery reforms and explains how those reforms supported the provision of the four essential functions of primary health care: first-contact access, coordination, continuity, and comprehensiveness. As countries around the world pursue high-quality universal health coverage to attain the Sustainable Development Goals, Costa Rica's experiences provide valuable lessons about both the types of primary health care reforms needed and potential mechanisms through which these reforms can be successfully implemented. Project HOPE—The People-to-People Health Foundation, Inc.

Conceptions of systemic reform: California science education as an investigative example

NASA Astrophysics Data System (ADS)

Sachse, Thomas Paul

This study explored three perspectives of systemic reform in the context of the California state strategies for improving science education. The three perspectives are those of conceptualizers, implementers, and government administrators. The California case study is examined during the ten-year period from 1983 to 1993. This study is of particular significance, because it examines science education reforms during the ten-year period of Bill Honig's state superintendency in the largest and most diverse state. By examining the facets of state science reforms from three rather different perspectives, the study contrasts how systemic reform definitions vary with role. This qualitative study employs document analysis, archival reviews, and participant interviews as the primary data collection methods. Document analysis included key curriculum frameworks, project proposals and reports, relevant legislation, and professional correspondence. Archival reviews included databases (such as the California Basic Educational Data System), assessment reports (such as the California Assessment Program---Rationale and Content), and policy analyses (such as the Policy Analysis for California Education---Conditions of Education). Interviews were conducted for each of the three perspectives across five segments of the reform strategy for a total of fifteen interviews. Data analysis consisted of combining detailed reviews of documents, archives, and interview information with an examination of perspectives, by role group. The study concludes with an analysis of how each role group perceived the facets of systemic reform in the context of the California case study of science education reform. In addition, the research points to "lessons learned", the strengths and weaknesses of systemic reform strategies at the state level. The study offers recommendations to other large-scale (state level) policy reformers interested in creating, sustaining, and maintaining lasting change.

Strategic management of the health workforce in developing countries: what have we learned?

PubMed

Fritzen, Scott A

2007-02-26

The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus. This paper reviews lessons relating to strategic management challenges emerging from the growing literature in this area. Workforce issues are strategic: they affect overall system performance as well as the feasibility and sustainability of health reforms. Viewing workforce issues strategically forces health authorities to confront the yawning gaps between policy and implementation in many developing countries. Lessons emerge in four areas. One concerns imbalances in workforce structure, whether from a functional specialization, geographical or facility lens. These imbalances pose a strategic challenge in that authorities must attempt to steer workforce distribution over time using a limited range of policy tools. A second group of lessons concerns the difficulties of central-level steering of the health workforce, often critically weak due to the lack of proper information systems and the complexities of public sector decentralization and service commercialization trends affecting the grassroots.A third cluster examines worker capacity and motivation, often shaped in developing countries as much by the informal norms and incentives as by formal attempts to support workers or to hold them accountable. Finally, a range of reforms centering on service contracting and improvements to human resource management are emerging. Since these have as a necessary (but not sufficient) condition some flexibility in personnel practices, recent trends towards the sharing of such functions with local authorities are promising. The paper identifies a number of current lines of productive research, focusing on the relationship between health policy reforms and the local institutional environments in which the workforce, both public and private, is deployed.

Florida's Lessons for Indiana K-12 Reform. School Choice Issues in the State

ERIC Educational Resources Information Center

Ladner, Matthew

2009-01-01

Jeb Bush campaigned for Governor on a clear and bracing set of education reforms in 1998. Having won office, he immediately pursued a dual track strategy of education reform: standards and accountability for public schools, choice options for dissatisfied parents. Florida lawmakers followed these reforms with additional measures, including…

Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective.

PubMed

Epping-Jordan, JoAnne E; van Ommeren, Mark; Ashour, Hazem Nayef; Maramis, Albert; Marini, Anita; Mohanraj, Andrew; Noori, Aqila; Rizwan, Humayun; Saeed, Khalid; Silove, Derrick; Suveendran, T; Urbina, Liliana; Ventevogel, Peter; Saxena, Shekhar

2015-01-01

Major gaps remain - especially in low- and middle-income countries - in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations' mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development. Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste. These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders. Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.

Pan-European Grading Scales: Lessons from National Systems and the ECTS. The Bologna Process: Retrospect and Prospects

ERIC Educational Resources Information Center

Karran, Terence

2005-01-01

This article assesses the impact of the Bologna Process on the grading schemes of EU member countries. In light of some problems regarding the implementation of the European Credit Transfer system (ECTS), the author proposes further reforms and offers some elements of a unified grading system for European higher education. The author explores the…

Redesigning Teacher Evaluation: Lessons Learned from a Pilot Implementation in New Hampshire

ERIC Educational Resources Information Center

Riordan, Julie; Lacireno-Paquet, Natalie; Shakman, Karen; Bocala, Candice

2016-01-01

Many studies have called attention to the limitations of current teacher evaluation systems and the need for reform nationwide. This study addresses three research questions: (1) What are the features of the new teacher evaluation systems in New Hampshire's districts with SIG schools?; (2) To what extent did schools implement the evaluation system…

Legacy of the Rural Systemic Initiatives: Innovation, Leadership, Teacher Development, and Lessons Learned

ERIC Educational Resources Information Center

Harmon, Hobart L.; Smith, Keith C.

2012-01-01

This monograph offers an in-depth look at the National Science Foundation's (NSF) Rural Systemic Initiative (RSI) efforts, an investment of more than $140 million to reform mathematics and science programs in rural K-12 public education and tribal education. The authors seek to promote a foundation of contextual understanding for improving public…

Mental health reform in Georgia, 1992 to 1996.

PubMed

Elliott, R L

1996-11-01

In 1992 Georgia embarked on an ambitious reform of its public mental health system. Regional mental health authorities were created with consumers and family members as decision makers. Reform legislation required that hospital and community funds be combined to provide for flexible shifting of funds to communities as use of state hospitals decreased. However, after four years and at a cost of almost $15 million, few tangible results can be demonstrated. In fact, hospital admissions have increased since 1991. Further, a proposal for a Medicaid section 1115 waiver that would permit managed care organizations to assume responsibility for key decisions threatens to undermine the decision-making authority of regional mental health authorities. This paper summarizes the background leading to Georgia's reform, reviews its accomplishments, and suggests lessons to be gained from Georgia's experiences.

A Framework for Rebuilding Initial Certification and Preparation Programs in Educational Leadership: Lessons from Whole-State Reform Initiatives

ERIC Educational Resources Information Center

Murphy, Joseph; Moorman, Hunter N.; McCarthy, Martha

2008-01-01

Background/Context: This study examines the extent of reform in preparation programs in school leadership in six states employing a comprehensive, whole-state intervention design. Although no studies of these or other comprehensive reform designs are available, there is a rich context surrounding preparation reform work that informed our…

Using stakeholder analysis to support moves towards universal coverage: lessons from the SHIELD project.

PubMed

Gilson, Lucy; Erasmus, Ermin; Borghi, Jo; Macha, Janet; Kamuzora, Peter; Mtei, Gemini

2012-03-01

Stakeholder analysis is widely recommended as a tool for gathering insights on policy actor interests in, positions on, and power to influence, health policy issues. Such information is recognized to be critical in developing viable health policy proposals, and is particularly important for new health care financing proposals that aim to secure universal coverage (UC). However, there remain surprisingly few published accounts of the use of stakeholder analysis in health policy development generally, and health financing specifically, and even fewer that draw lessons from experience about how to do and how to use such analysis. This paper, therefore, aims to support those developing or researching UC reforms to think both about how to conduct stakeholder analysis, and how to use it to support evidence-informed pro-poor health policy development. It presents practical lessons and ideas drawn from experience of doing stakeholder analysis around UC reforms in South Africa and Tanzania, combined with insights from other relevant material. The paper has two parts. The first presents lessons of experience for conducting a stakeholder analysis, and the second, ideas about how to use the analysis to support policy design and the development of actor and broader political management strategies. Comparison of experience across South Africa and Tanzania shows that there are some commonalities concerning which stakeholders have general interests in UC reform. However, differences in context and in reform proposals generate differences in the particular interests of stakeholders and their likely positioning on reform proposals, as well as in their relative balance of power. It is, therefore, difficult to draw cross-national policy comparisons around these specific issues. Nonetheless, the paper shows that cross-national policy learning is possible around the approach to analysis, the factors influencing judgements and the implications for, and possible approaches to, management of policy processes. Such learning does not entail generalization about which UC reform package offers most gain in any setting, but rather about how to manage the reform process within a particular context.

Libya After Qaddafi: Lessons and Implications for the Future

DTIC Science & Technology

2014-01-01

research findings and objective analysis that address the challenges facing the public and private sectors . All RAND reports undergo rigorous peer...8 The Need for Far-Reaching Security Sector Reform...World Bank , International Monetary Fund, IHS, Inter- national Foundation for Electoral Systems, Dartmouth College, the National Endowment for

The Journey towards Inclusive Education in Bangladesh: Lessons Learned

ERIC Educational Resources Information Center

Ahsan, M. Tariq; Mullick, Jahirul

2013-01-01

Several international declarations, signed over the last few decades, are helping to promote Education for All, by eliminating inequalities in both society and education systems. This article, a descriptive review of policy documents and reform initiatives, reports on ways the Government of Bangladesh has responded to these international…

From scheme to system: social health insurance funds and the transformation of health financing in Kyrgyzstan and Moldova.

PubMed

Kutzin, Joseph; Jakab, Melitta; Shishkin, Sergey

2009-01-01

The aim of the paper is to bring evidence and lessons from two low- and middle-income countries (LMIs) of the former USSR into the global debate on health financing in poor countries. In particular, we analyze the introduction of social health insurance (SHI) in Kyrgyzstan and Moldova. To some extent, the intent of SHI introduction in these countries was similar to that in LMIs elsewhere: increase prepaid revenues for health and incorporate the entire population into the new system. But the approach taken to universality was different. In particular, the SHI fund in each country was used as the key instrument in a comprehensive reform of the health financing system, with the new revenues from payroll taxation used in an explicitly complementary manner to general budget revenues. From a functional perspective, the reforms in these countries involved not only the introduction of a new source of funds, but also the centralization of pooling, a shift from input- to output-based provider payment methods, specification of a benefit package, and greater autonomy for public sector health care providers. Hence, their reforms were not simply the introduction of an SHI scheme, but rather the use of an SHI fund as an instrument to transform the entire system of health financing. The study uses administrative and household data to demonstrate the impact of the reforms on regional inequality and household financial burden. The approach used in these two countries led to improved equity in the geographic distribution of government health spending, improved financial protection, and reduced informal payments. The comprehensive approach taken to reform in these two countries, and particularly the redirection of general budget revenues to the new SHI funds, explain much of the success that was achieved. This experience offers potentially useful lessons for LMIs elsewhere in the world, and for shifting the global debate away from what we see as a false dichotomy between SHI and general revenue-funded systems. By demonstrating that sources are not systems, these cases illustrate how, in particular by careful design of pooling and coverage arrangements, the introduction of SHI in an LMI context can avoid the fragmentation problem often associated with this reform instrument.

Using Competency-Based Evaluation to Drive Teacher Excellence: Lessons from Singapore. Building an Opportunity Culture for America's Teachers

ERIC Educational Resources Information Center

Steiner, Lucy

2010-01-01

The United States' education system needs to take its critical next step: fairly and accurately measuring teacher performance. Successful reforms to teacher pay, career advancement, professional development, retention, and other human capital systems that lead to better student outcomes depend on it. Where can the U.S. find the best-practice…

Using Research and Evaluation to Support Comprehensive Reform

ERIC Educational Resources Information Center

Brock, Thomas; Mayer, Alexander K.; Rutschow, Elizabeth Zachry

2016-01-01

This chapter explores the role that research and evaluation play in supporting comprehensive reform in community colleges, focusing on lessons from two major initiatives: Achieving the Dream and Completion by Design.

Health-system reform and universal health coverage in Latin America.

PubMed

Atun, Rifat; de Andrade, Luiz Odorico Monteiro; Almeida, Gisele; Cotlear, Daniel; Dmytraczenko, T; Frenz, Patricia; Garcia, Patrícia; Gómez-Dantés, Octavio; Knaul, Felicia M; Muntaner, Carles; de Paula, Juliana Braga; Rígoli, Felix; Serrate, Pastor Castell-Florit; Wagstaff, Adam

2015-03-28

Starting in the late 1980s, many Latin American countries began social sector reforms to alleviate poverty, reduce socioeconomic inequalities, improve health outcomes, and provide financial risk protection. In particular, starting in the 1990s, reforms aimed at strengthening health systems to reduce inequalities in health access and outcomes focused on expansion of universal health coverage, especially for poor citizens. In Latin America, health-system reforms have produced a distinct approach to universal health coverage, underpinned by the principles of equity, solidarity, and collective action to overcome social inequalities. In most of the countries studied, government financing enabled the introduction of supply-side interventions to expand insurance coverage for uninsured citizens--with defined and enlarged benefits packages--and to scale up delivery of health services. Countries such as Brazil and Cuba introduced tax-financed universal health systems. These changes were combined with demand-side interventions aimed at alleviating poverty (targeting many social determinants of health) and improving access of the most disadvantaged populations. Hence, the distinguishing features of health-system strengthening for universal health coverage and lessons from the Latin American experience are relevant for countries advancing universal health coverage. Copyright © 2015 Elsevier Ltd. All rights reserved.

Examining the Role of Leadership in an Undergraduate Biology Institutional Reform Initiative

PubMed Central

Matz, Rebecca L.; Jardeleza, Sarah E.

2016-01-01

Undergraduate science, technology, engineering, and mathematics (STEM) education reform continues to be a national priority. We studied a reform process in undergraduate biology at a research-intensive university to explore what leadership issues arose in implementation of the initiative when characterized with a descriptive case study method. The data were drawn from transcripts of meetings that occurred over the first 2 years of the reform process. Two literature-based models of change were used as lenses through which to view the data. We find that easing the burden of an undergraduate education reform initiative on faculty through articulating clear outcomes, developing shared vision across stakeholders on how to achieve those outcomes, providing appropriate reward systems, and ensuring faculty have ample opportunity to influence the initiative all appear to increase the success of reform. The two literature-based models were assessed, and an extended model of change is presented that moves from change in STEM instructional strategies to STEM organizational change strategies. These lessons may be transferable to other institutions engaging in education reform. PMID:27856545

The health care reform in Mexico: before and after the 1985 earthquakes.

PubMed Central

Soberón, G; Frenk, J; Sepúlveda, J

1986-01-01

The earthquakes that hit Mexico City in September 1985 caused considerable damage both to the population and to important medical facilities. The disaster took place while the country was undertaking a profound reform of its health care system. This reform had introduced a new principle for allocating and distributing the benefits of health care, namely, the principle of citizenship. Operationally, the reform includes an effort to decentralize the decision-making authority, to modernize the administration, to achieve greater coordination within the health sector and among sectors, and to extend coverage to the entire population through an ambitious primary care program. This paper examines the health context in which the reform was taking place when the September earthquakes hit. After presenting the damages caused by the quakes, the paper analyzes the characteristics of the immediate response by the health system. Since many facilities within the system were severely damaged, a series of options for reconstruction are posited. The main lesson to be learned from the Mexican case is that cuts in health care programs are not the inevitable response to economic or natural crises. On the contrary, it is precisely when the majority of the population is undergoing difficulties that a universal and equitable health system becomes most necessary. PMID:3706595

The health care reform in Mexico: before and after the 1985 earthquakes.

PubMed

Soberón, G; Frenk, J; Sepúlveda, J

1986-06-01

The earthquakes that hit Mexico City in September 1985 caused considerable damage both to the population and to important medical facilities. The disaster took place while the country was undertaking a profound reform of its health care system. This reform had introduced a new principle for allocating and distributing the benefits of health care, namely, the principle of citizenship. Operationally, the reform includes an effort to decentralize the decision-making authority, to modernize the administration, to achieve greater coordination within the health sector and among sectors, and to extend coverage to the entire population through an ambitious primary care program. This paper examines the health context in which the reform was taking place when the September earthquakes hit. After presenting the damages caused by the quakes, the paper analyzes the characteristics of the immediate response by the health system. Since many facilities within the system were severely damaged, a series of options for reconstruction are posited. The main lesson to be learned from the Mexican case is that cuts in health care programs are not the inevitable response to economic or natural crises. On the contrary, it is precisely when the majority of the population is undergoing difficulties that a universal and equitable health system becomes most necessary.

Lessons for (and From) America

PubMed Central

Klein, Rudolf

2003-01-01

Drawing lessons from international experience for health care reform in the United States requires striking a difficult balance between historical determinism and free will, between cynical pessimism and naïve optimism. The key to this puzzle may lie in a paradox: the United States is the most successful exporter of public health policy ideas and instruments yet has failed to build an effective health care system. General ideas (like notions about the role of competition) and microinstruments (like diagnosis-related groups) travel better than do health care systems. Ideas can be adapted to local circumstances, and instruments may easily fit into preexisting systems. Importing systems from countries with different histories and institutions would require a tectonic shift in the American political landscape. PMID:12511387

Western impressions of the Hong Kong health care system.

PubMed Central

Bennett, C L; Pei, G K; Ultmann, J E

1996-01-01

Hong Kong, Taiwan, Singapore, and Malaysia are initiating health care reform to meet the changing demands of populations with improved socioeconomic status and access to modern technologies and who are living longer than in previous generations. Hong Kong, in particular, is facing a unique set of circumstances as its people prepare for the transition in 1997 from a British colony to a Special Administrative Region of China. While spending only 4% of its gross domestic product on health care, it has a large and regulated public hospital system for most inpatient medical care and a separate, loosely regulated private health care system for most outpatient medical care. In 1993 the Secretary for Health and Welfare of Hong Kong initiated a year-long process to debate the pros and cons of 5 fundamental programs for health care reform. After a year of open consultation, options were chosen. We describe the Hong Kong health care system, the fundamental changes that have been adopted, and lessons for reformers in the United States. PMID:8855683

Western impressions of the Hong Kong health care system.

PubMed

Bennett, C L; Pei, G K; Ultmann, J E

1996-01-01

Hong Kong, Taiwan, Singapore, and Malaysia are initiating health care reform to meet the changing demands of populations with improved socioeconomic status and access to modern technologies and who are living longer than in previous generations. Hong Kong, in particular, is facing a unique set of circumstances as its people prepare for the transition in 1997 from a British colony to a Special Administrative Region of China. While spending only 4% of its gross domestic product on health care, it has a large and regulated public hospital system for most inpatient medical care and a separate, loosely regulated private health care system for most outpatient medical care. In 1993 the Secretary for Health and Welfare of Hong Kong initiated a year-long process to debate the pros and cons of 5 fundamental programs for health care reform. After a year of open consultation, options were chosen. We describe the Hong Kong health care system, the fundamental changes that have been adopted, and lessons for reformers in the United States.

Flawed Implementation or Inconsistent Logics? Lessons from Higher Education Reform in Ukraine

ERIC Educational Resources Information Center

Shaw, Marta A.

2013-01-01

This article investigates two competing explanations of why reforms associated with the Bologna process brought disappointing results in Ukraine. The lack of anticipated benefits from the reforms may stem either from a flawed implementation of the Bologna process, or from more fundamental differences between the models of higher education…

Toward State Tax Reform: Lessons from State Tax Studies.

ERIC Educational Resources Information Center

McGuire, Therese J.; Rio, Jessica E.

This paper reviews recent state tax-commission recommendations in selected states and identifies critical factors for the success of state tax-reform commissions. The paper focuses on factors linked to the process of forming a commission and generating the necessary consensus to enact tough reforms. It describes and compares comprehensive studies…

Reform in Literacy Education in China. Literacy Lessons.

ERIC Educational Resources Information Center

Yianwei, Wang; Jiyuan, Li

Literacy in China is mainly concerned with illiteracy in rural areas. Therefore, reforming literacy education is largely a problem of how to eliminate rural literacy within the general framework of reform in contemporary China. From 1949 to 1988, the illiteracy rate among the population decreased from 80 percent to 20 percent. There are still…

Ethical and Epistemic Dilemmas in Empirically-Engaged Philosophy of Education

ERIC Educational Resources Information Center

Newman, Anne; Glass, Ronald David

2015-01-01

This essay examines several ethical and epistemological issues that arise when philosophers conduct empirical research focused on, or in collaboration with, community groups seeking to bring about systemic change. This type of research can yield important policy lessons about effective community-driven reform and how to incorporate the voices of…

More Recess Time, Please!

ERIC Educational Resources Information Center

Chang, Rong; Coward, Fanni Liu

2015-01-01

Students in Shanghai, China, get much more recess time than their U.S. counterparts throughout their education. As U.S. education reform efforts seek ways of raising achievement, they have begun replacing recess with academic time. The lesson from Shanghai is that this may not be the best strategy. But whether the Shanghai system of more and…

Chapter 7: Lessons, Conclusions, and Implications of the Saber-Tooth Project.

ERIC Educational Resources Information Center

Ward, Phillip; Doutis, Panayiotis; Evans, Sharon A.

1999-01-01

Summarizes findings from the Saber-Tooth Project related to systemic change and student learning, concluding that vision is everything; workplace conditions must be addressed at multiple levels; strong relationships exist among planning, teaching, and assessment; and improvement in reform may occur due to the cessation of business as usual. This…

Lessons Learned from Safe Kids/Safe Streets. Juvenile Justice Bulletin

ERIC Educational Resources Information Center

Cronin, Roberta; Gragg, Frances; Schultz, Dana; Eisen, Karla

2006-01-01

This bulletin reports results from an evaluation of six sites of the Safe Kids/Safe Streets (SK/SS) program, which applies a comprehensive, collaborative approach to the child maltreatment field. The bulletin provides insights into collaboration building, systems reform, service options, and other strategies. Among the findings were that the SK/SS…

Governance of Governance in Higher Education: Practices and Lessons Drawn from the Portuguese Case

ERIC Educational Resources Information Center

Magalhaes, Antonio; Veiga, Amelia; Amaral, Alberto; Sousa, Sofia; Ribeiro, Filipa

2013-01-01

The implementation of the governance reform of Portuguese higher education has been developed under the influence of "new public management" resulting in the loss of collegial governance. Additionally, the need for meta-governance of the higher education system and institutions to monitor institutional performance against policy…

Constitutional Reform and Violent Conflict: Lessons from Africa, for Africa

DTIC Science & Technology

2013-07-01

gradual reform of Africa’s existing, centralized constitutional designs by counter-balancing them with liberal institutions, especially the separation of powers , which could foster both peace and democracy on the continent.

Enabling Health Reform through Regional Health Information Exchange: A Model Study from China

PubMed Central

Wen, Dong; Meng, Qun

2017-01-01

Objective. To investigate and share the major challenges and experiences of building a regional health information exchange system in China in the context of health reform. Methods. This study used interviews, focus groups, a field study, and a literature review to collect insights and analyze data. The study examined Xinjin's approach to developing and implementing a health information exchange project, using exchange usage data for analysis. Results. Within three years and after spending approximately $2.4 million (15 million RMB), Xinjin County was able to build a complete, unified, and shared information system and many electronic health record components to integrate and manage health resources for 198 health institutions in its jurisdiction, thus becoming a model of regional health information exchange for facilitating health reform. Discussion. Costs, benefits, experiences, and lessons were discussed, and the unique characteristics of the Xinjin case and a comparison with US cases were analyzed. Conclusion. The Xinjin regional health information exchange system is different from most of the others due to its government-led, government-financed approach. Centralized and coordinated efforts played an important role in its operation. Regional health information exchange systems have been proven critical for meeting the global challenges of health reform. PMID:29065565

Reflections on a decade of funding public hospital systems.

PubMed

Brousseau, Ruth; Chang, Sophia

2013-07-01

As the nation embarks upon health reform, many questions remain unanswered. Important among them is the fate of public hospitals, which have historically cared for the uninsured. Under health reform, public hospitals will face marketplace competition to serve newly insured people. Can public hospitals change, so that they can survive and thrive in a competitive environment? This article describes lessons learned from a decade of funding by the California HealthCare Foundation to improve clinical care in California's public hospitals. It also identifies factors that will influence California's public hospitals in the coming months and years.

Scientific and social landscapes: New frameworks and forums for water management and sustainability

USGS Publications Warehouse

Turner, Christine; Karl, Herman A.

2001-01-01

The Two Decades of Water Law and Policy Reform conference examines the agenda for reforming and improving water law that has developed during the past two decades in the West, assesses what has (and has not) been accomplished by pursuing these reforms, and explores lessons and implications for future water law and policy. The papers and discussion provide analysis and lessons that can guide the new administration, Congress, federal agencies, state governments, and communities as they seek to find policy solutions to the challenges posed by the tremendous economic and demographic changes occurring in the West, in order to ensure the sustainability of the region’s unique environment. Specific sessions focus on reforms such as improving the scientific and technical basis for water management, water conservation and efficiency, protecting environmental values in meeting water demands, and creating new models of governance for water issues.

Education Reform and the Limits of Policy: Lessons from Michigan

ERIC Educational Resources Information Center

Addonizio, Michael F.; Kearney, C. Philip

2012-01-01

During the last 20 years, the United States has experienced more attempts at education reform than at any other time in its history. Efforts to reform financing, the assessment of student performance, accountability and equity, and school choice have all been implemented--with varying levels of success. Michael F. Addonizio and C. Philip Kearney…

The link between UHC reforms and health system governance: lessons from Asia.

PubMed

Hort, Krishna; Jayasuriya, Rohan; Dayal, Prarthna

2017-05-15

Purpose The purpose of this paper is to examine how and to what extent the design and implementation of universal health coverage (UHC) reforms have been influenced by the governance arrangements of health systems in low- and middle-income countries (LMIC); and how governments in these countries have or have not responded to the challenges of governance for UHC. Design/methodology/approach Comparative case study analysis of three Asian countries with substantial experience of UHC reforms (Thailand, Vietnam and China) was undertaken using data from published studies and grey literature. Studies included were those which described the modifications and adaptations that occurred during design and implementation of the UHC programme, the actors and institutions involved and how these changes related to the governance of the health system. Findings Each country adapted the design of their UHC programmes to accommodate their specific institutional arrangements, and then made further modifications in response to issues arising during implementation. The authors found that these modifications were often related to the impacts on governance of the institutional changes inherent in UHC reforms. Governments varied in their response to these governance impacts, with Thailand prepared to adopt new governance modes (which the authors termed as an "adaptive" response), while China and Vietnam have tended to persist with traditional hierarchical governance modes ("reactive" responses). Originality/value This study addresses a gap in current knowledge on UHC reform, and finds evidence of a complex interaction between substantive health sector reform and governance reform in the LMIC context in Asia, confirming recent similar observations on health reforms in high-income countries.

Experiences and Lessons from Urban Health Insurance Reform in China.

PubMed

Xin, Haichang

2016-08-01

Health care systems often face competing goals and priorities, which make reforms challenging. This study analyzed factors influencing the success of a health care system based on urban health insurance reform evolution in China, and offers recommendations for improvement. Findings based on health insurance reform strategies and mechanisms that did or did not work can effectively inform improvement of health insurance system design and practice, and overall health care system performance, including equity, efficiency, effectiveness, cost, finance, access, and coverage, both in China and other countries. This study is the first to use historical comparison to examine the success and failure of China's health care system over time before and after the economic reform in the 1980s. This study is also among the first to analyze the determinants of Chinese health system effectiveness by relating its performance to both technical reasons within the health system and underlying nontechnical characteristics outside the health system, including socioeconomics, politics, culture, values, and beliefs. In conclusion, a health insurance system is successful when it fits its social environment, economic framework, and cultural context, which translates to congruent health care policies, strategies, organization, and delivery. No health system can survive without its deeply rooted socioeconomic environment and cultural context. That is why one society should be cautious not to radically switch from a successful model to an entirely different one over time. There is no perfect health system model suitable for every population-only appropriate ones for specific nations and specific populations at the right place and right time. (Population Health Management 2016;19:291-297).

Lessons from the 1%: Children with Labels of Severe Disabilities and Their Peers as Architects of Inclusive Education

ERIC Educational Resources Information Center

Bentley, Judy K. C.

2008-01-01

The 1% of US students with labels of severe disabilities including mental retardation have been historically excluded from "inclusive" education, and from the important epistemological, political, pedagogical, and pragmatic currents in systemic education reform. They have been also been excluded from the design of, and participation in, the…

Childcare in the Netherlands: Lessons in Privatisation

ERIC Educational Resources Information Center

Akgunduz, Yusuf Emre; Plantenga, Janneke

2014-01-01

In 2005 the Child Care Act was introduced in the Netherlands. The explicit objective of the childcare reform has been to stimulate the operation of market forces so that childcare services are provided in an efficient way. The change towards a demand-driven financing system implies that there is no longer public provision of childcare services in…

Transforming Our Schools: Lessons from the Jefferson County Public Schools/Gheens Professional Development Academy, 1983-1991.

ERIC Educational Resources Information Center

Kyle, Regina M. J.

A school/community partnership in Louisville, Kentucky, the Jefferson County Public Schools/Gheens Professional Development Academy, is described. This report provides a framework for assessing Jefferson County School System reforms in the past 8 years or more designed to enhance student success in learning. A Spiral of Assessment was used to…

EFA and Beyond: Service Provision and Quality Assurance in China. Education Notes

ERIC Educational Resources Information Center

Wang, Yidan

2005-01-01

This note series is intended to summarize lessons learned and key policy findings on the World Bank's work in education. Over the past 20 years China's education sector has provided many lessons for countries that are approaching Universal Primary Education (UPE). The most important lesson may be that the need for educational reform does not…

Taking Root: South Carolina's Lessons for Sustaining the College- and Career-Ready Agenda

ERIC Educational Resources Information Center

Achieve, Inc., 2009

2009-01-01

To give states the information they need to sustain hard-fought education reform effectively, Achieve conducted research on state education reforms that have been sustained successfully for over a decade or more. Funded by the GE Foundation, Achieve hopes this work will help other state leaders, wherever they may be on their road to reform,…

The Failure of Progressive Classroom Reform: Lessons from the Curriculum Reform Implementation Project in Papua New Guinea

ERIC Educational Resources Information Center

Guthrie, Gerard

2012-01-01

Progressive education has been an article of educational faith in Papua New Guinea during the last 50 years but the best available evidence indicates that major reforms to formalistic curriculum and teaching in primary and secondary classrooms have failed during this period despite large-scale professional, administrative and financial support. In…

Taking Root: Massachusetts' Lessons for Sustaining the College- and Career-Ready Agenda

ERIC Educational Resources Information Center

Achieve, Inc., 2009

2009-01-01

To give states the information they need to sustain hard-fought education reform effectively, Achieve conducted research on state education reforms that have been sustained successfully for over a decade or more. Funded by the GE Foundation, Achieve hopes this work will help other state leaders, wherever they may be on their road to reform,…

Taking Root: Indiana's Lessons for Sustaining the College- and Career-Ready Agenda

ERIC Educational Resources Information Center

Achieve, Inc., 2009

2009-01-01

To give states the information they need to sustain hard-fought education reform effectively, Achieve conducted research on state education reforms that have been sustained successfully for over a decade or more. Funded by the GE Foundation, Achieve hopes this work will help other state leaders, wherever they may be on their road to reform,…

Technology for Empowering or Subjugating Teachers: Analysis of Ethiopia's Education Reform Discourse Practice

ERIC Educational Resources Information Center

Birbirso, Dereje Tadesse

2013-01-01

In the wake of national educational reform, the author discovered a secondary education style where all students were taught through centrally aired TV-lessons beaming from a studio in the capital city. In order to understand the motive behind the reform and its impacts on teaching, the author collected qualitative data for critical analysis.…

Interest Groups' Influence over Drug Pricing Policy Reform in South Korea

PubMed Central

Chung, Woojin

2005-01-01

In 1999, the Korean government made a drug pricing policy reform to improve the efficiency and transparency of the drug distribution system. Yet, its policy formation process was far from being rational. Facing harsh resistance from various interest groups, the government changed its details into something different from what was initially investigated and planned. So far, little evidence supports any improvement in Korea's drug distribution system. Instead, the new drug pricing policy has deteriorated Korea's national health insurance budget, indicating a heavier economic burden for the general public. From Korea's experience, we may draw some lessons for the future development of a better health care system. As a society becomes more pluralistic, the government should come out of authoritarianism and thoroughly prepare in advance for resistance to reform, by making greater efforts to persuade strong interest groups while informing the general public of potential benefits of the reform. Additionally, facing developing civic groups, the government should listen but not rely too much on them at the final stage of the policy formation. Many of the civic groups lack expertise to evaluate the details of policy and tend to act in a somewhat emotional way. PMID:15988802

Interest groups' influence over drug pricing policy reform in South Korea.

PubMed

Chung, Woo Jin; Kim, Han Joong

2005-06-30

In 1999, the Korean government made a drug pricing policy reform to improve the efficiency and transparency of the drug distribution system. Yet, its policy formation process was far from being rational. Facing harsh resistance from various interest groups, the government changed its details into something different from what was initially investigated and planned. So far, little evidence supports any improvement in Korea's drug distribution system. Instead, the new drug pricing policy has deteriorated Korea's national health insurance budget, indicating a heavier economic burden for the general public. From Korea's experience, we may draw some lessons for the future development of a better health care system. As a society becomes more pluralistic, the government should come out of authoritarianism and thoroughly prepare in advance for resistance to reform, by making greater efforts to persuade strong interest groups while informing the general public of potential benefits of the reform. Additionally, facing developing civic groups, the government should listen but not rely too much on them at the final stage of the policy formation. Many of the civic groups lack expertise to evaluate the details of policy and tend to act in a somewhat emotional way.

The TIMSS 1999 Video Study and the Reform of Mathematics Teaching. Invited Commentary.

ERIC Educational Resources Information Center

Cooney, Thomas J.

2003-01-01

The report on the Third International Mathematics and Science Study (TIMSS) Video Study of mathematics teaching demonstrates the complexity of teaching as it provides lessons about conservatism and the role of reform in mathematics teaching. (SLD)

Lessons from Australian Water Reform for the Colorado River Basin (Invited)

NASA Astrophysics Data System (ADS)

Udall, B.

2010-12-01

The Murray Darling Basin in Australia (MDB) and the Colorado River Basin (CRB) share many geographical, climatic, and legal similarities. Both are predominantly arid, approximately the same size, occupy similar latitudes, have major snowmelt tributaries as well as very arid tributaries, were allocated by interstate agreements early in the 20th century, have multi-year carryover storage, are threatened by mid-latitude climate change related drying, and during the last ten years have suffered under droughts of historic proportions. Some management practices have begun to change in the CRB, e.g. the multi-state 2007 shortage-sharing agreement, but in the MDB significant water management reform began in 1994 and has accelerated during the recent drought. The Australian language around water, conservation ethic, national and state policies, infrastructure, especially desalination, and even water management entities have undergone substantial changes during the last five years. Australia’s new National Water Commission, set up specifically to oversee reform, is on the verge of releasing a new basin management plan which will govern MDB management over the next decade. Which of these many reform-related lessons from Australia might be applicable to the Colorado River Basin and why? And which of the lessons might not be applicable and why?

Court-Led Educational Reforms in Political Third Rails: Lessons from the Litigation over Ultra-Religious Jewish Schools in Israel

ERIC Educational Resources Information Center

Perry-Hazan, Lotem

2015-01-01

This paper offers a model for evaluating the strengths and weaknesses of judicial involvement in educational reforms. It uses the model to analyze two case studies of court-led educational reforms in the third rail of Israeli politics--the curricula and the admission policies of ultra-Othodox (Haredi) schools. These case studies are located at the…

Putting politics first.

PubMed

Hacker, Jacob S

2008-01-01

The greatest lesson of the failure of comprehensive health reform in the early 1990s is that politics comes first. Even the best-laid policy plans are worthless if they lack the political support to pass. Putting politics first means avoiding the overarching mistake of the Clinton reformers: envisioning a grand policy compromise rather than hammering out a real political compromise. It also means addressing the inevitable fears of those who believe that they are well protected by our eroding employment-based system. And it means formulating political strategies that are premised on the contemporary realities of the hyperpolarized U.S. political environment, rather than wistfully recalled images of the bipartisan politics of old.

Lessons from Hurricane Katrina: The Employment Effects of The Mass Dismissal of New Orleans Teachers

ERIC Educational Resources Information Center

Lincove, Jane Arnold; Barrett, Nathan; Strunk, Katharine O.

2018-01-01

In the aftermath of Hurricane Katrina, the Orleans Parish school district fired over 4,000 public school teachers as the city underwent a transition to a market-based system of charter schools. Using administrative data, we examine whether and how these teachers returned to public school employment and teaching. We estimate that school reform and…

Insights From Health Care in Germany

PubMed Central

Altenstetter, Christa

2003-01-01

German Statutory Health Insurance (national health insurance) has remained relatively intact over the past century, even in the face of governmental change and recent reforms. The overall story of German national health insurance is one of political compromise and successful implementation of communitarian values. Several key lessons from the German experience can be applied to the American health care system. PMID:12511381

Aligning Secondary and Postsecondary Education: Lessons from the Past. WISCAPE Policy Brief

ERIC Educational Resources Information Center

VanOverbeke, Marc

2009-01-01

Educators, reformers, and commissions have long underscored the need to align all levels of education and build a seamless, coordinated P-16 system. Failing to do so, they have argued, has kept too many students from pursuing an advanced education and the nation from benefiting from a more educated populace. Such was the case in the late…

Instructional Partnerships to Extend Learning in Urban High Schools: Lessons from New York City and Boston

ERIC Educational Resources Information Center

Foley, Eileen M.; Allender, Sara; Cooc, North; Edwards, Sara; Riley, Derek R.; Reisner, Elizabeth R.

2009-01-01

Late in 2007 New Visions for Public Schools, a New York City reform organization, received a grant from the C.S. Mott Foundation to organize select high schools and community partners into delivery systems that could improve student achievement. New Visions asked Policy Studies Associates, Inc. to provide research support for this effort in the…

Russian Military Reform From Perestroika to Putin: Implications for U.S. Policy

DTIC Science & Technology

2004-04-01

AU/AF FELLOWS/NNN/2004-00 AIR FORCE FELLOWS (SDE) AIR UNIVERSITY RUSSIAN MILITARY REFORM FROM PERESTROIKA TO PUTIN: IMPLICATIONS FOR U.S...TITLE AND SUBTITLE Russian Military Reform : From Perestroika to Putin: Implications for U.S. Policy 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...kept the troops in place at the request of the leaders of the breakaway regions. 5 Major Scott C. Dullea, “ Russian Military Reform : Lessons from America

Organizational Culture in a Mexican School: Lessons for Reform.

ERIC Educational Resources Information Center

Davila, Anabella; Willower, donald J.

1996-01-01

Discusses a study of a Mexican Roman Catholic high school's organizational culture, highlighting findings concerning school reform and improvement processes. The school stressed community and featured activities and values promoting student commitment to learning. Religion reinforced the school's "hidden curriculum" of good conduct and…

The Superconducting Supercollider and US Science Policy

NASA Astrophysics Data System (ADS)

Marburger, John H.

2014-06-01

Reasons for the Superconducting Supercollider's (SSC's) termination include significant changes in the attitude of the government towards large scientific projects originating with management reforms introduced decades earlier. In the 1980s, the government insisted on inclusion of elements of these reforms in the SSC's management contract, including increased demands for accountability, additional liability for contractors, and sanctions for infractions. The SSC's planners could not have opted out of the reforms, which were by then becoming part of all large publicly funded projects. Once these reforms were in place, management mistakes in the SSC's planning and construction became highly visible, leading to termination of the machine. This episode contains two key lessons about science policy. One is that the momentum of the government's management reforms was unstoppable, and its impact on large scientific facilities and projects could not be reversed. The other is that specific measures such as cost and schedule-tracking systems to provide measures of program performance and impact were also inevitable; large scientific projects needed new parameters of accountability and transparency in what can be called the Principle of Assurance.

The new institutionalist approaches to health care reform: lessons from reform experiences in Central Europe.

PubMed

Sitek, Michał

2010-08-01

This article discusses the applicability of the new institutionalism to the politics of health care reform in postcommunist Central Europe. The transition to a market economy and democracy after the fall of communism has apparently strengthened the institutional approaches. The differences in performance of transition economies have been critical to the growing understanding of the importance of institutions that foster democracy, provide security of property rights, help enforce contracts, and stimulate entrepreneurship. From a theoretical perspective, however, applying the new institutionalist approaches has been problematic. The transitional health care reform exposes very well some inherent weaknesses of existing analytic frameworks for explaining the nature and mechanisms of institutional change. The postcommunist era in Central Europe has been marked by spectacular and unprecedented radical changes, in which the capitalist system was rebuilt in a short span of time and the institutions of democracy became consolidated. Broad changes to welfare state programs were instituted as well. However, the actual results of the reform processes represent a mix of change and continuity, which is a challenge for the theories of institutional change.

The health of hospitals and lessons from history: public health and sanitary reform in the Dublin hospitals, 1858-1898.

PubMed

Fealy, Gerard M; McNamara, Martin S; Geraghty, Ruth

2010-12-01

The aim was to examine, critically, 19th century hospital sanitary reform with reference to theories about infection and contagion. In the nineteenth century, measures to control epidemic diseases focused on providing clean water, removing waste and isolating infected cases. These measures were informed by the ideas of sanitary reformers like Chadwick and Nightingale, and hospitals were an important element of sanitary reform. Informed by the paradigmatic tradition of social history, the study design was a historical analysis of public health policy. Using the methods of historical research, documentary primary sources, including official reports and selected hospital archives and related secondary sources, were consulted. Emerging theories about infection were informing official bodies like the Board of Superintendence of Dublin Hospitals in their efforts to improve hospital sanitation. The Board secured important reforms in hospital sanitation, including the provision of technically efficient sanitary infrastructure. Public health measures to control epidemic infections are only as effective as the state of knowledge of infection and contagion and the infrastructure to support sanitary measures. Today, public mistrust about the safety of hospitals is reminiscent of that of 150 years ago, although the reasons are different and relate to a fear of contracting antimicrobial-resistant infections. A powerful historical lesson from this study is that resistance to new ideas can delay progress and improved sanitary standards can allay public mistrust. In reforming hospital sanitation, policies and regulations were established--including an inspection body to monitor and enforce standards--the benefits of which provide lessons that resonate today. Such practices, especially effective independent inspection, could be adapted for present-day contexts and re-instigated where they do not exist. History has much to offer contemporary policy development and practice reform and is a relevant method for health professionals. © 2010 Blackwell Publishing Ltd.

Implementing Health Financing Reforms in Africa: Perspectives of Health System Stewards.

PubMed

Achoki, Tom; Lesego, Abaleng

A majority of health systems in the sub-Saharan Africa region are faced with multiple competing priorities amid pressing resource constraints. Health financing reforms, characterized by expansion of health insurance coverage, have been proposed as promising in the quest to improve health sustainably. However, in many countries where these measures are being attempted, their broader implications have not been fully appreciated. This study was based on perspectives of 37 health system stewards from Botswana who were interviewed in order to understand opportunities and challenges that would result in the quest to expand health insurance coverage in the country. Thematic synthesis of their perspectives, focusing on the key aspects of the health systems, was done in order to draw informative lessons that could be applicable to a broader set of low- and middle-income countries. Health systems attempting to expand health insurance coverage would be faced with various opportunities and challenges that have implications on performance. By increasing the pool of resources available to spend on health, health insurance would afford health systems the opportunity to increase population access to and use of health services. However, if unchecked, this could also translate to uncontrolled demand for expensive medicines and other health technologies, leading to cost escalation and inefficiencies within the system. Therefore, the success of any health financing reform is dependent on embracing sound policies, regulations, and accountability measures. Health financing reforms have broader implications to health system performance that should be fully appreciated and anticipated before implementation. Therefore, health system leaders who are keen to improve health must view any health financing reforms through the broader framework of the health system framework in order to make progress. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

What Teachers Understand of Model Lessons

ERIC Educational Resources Information Center

Courtney, Scott A.

2017-01-01

Over the past two decades, researchers in mathematics teacher education have identified characteristics of high quality professional development (PD). This report describes an investigation of a common approach to PD with secondary mathematics teachers, providing teachers with opportunities to experience reform-oriented model lessons as students…

Rethinking Recycling: Why Teach about Garbage?

ERIC Educational Resources Information Center

Clearing, 1993

1993-01-01

Ties environmental education, via garbage disposal issues, to Oregon's educational reform agenda. Discusses teaching the basics through "garbage" lessons. Includes how to (1) take an interdisciplinary approach; (2) introduce waste management concepts in other lessons; (3) use waste management examples to apply existing concepts; and (4)…

[Health governance and social protection indicators in Latin-America: strengths, weaknesses and lessons-learned from six Mexican states].

PubMed

Arredondo-López, Armando; Orozco-Núñez, Emanuel

2014-01-01

Evaluative research projects for identifying good practice have been postponed regarding health system reform. This study was thus aimed at identifying health governance and social protection indicators. This study involved evaluative research regarding the health system for the uninsured part of the population in six Mexican states. The primary data was obtained from in-depth interviews with key players from the participating states; official statistics and the results of a macro-project concerned with Mexican health and governance reform and policy was used for secondary. Atlas Ti and Policy Maker software were used for processing and analysing the data. A list of strengths and weaknesses was presented as evidence of health system governance. Accountability at federal level (even though not lacking) was of a prescriptive nature and a system of accountability and transparency regarding the assignment of resources and strategies for the democratisation of health in the states and municipalities was still lacking. All six states had low levels of governance and experienced difficulty in conducting effective reform programmes and strategies involving a lack of precision regarding the rules and roles adopted by different health system actors.

Inclusion and Comprehensive School Reform: Lessons from the Field

ERIC Educational Resources Information Center

Bain, Alan; Lancaster, Julie

2006-01-01

Sustaining comprehensive secondary school reform (CSR) represents an immensely difficult and unresolved challenge for the field. The problems associated with CSR are of significant concern to proponents of inclusion given that more responsive schools and classrooms are connected to, if not dependent upon, the success of broader school reform…

Teacher Agency in Educational Reform: Lessons from Social Networks Research

ERIC Educational Resources Information Center

Datnow, Amanda

2012-01-01

This article provides a context for understanding how social networks among teachers support or constrain school improvement in terms of instructional practice, professional development, and educational reform. It comments on the articles in this special issue, summarizing their contributions to the field. This analysis reveals several important…

Closing the Achievement Gap: Urban Schools. CSR Connection.

ERIC Educational Resources Information Center

Porter, Kathleen; Soper, Stephanie

This report reviews efforts to reform urban schools, focusing on initiatives in Tennessee and California as examples from which distric leaders may draw useful lessons. The report suggests that comprehensive school reform (CSR) offers promise to struggling urban schools by focusing on transforming the academic climate, school culture, and…

Examinations as an Instrument for Strengthening Pedagogy: Lessons from Three Decades of Experience in Kenya

ERIC Educational Resources Information Center

Wasanga, Paul; Somerset, Anthony

2013-01-01

This paper starts with an analysis of the twin purposes of an examination reform programme originally launched in Kenya during the 1970s: first, to broaden the spectrum of cognitive skills being tested; and second, to set up a feedback system based on the performance profiles, providing schools and teachers with guidance as to how pedagogy and…

Qualitative analysis of governance trends after health system reforms in Latin America: lessons from Mexico.

PubMed

Arredondo, A; Orozco, E; Recaman, A L

2018-03-01

Health policies in Latin America are centered on the democratization of health. Since 2003, during the last generation of reforms, health systems in this region have promoted governance strategies for better agreements between governments, institutions, and civil society. In this context, we develop an evaluative research to identify trends and evidence of governance after health care reforms in six regions of Mexico. Evaluative research was developed with a retrospective design based on qualitative analysis. Primary data were obtained from 189 semi-structured interviews with purposively selected health care professionals and key informants. Secondary data were extracted from a selection of 95 official documents on results of the reform project at the national level, national health policies, and lines of action for good governance. Data processing and analysis were performed using ATLAS.ti and PolicyMaker. A list of main strengths and weaknesses is presented as evidence of health system governance. Accountability at the federal level remains prescriptive; in the regions, a system of accountability and transparency in the allocation of resources and in terms of health democratization strategies is still absent. Social protection and decentralization schemes are strategies that have allowed for improvements with a proactive role of users and civil society. Regarding challenges, there are still low levels of governance and difficulties in the effective conduct of programs and reform strategies together with a lack of precision in the rules and roles of the different actors of the health system. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Progress towards universal health coverage in BRICS: translating economic growth into better health.

PubMed

Rao, Krishna D; Petrosyan, Varduhi; Araujo, Edson Correia; McIntyre, Diane

2014-06-01

Brazil, the Russian Federation, India, China and South Africa--the countries known as BRICS--represent some of the world's fastest growing large economies and nearly 40% of the world's population. Over the last two decades, BRICS have undertaken health-system reforms to make progress towards universal health coverage. This paper discusses three key aspects of these reforms: the role of government in financing health; the underlying motivation behind the reforms; and the value of the lessons learnt for non-BRICS countries. Although national governments have played a prominent role in the reforms, private financing constitutes a major share of health spending in BRICS. There is a reliance on direct expenditures in China and India and a substantial presence of private insurance in Brazil and South Africa. The Brazilian health reforms resulted from a political movement that made health a constitutional right, whereas those in China, India, the Russian Federation and South Africa were an attempt to improve the performance of the public system and reduce inequities in access. The move towards universal health coverage has been slow. In China and India, the reforms have not adequately addressed the issue of out-of-pocket payments. Negotiations between national and subnational entities have often been challenging but Brazil has been able to achieve good coordination between federal and state entities via a constitutional delineation of responsibility. In the Russian Federation, poor coordination has led to the fragmented pooling and inefficient use of resources. In mixed health systems it is essential to harness both public and private sector resources.

Progress towards universal health coverage in BRICS: translating economic growth into better health

PubMed Central

Petrosyan, Varduhi; Araujo, Edson Correia; McIntyre, Diane

2014-01-01

Abstract Brazil, the Russian Federation, India, China and South Africa – the countries known as BRICS – represent some of the world’s fastest growing large economies and nearly 40% of the world’s population. Over the last two decades, BRICS have undertaken health-system reforms to make progress towards universal health coverage. This paper discusses three key aspects of these reforms: the role of government in financing health; the underlying motivation behind the reforms; and the value of the lessons learnt for non-BRICS countries. Although national governments have played a prominent role in the reforms, private financing constitutes a major share of health spending in BRICS. There is a reliance on direct expenditures in China and India and a substantial presence of private insurance in Brazil and South Africa. The Brazilian health reforms resulted from a political movement that made health a constitutional right, whereas those in China, India, the Russian Federation and South Africa were an attempt to improve the performance of the public system and reduce inequities in access. The move towards universal health coverage has been slow. In China and India, the reforms have not adequately addressed the issue of out-of-pocket payments. Negotiations between national and subnational entities have often been challenging but Brazil has been able to achieve good coordination between federal and state entities via a constitutional delineation of responsibility. In the Russian Federation, poor coordination has led to the fragmented pooling and inefficient use of resources. In mixed health systems it is essential to harness both public and private sector resources. PMID:24940017

How Does Lesson Structure Shape Teacher Perceptions of Teaching with Challenging Tasks?

ERIC Educational Resources Information Center

Russo, James; Hopkins, Sarah

2017-01-01

Despite reforms in mathematics education, many teachers remain reluctant to incorporate challenging (i.e., more cognitively demanding) tasks into their mathematics instruction. The current study examines how lesson structure shapes teacher perceptions of teaching with challenging tasks. Participants included three Year 1/2 classroom teachers who…

Argentina: no lesson learned.

PubMed

Iriart, Celia; Waitzkin, Howard

2006-01-01

This article examines the political, ideological, social, and economic processes by which the Argentinean economy was transformed, the structural consequences, and the policies responsible for dismantling the welfare state. The health care system reform during the 1990s was an important component in accomplishing the last objective. Analyses of the policies adopted after the crisis of 2001 reveal that, despite the discourse against international financial institutions, President Nestor Kirchner, elected in 2002, followed the same approach by accepting and applying the second generation of health reforms recommended by the World Bank and the Inter-American Development Bank with additional pressure from the World Trade Organization and several free trade agreements. This "new reform" furthered business opportunities for multinational corporations while further shrinking the state administration's role in supplying health, education, and other social services to people who need them more than ever. Social movements have emerged that are developing alternative projects and showing that, when the base is solidarity, "another world is possible."

A European late starter: lessons from the history of reform in Irish health care.

PubMed

Wren, Maev-Ann; Connolly, Sheelah

2017-12-26

The Irish health care system is unusual within Europe in not providing universal, equitable access to either primary or acute hospital care. The majority of the population pays out-of-pocket fees to access primary health care. Due to long waits for public hospital care, many purchase private health insurance, which facilitates faster access to public and private hospital services. The system has been the subject of much criticism and repeated reform attempts. Proposals in 2011 to develop a universal health care system, funded by Universal Health Insurance, were abandoned in 2015 largely due to cost concerns. Despite this experience, there remains strong political support for developing a universal health care system. By applying an historical institutionalist approach, the paper develops an understanding of why Ireland has been a European outlier. The aim of the paper is to identify and discuss issues that may arise in introducing a universal healthcare system to Ireland informed by an understanding of previous unsuccessful reform proposals. Challenges in system design faced by a late-starter country like Ireland, including overcoming stakeholder resistance, achieving clarity in the definition of universality and avoiding barriers to access, may be shared by countries whose universal systems have been compromised in the period of austerity.

Lessons in Reading Reform: Finding What Works. Technical Appendix

ERIC Educational Resources Information Center

Betts, Julian R.; Zau, Andrew C.; Koedel, Cory

2010-01-01

This technical appendix provides more detail on the reading reforms implemented under the Blueprint for Student Success project in the San Diego Unified School District (SDUSD) between 2000 and 2005. It provides details on the dataset, the econometric methods the authors employed, and the results, which are also detailed and discussed in the main…

Accomplishing Districtwide Reform

ERIC Educational Resources Information Center

Sharratt, Lyn; Fullan, Michael

2006-01-01

This is a mystery story. It is about a district that apparently did the right things but seemed not to get commensurate results across all classrooms and schools. In this article, we look closely at the details and discover an important lesson about districtwide reform. The district is York Region District School Board, which is a large…

Elevating Teacher Quality: Teacher Tenure Reform Applying Lessons from Other Fields

ERIC Educational Resources Information Center

Martin, Kevin M.

2016-01-01

The increased pressure of changing how teacher evaluations are conducted and increasing the level of teacher quality are pushing schools to reform. Due to changes in state mandates and federal laws, schools are required to demonstrate teacher effectiveness and student growth in teacher evaluations to assure students are receiving top quality…

The Transformation of Russian Military Doctrine: Lessons Learned from Kosovo and Chechnya

DTIC Science & Technology

2000-07-01

operations. However, due to the failures of Russian military reform from 1992–1997 and the chronic underfunding of Russian defense from 1997–1999 (in...since NATO’s attack. A serious reassessment of Russian military reform became essential. Once again conventional forces would need to be ready for the

Integrating Districts in Comprehensive School Reform in the Middle-Grades: Lessons from Middle Start CSR

ERIC Educational Resources Information Center

Gopalan, Pritha

2004-01-01

This report compares district leaders' perspectives on changes in school capacity, student outcomes and district policy over three years of implementation of Middle Start (MS), a comprehensive school reform program to demonstrate the potential for improving the effectiveness and sustainability of CSR at the school level through integrating…

Lessons in Leadership: Perspectives on Corporate Managerialism and Educational Reform

ERIC Educational Resources Information Center

Galway, Gerald

2012-01-01

Between 1970 and 1990 enrolment in Newfoundland and Labrador schools dropped by 22 percent. The first wave of major educational reform (1990 to 2000) saw massive reductions in public school expenditures and the reduction of more than 1650 teachers. Facing continued enrolment loss and a large current account deficit, in 2004, government again…

Creating Nongraded K-3 Classrooms: Teachers' Stories and Lessons Learned.

ERIC Educational Resources Information Center

Hovda, Ric A., Ed.; And Others

Based on the experiences of teachers, principals, and parents involved in the Kentucky Education Reform Act (KERA), this book is a collection of accounts and reflections by teachers or administrators who have engaged in developing and implementing nongraded primary education programs. The articles in this book are: (1) "Reforming the…

Re-Forming the School: Taking Swedish Lessons

ERIC Educational Resources Information Center

Johansson, Inge; Moss, Peter

2012-01-01

In the context of government decentralisation and integration of services, over the last 15 years Sweden has been developing an all-day school based on inter-professional teamworking and adopting a holistic approach to working with children. The article describes these recent educational reforms in Sweden, which have sought to re-structure the…

Lesson Study for Learning Community (LSLC): Conceptualising Teachers' Practices within a Social Justice Perspective

ERIC Educational Resources Information Center

Saito, Eisuke; Atencio, Matthew

2015-01-01

Under neo-liberal policies in many countries, there has been an extensive trend of educational reform which intensifies competition. Such educational reform is underpinned by direct government control, seen in centre to periphery forms of policy administration and implementation with strong emphasis on managerialism and test-oriented…

Review of "Florida Formula for Student Achievement: Lessons for the Nation"

ERIC Educational Resources Information Center

Mathis, William

2011-01-01

Former Florida Governor Jeb Bush and the Foundation for Excellence in Education have embarked on a well-funded campaign to spread selected Florida education reforms to other states. These reforms include assigning letter grades to schools, high-stakes testing, promotion and graduation requirements, bonus pay, a wide variety of alternative teacher…

The Benwood Plan: A Lesson in Comprehensive Teacher Reform

ERIC Educational Resources Information Center

Silva, Elena

2008-01-01

Hamilton County, Tennessee, engaged in a multi-year effort to improve teaching in a group of eight central city elementary schools. This reform, known as the Benwood Initiative, was funded with $5 million from the Chattanooga-based Benwood Foundation. Student achievement improved dramatically as a result of this initiative. The Benwood successes…

Lessons for "Community" Democratic School Reformers from "Publius" and Friends.

ERIC Educational Resources Information Center

Dixon, Douglas A.

Recent efforts to improve schools through community democratic school decision making and practices conflict with ideas of some of the founding fathers of the U.S. Constitution. There are several differences between the ideas of some contemporary democratic education reformers and those of Publius (the pen name of the authors of the Federalist…

An evaluation of systemic reforms of public hospitals: the Sanming model in China.

PubMed

Fu, Hongqiao; Li, Ling; Li, Mingqiang; Yang, Chunyu; Hsiao, William

2017-10-01

Low- and middle-income countries (LMICs) have been searching for effective strategies to reform their inefficient and wasteful public hospitals. Recently, China developed a model of systemic reforms called the Sanming model to address the inefficiency and waste at public hospitals. In this article, we explain and evaluate how the Sanming model reformed its 22 public hospitals in 2013 by simultaneously restructuring the hospital governance structure, altering the payment system to hospitals, and realigning physicians' incentives. By employing the difference-in-difference (DID) method and using the hospital-level data from 187 public hospitals in Fujian province, we find that the Sanming model has reduced medical costs significantly without measurably sacrificing clinical quality and productive efficiency. The systemic reform, on average, has reduced the medical care cost per outpatient visit and per inpatient admission by 6.1% (P-value = 0.0445) and 15.4% (P-value < 0.001), respectively. It is largely accomplished through a decrease in drug expenditures per outpatient visit and per inpatient admission of about 29% (P-value < 0.001) and 53% (P-value < 0.001). These results show that the Sanming model has achieved at least a short-term success in improving the performance of the public hospitals. These findings suggest that such a systemic transformation of public hospitals, where the governance structure, payment system and physician compensation methods are aligned, are crucial to improving their performance; it holds critical lessons for China and other LMICs. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Policy challenges and reforms in small EU member state health systems: a narrative literature review.

PubMed

Azzopardi-Muscat, Natasha; Funk, Tjede; Buttigieg, Sandra C; Grech, Kenneth E; Brand, Helmut

2016-12-01

The EU directive on patients' rights and cross-border care is of particular interest to small states as it reinforces the concept of health system cooperation. An analysis of the challenges faced by small states, as well as a deep evaluation of their health system reform characteristics is timely and justified. This paper identifies areas in which EU level cooperation may bring added value to these countries' health systems. Literature search is based primarily on PUBMED and is limited to English-language papers published between January 2000 and September 2014. Results of 76 original research papers appearing in peer-reviewed journals are summarised in a literature map and narrative review. Primary care, health workforce and medicines emerge as the salient themes in the review. Lack of capacity and small market size are found to be the frequently encountered challenges in governance and delivery of services. These constraints appear to also impinge on the ability of small states to effectively implement health system reforms. The EU appears to play a marginal role in supporting small state health systems, albeit the stimulus for reform associated with EU accession. Small states face common health system challenges which could potentially be addressed through enhanced health system cooperation at EU level. The lessons learned from research on small states may be of relevance to health systems organized at regional level in larger European states. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The Patient Protection and Affordable Care Act: the victory of unorthodox lawmaking.

PubMed

Beaussier, Anne-Laure

2012-10-01

The 2010 Patient Protection and Affordable Care Act was a major legislative achievement of the 111th Congress. This law structurally reforms the US health care system by encouraging universal health care coverage through regulated competition among private insurance companies. When looking at the process for reform, what strikes an observer of US health care policy in the first place is that the Democratic majority was able to enact something in a political field characterized by strong resistance to change. This article builds on that observation. Arguments concentrate on the legislative process of the reform and support the idea that it may be partly explained by considering an evolution of US legislative institutions, mostly in the sense of a more centralized legislative process. Based on approximately one hundred semidirected interviews, I argue that the Democratic majority, building on lessons from both President Bill Clinton's health care reform attempt and the Republicans' strategy of using strong congressional leadership to pass social reforms, was able to overcome institutional constraints that have long prevented comprehensive change. A more centralized legislative process, which has been described as "unorthodox lawmaking," enabled the Democratic leadership to overcome multiple institutional and political veto players.

Financing Higher Education: Lessons from Economic Theory and Reform in England

ERIC Educational Resources Information Center

Barr, Nicholas

2009-01-01

The finance of higher education faces a clash between technological advance, driving up the demand for skills, and fiscal constraints, given competing imperatives for public spending. Paying for universities is also immensely politically sensitive. This paper sets out core lessons for financing higher education deriving from economic theory,…

(Mis)Conceptions about Geometric Shapes in Pre-Service Primary Teachers

ERIC Educational Resources Information Center

Žilková, Katarína; Guncaga, Ján; Kopácová, Janka

2015-01-01

During the last reform, Slovakia has reduced geometry in curriculum in primary mathematics education. Pre-school education schools devote more time to geometry in curriculum, but this is not mandatory for all the children. In the primary schools, teachers devote very little lessons time to this problem. These lessons are mainly focused on…

A Historical Perspective from "a" to "c"

ERIC Educational Resources Information Center

Edwards, Thomas G.; Ozgun-Koca, S. Asli

2010-01-01

Evolving technology has played an important part in a common quadratic-function lesson. Having been mentioned repeatedly in numerous reform documents, a recurring lesson has involved changing the parameters in f(x) = ax[superscript 2] + bx + c and studying the effects on the graph. In both NCTM Yearbooks and NCTM Standards documents, technology is…

Building a Model PE Curriculum: Education Reform in Action

ERIC Educational Resources Information Center

Moore, John

2012-01-01

The blueprint to build a model physical education (PE) curriculum begins by establishing a sound curricular foundation based on a lesson plan template that incorporates clear and concise program goals, the alignment of lessons to state or national content standards, and the collection, analysis and use of objective assessment data that informs…

A comprehensive approach to women’s health: lessons from the Mexican health reform

PubMed Central

2012-01-01

Background This paper discusses the way in which women’s health concerns were addressed in Mexico as part of a health system reform. Discussion The first part sets the context by examining the growing complexity that characterizes the global health field, where women’s needs occupy center stage. Part two briefly describes a critical conceptual evolution, i.e. from maternal to reproductive to women’s health. In the third and last section, the novel “women and health” (W&H) approach and its translation into policies and programs in the context of a structural health reform in Mexico is discussed. W&H simultaneously focuses on women’s health needs and women’s critical roles as both formal and informal providers of health care, and the links between these two dimensions. Summary The most important message of this paper is that broad changes in health systems offer the opportunity to address women’s health needs through innovative approaches focused on promoting gender equality and empowering women as drivers of change. PMID:23228037

Technology in Education. The Progress of Education Reform, 2006. Volume 6, Number 6

ERIC Educational Resources Information Center

Weiss, Suzanne

2006-01-01

For policymakers, educators and others interested in learning more about the one-to-one computing movement, this issue of "The Progress of Education Reform" spotlights three particularly useful resources: (1) a detailed review of the challenges faced by states and districts implementing laptop programs, and of lessons learned to date in…

Conspiracy Theory: Lessons for Leaders from Two Centuries of School Reform

ERIC Educational Resources Information Center

Nehring, James H.

2007-01-01

If school leaders are to bring about successful reform, they must thwart the forces that have conspired against it since the 19th century. In this article, the author identifies six "conspirators" against thoughtful school practice and offers practical suggestions for rooting them out. The six conspirators are: (1) The tendency to view schools as…

Retention and Satisfaction of Novice Teachers: Lessons from a School Reform Model

ERIC Educational Resources Information Center

Glennie, Elizabeth J.; Mason, Marcinda; Edmunds, Julie A.

2016-01-01

In many countries, novice teachers, or those with fewer than four years of experience, have a higher turnover rate than do more experienced teachers. Using teacher employment data, we examine whether schools in an American whole-school reform model are better able to retain novice teachers. Using survey data, we investigate whether novice teachers…

Effective Partnerships in School Reform: Lessons Learned from the Midwest Child-Parent Center Expansion

ERIC Educational Resources Information Center

Hayakawa, Momoko; Englund, Michelle M.; Candee, Allyson; Lease, Erin; Sullivan, Molly; Warner-Richter, Mallory; Reynolds, Arthur J.

2015-01-01

The Midwest Expansion of the Child-Parent Center Education Program (MCPC) is a pre-K to 3rd grade intervention program aimed at improving economically disadvantaged children's school success by enhancing continuity in instruction and increasing parental involvement. Opened in Chicago in the 1960s, this school reform model has undergone significant…

Finnish Mathematics Teaching from a Reform Perspective: A Video-Based Case-Study Analysis

ERIC Educational Resources Information Center

Andrews, Paul

2013-01-01

This article offers a qualitative analysis of videotaped mathematics lessons taught by four teachers in a provincial university city in Finland. My study is framed not only by Finnish success on Programme for International Student Assessment (PISA) but also by the objectives of current mathematics education reform, which are consistent with PISA's…

Charter Schools: Lessons in School Reform. Topics in Educational Leadership.

ERIC Educational Resources Information Center

Brouillette, Liane

This book investigates the strengths and limitations of charter schools as an approach to reform by focusing on the day-to-day reality of students, teachers, administrators, and parents involved. Detailed case studies of seven schools are included. Seymour Sarason's work on the creation of settings provides the lens through which these schools are…

The Link between Pensions and Retirement Timing: Lessons from California Teachers. Conference Paper 2009-12

ERIC Educational Resources Information Center

Brown, Kristine M.

2009-01-01

This paper exploits a major, unanticipated reform of the California teachers' pension to provide quasi-experimental evidence on the link between pension generosity and retirement timing. Using two large administrative datasets, the author conducts a reduced-form analysis of the pension reform and estimates a structural model of retirement timing.…

How Welfare Reform Can Help or Hurt Children. Children and Welfare Reform Issue Brief 1.

ERIC Educational Resources Information Center

Collins, Ann; Aber, J. Lawrence

The issue brief describes the research base for the National Center for Children in Poverty's (NCCP's) framework to assess welfare changes from a children's perspective and points to lessons from current and past welfare-to-work evaluations. Many changes are now implemented in welfare policies due to new legislation titled the Personal…

Beyond Incrementalism? SCHIP and the politics of health reform.

PubMed

Oberlander, Jonathan B; Lyons, Barbara

2009-01-01

When Congress enacted the State Children's Health Insurance Program (SCHIP) in 1997, it was heralded as a model of bipartisan, incremental health policy. However, despite the program's achievements in the ensuing decade, SCHIP's reauthorization triggered political conflict, and efforts to expand the program stalemated in 2007. The 2008 elections broke that stalemate, and in 2009 the new Congress passed, and President Barack Obama signed, legislation reauthorizing SCHIP. Now that attention is turning to comprehensive health reform, what lessons can reformers learn from SCHIP's political adventures?

Water reform in Sub-Saharan Africa: what is the difference?

NASA Astrophysics Data System (ADS)

Van Koppen, Barbara

Since the early 1990s African governments took an active part in the global movement of water reform towards Integrated Water Resources Management (IWRM). The first step consisted primarily of assimilating the generic principles of IWRM. At this generic level, water reform in Sub-Saharan Africa seems quite similar to water reform elsewhere in the developed and developing world. However, in taking the second step of operationalizing generic principles into concrete actions on the ground, at least three salient differences between Sub-Saharan Africa and elsewhere emerged: (a) Africa’s relative abundance of water resources but its scarcity of economic means to harness available water resources; (b) the importance of agriculture and agricultural water development for economic growth and poverty eradication; and (c) the need for systems of water rights and financial resource mobilization that are separated and suit the African reality in which large water users are relatively few, while the bulk of water users are scattered smallholders. This paper discusses the early operationalization with regard to these three unique features and identifies lessons learnt.

Medical workforce education and training: A failed decentralisation attempt to reform organisation, financing, and planning in England.

PubMed

Ovseiko, Pavel V; Buchan, Alastair M

2015-12-01

The 2010-2015 Conservative and Liberal Democrat coalition government proposed introducing a radical decentralisation reform of the organisation, financing, and planning of medical workforce education and training in England. However, following public deliberation and parliamentary scrutiny of the government's proposals, it had to abandon and alter its original proposals to the extent that they failed to achieve their original decentralisation objectives. This failed decentralisation attempt provides important lessons about the policy process and content of both workforce governance and health system reforms in Europe and beyond. The organisation, financing, and planning of medical workforce education is as an issue of national importance and should remain in the stewardship of the national government. Future reform efforts seeking to enhance the skills of the workforce needed to deliver high-quality care for patients in the 21st century will have a greater chance of succeeding if they are clearly articulated through engagement with stakeholders, and focus on the delivery of undergraduate and postgraduate multi-professional education and training in universities and teaching hospitals. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

From instinct to evidence: the role of data in country decision-making in Chile.

PubMed

Aguilera, Ximena Paz; Espinosa-Marty, Consuelo; Castillo-Laborde, Carla; Gonzalez, Claudia

2016-01-01

The Chilean health system has undergone profound reforms since 1990, while going through many political upheavals, and faced demographic, health, and economic transformations. The full information requirements to develop an evidence-informed process implied the best possible use of available data, as well as efforts for improving the information systems. To examine, from a historical perspective, the use of data during the health reforms undertaken in Chile since 1990, and to identify the factors that have determined its utilization and improvement. A qualitative methodological approach was followed to review the case study of the Chilean experience with data on decision-making. We use as the primary source our first-hand experience as officials of the Ministry of Health (MOH) and the Ministry of Finance during the reform period considered. Second, a literature review was conducted, using documents from official sources, historical accounts, books, policy reports, and articles about the reform process, looking for the use of data. The Chilean health care reform process was intensive in utilization and production of information. In this context, the MOH conducted several studies, from the burden of disease, efficacy of interventions, cost-effectiveness, out-of-pocket payments, and fiscal impact to social preferences, among others. Policy and prioritization frameworks developed by international agencies influenced the use of data and the studies' agenda. Health systems in Latin America have struggled to adapt to changing health needs caused by demographic transition and economic growth. Health reforms in Chile provide lessons of this sustained effort, based on data and scientific grounds, with lights and shadows. Tradition, receptiveness to foreign ideas, and benchmarking with international data determined this approach, facilitated by the political influence of physicians and other technocrats. Besides, internationally comparable statistics are shown to play a significant role in policy debate.

Data for development in health: a case study and monitoring framework from Kazakhstan

PubMed Central

Obermann, Konrad; Chanturidze, Tata; Richardson, Erica; Tanirbergenov, Serik; Shoranov, Marat; Nurgozhaev, Ali

2016-01-01

Healthcare reforms are often not coupled with a relevant and appropriate monitoring framework, leaving policymakers and the public without evidence about the implications of such reforms. Kazakhstan has embarked on a large-scale reform of its healthcare system in order to achieve Universal Health Coverage. The health-related 2020 Strategic Development Goals reflect this political ambition. In a case-study approach and on the basis of published and unpublished evidence as well as personal involvement and experience (A) the indicators in the 2020 Strategic Development Goals were assessed and (B) a ‘data-mapping’ exercise was conducted, where the WHO health system framework was used to describe the data available at present in Kazakhstan and comment on the different indicators regarding their usefulness for monitoring the current health-related 2020 Strategic Development Goals in Kazakhstan. It was concluded that the country’s current monitoring framework needs further development to track the progress and outcomes of policy implementation. The application of a modified WHO/World Bank/Global Fund health system monitoring framework was suggested to examine the implications of recent health sector reforms. Lessons drawn from the Kazakhstan experience on tailoring the suggested framework, collecting the data, and using the generated intelligence in policy development and decision-making can serve as a useful example for other middle-income countries, potentially enabling them to fast-track developments in the health sector. PMID:28588905

Learning from health system reforms: lessons from Burkina Faso.

PubMed

Haddad, Slim; Nougtara, Adrien; Fournier, Pierre

2006-12-01

Burkina Faso has implemented a macroeconomic adjustment programme (MAP) along with an ambitious reform of the health care system. Our aim was (1) to verify whether MAPs led to a reduction in health resources, and (2) to analyze the consequences of health policies implemented. Cross-sectional and retrospective study, spanning the years 1983-2003. The macro aspect is based upon documents from national and international sources, a database of secondary socioeconomic data, and interviews of key informants working in upper management. Household and health facility surveys were conducted in three regions covering 53 communities. Within the reforms, the health sector benefited from an important flow of resources. There were significant increases in public expenditures, health care staff, the number of primary care facilities and the availability of generic drugs. However, health facilities in the public sector remain underused and major inequities subsist. Access to health care is constrained by the population's ability to pay. Health expenditures impoverish households, creating new poor and impoverishing the already poor. The success of reforms depends largely on the extent to which they remove financial barriers to access to services. The experience of Burkina Faso also reveals the need for fundamental changes that will motivate staff, improve productivity, and ensure good quality services. Integrating health development policies with strategic plans for poverty reduction can provide new opportunities for African countries to redesign their health systems within this type of perspective.

Implementing Reform: Teachers' Beliefs about Students and the Curriculum

NASA Astrophysics Data System (ADS)

Bartiromo, Tara; Etkina, Eugenia

2009-11-01

This paper presents findings on how consistent teachers' perceptions of their students, their own role in the classroom, and the reformed curriculum are with the actual implementation of the reformed curriculum in the classroom. This study shows that the five participating teachers were consistent with their perceptions and their actual behavior in the classroom. The teachers who were engaged in designing the curriculum demonstrated consistent reformed teaching views and behaviors. The degree to which the teachers viewed the curriculum as useful to them and their students was an indicator of how reformed their teaching was as measured by the Reformed Teaching Observation Protocol (RTOP) [1][2]. Finally, it was determined that faithful implementation of a curriculum can mean faithfully implementing the theoretical foundation of the curriculum materials during instruction instead of implementing every component or lesson of the reformed curriculum.

Change in Chaos: Seven Lessons Learned from Katrina

ERIC Educational Resources Information Center

Carr-Chellman, Alison A.; Beabout, Brian; Alkandari, Khaled A.; Almeida, Luis C.; Gursoy, Husra T.; Ma, Ziyan; Modak, Rucha S.; Pastore, Raymond S.

2008-01-01

This article discusses seven lessons learned from Katrina, suggesting that after chaos: (1) there is hope; (2) there is a strong atmosphere of indeterminacy; (3) things tend to break apart and reform in somewhat similar ways but with different values; (4) there is a desire for organization, leadership, and familiarity; (5) there is a sense of…

Teachers' and Students' Negotiation Moves When Teachers Scaffold Group Work

ERIC Educational Resources Information Center

González, Gloriana; DeJarnette, Anna F.

2015-01-01

Group work has been a main activity recommended by mathematics education reform. We aim at describing the patterns of interaction between teachers and students during group work. We ask: How do teachers scaffold group work during a problem-based lesson? We use data from a problem-based lesson taught in six geometry class periods by two teachers…

Teacher Practice Online: Sharing Wisdom, Opening Doors. School Reform Series

ERIC Educational Resources Information Center

Pointer Mace, Desiree H.

2009-01-01

Teachers know how complicated their work is. They constantly balance considerations of individual students with those of the group; they think about how past events affect today's lessons; and they constantly adapt and revise for future lessons. But few people ever get to see teachers' work in this way. The most energizing, relational,…

Learning Trajectories, Lesson Planning, Affordances, and Constraints in the Design and Enactment of Mathematics Teaching

ERIC Educational Resources Information Center

Amador, Julie; Lamberg, Teruni

2013-01-01

Recent reform efforts in mathematics education have stimulated a focus on learning trajectories. At the same time, a global increase in high-stakes testing has influenced instructional practices. This study investigated how four fourth grade teachers within a school planned and enacted lessons to understand what mediated their planning and…

Exploring Lesson Study as an Improvement Strategy at a High-Stakes Accountability School

ERIC Educational Resources Information Center

Lee, Alice Tae

2012-01-01

This study addressed the problem of chronic low student achievement in language arts at a Program Improvement 5+ school by implementing two cycles of facilitated lesson study. Using action research to facilitate and monitor change in instructional practices at a school that is currently undergoing a teacher-initiated turnaround reform effort, this…

Glen Echo Park: Center for Education and Recreation. Teaching with Historic Places.

ERIC Educational Resources Information Center

Gray, Stephanie

This lesson is based on the National Register of Historic Places registration file "Glen Echo Amusement Park," park planning documents, and newspaper and magazine accounts. The lesson can be used in U.S. history units on the Gilded Age and the Progressive Era to explore religious and educational reform movements (including the Chautauqua…

New Orleans-Style Education Reform: A Guide for Cities--Lessons Learned 2004-2010

ERIC Educational Resources Information Center

Brinson, Dana; Boast, Lyria; Hassel, Bryan C.; Kingsland, Neerav

2012-01-01

New Schools for New Orleans (NSNO) commissioned this guide, in collaboration with the Louisiana Recovery School District and the Tennessee Achievement School District, to meet the Investing in Innovation (i3) requirement that grantees disseminate the lessons of their work. To create this guide, NSNO worked with Public Impact to build on prior…

Understanding electricity market reforms and the case of Philippine deregulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Santiago, Andrea; Roxas, Fernando

2010-03-15

The experience of the Philippines offers lessons that should be relevant to any country seeking to deregulate its power industry. Regardless of structure, consumers must face the real price of electricity production and delivery that is closer to marginal cost. Politically motivated prices merely shift the burden from ratepayers to taxpayers. And any reform should work within a reasonable timetable. (author)

Taking Root: Texas' Lessons for Sustaining the College- and Career-Ready Agenda

ERIC Educational Resources Information Center

Achieve, Inc., 2009

2009-01-01

To give states the information they need to sustain hard-fought education reform policy changes effectively, Achieve conducted research on state education reforms that have been sustained successfully for over a decade or more. Funded by the GE Foundation, Achieve hopes this work will help other state leaders, wherever they may be on their road to…

Evaluation of the Oregon Business Council-David Douglas Model School District Partnership Program.

ERIC Educational Resources Information Center

Conley, David T.; Stone, Patricia

The Oregon Business Council (OBC)-David Douglas Model District Project was undertaken for two reasons: (1) to create a model for a district's accelerated implementation of all the elements of school reform as mandated in Oregon House Bill 3565; and (2) to learn lessons about school reform that would inform OBC member companies and school districts…

Where does the insurance industry stand on health reform today?

PubMed

Bodaken, Bruce G

2008-01-01

With another national health care debate on the horizon, many assume that health plans will present a major source of opposition to universal coverage and other reforms. But a closer look reveals signs of change. Some plans continue their reflexive opposition to increasing government's role in health care; other plans have stepped forward to advocate meaningful reform. Experience in Massachusetts, California, Minnesota, and elsewhere suggests a clear lesson for policymakers. Sensible proposals and a genuine commitment to cooperation can not only neutralize opposition from a potentially powerful opponent, but can actually bring health plans on board to support coverage mandates, guaranteed issue, and other reforms.

Intergovernmental relations and Long Term Care reforms: lessons from the Italian case.

PubMed

Gabriele, Stefania; Tediosi, Fabrizio

2014-05-01

The article aims at analysing the reasons why Italy failed to reform Long Term Care (LTC) policies, focusing on an aspect which has been overlooked: the interplay between LTC policies and the intergovernmental multilevel relationships. In the Italian LTC system, the main central intervention has been the regularisation of migrant care work, while the automatic growth of the cash benefits has accompanied the care needs evolution. Therefore the only institutional change has been a "gradual transformation". The causes of the failure to reform LTC have been mainly related to a strong fragmentation of the policy field, the existence of a universalistic cash benefit, the fiscal constraint. We argue that a further obstacle to reform LTC policies has been the weak and uncertain legislative framework of federalism. The uncertainty on the allocation and distribution of resources and the delay to apply the equalisation mechanism based on needs engendered a lame federalism that contributed to hindering welfare innovations and to increasing the institutional fragmentation. The analysis is partly consistent with previous literature, although it places less emphasis on the role of the constituencies and the scarcity of resources in influencing decisions, focusing more on the implications of the failure to fully realise the federalist reform. This focus shows that to implement institutional change in the welfare system, it is important to take into account the features of the federal governance, the intergovernmental relations, and to address the challenges that are connected to them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

When Business Gets Involved: A Case Study of Business Community Involvement In Illinois' Early Childhood Education Policy

ERIC Educational Resources Information Center

Kovach, Melissa

2009-01-01

As the first state to offer universal preschool to three-year-olds, Illinois' experience with early childhood education (ECE) policy reform efforts offers lessons about how such change takes shape. This report details Illinois' ECE activities from 1992 to the present, with a particular focus on the business role in ECE policy. Lessons learned…

Learning within Context: Exploring Lesson Study as an Aid in Enhancing Teachers' Implementations, Conceptions, and Perceptions of the Mathematics Teaching Practices

ERIC Educational Resources Information Center

Prince, Kyle

2016-01-01

With traditional teaching methods pervasive in the U.S., it is crucial that mathematics teacher educators and professional development leaders understand what methods result in authentic changes in classroom instruction. Lesson study presents a promising approach to developing reform-oriented instruction, as it is situated within the classroom,…

Examining the Role of Leadership in an Undergraduate Biology Institutional Reform Initiative.

PubMed

Matz, Rebecca L; Jardeleza, Sarah E

Undergraduate science, technology, engineering, and mathematics (STEM) education reform continues to be a national priority. We studied a reform process in undergraduate biology at a research-intensive university to explore what leadership issues arose in implementation of the initiative when characterized with a descriptive case study method. The data were drawn from transcripts of meetings that occurred over the first 2 years of the reform process. Two literature-based models of change were used as lenses through which to view the data. We find that easing the burden of an undergraduate education reform initiative on faculty through articulating clear outcomes, developing shared vision across stakeholders on how to achieve those outcomes, providing appropriate reward systems, and ensuring faculty have ample opportunity to influence the initiative all appear to increase the success of reform. The two literature-based models were assessed, and an extended model of change is presented that moves from change in STEM instructional strategies to STEM organizational change strategies. These lessons may be transferable to other institutions engaging in education reform. © 2016 R. L. Matz and S. E. Jardeleza. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Autonomy as an Element in Chinese Educational Reform: A Case Study of English Lessons in a Senior High School in Beijing

ERIC Educational Resources Information Center

Halstead, J. Mark; Zhu, Chuanyan

2009-01-01

Recent educational reforms in China have emphasized "learner autonomy", but this differs in crucial respects from the concept of "personal autonomy", which is a central goal of western liberal education. The many changes that have resulted from the opening up policy in China in the last 30 years include what has been called…

Enhancing and Well-Being of Young Children and Families in the Context of Welfare Reform: Lessons from Early Childhood, TANF, and Family Support Programs.

ERIC Educational Resources Information Center

Knitzer, Jane; Cauthen, Nancy K.

This report presents findings about emerging approaches to enhance the well-being of young children and families in the context of welfare reform. Information on programs and initiatives was obtained from nomination forms sent to over 300 key informants, including child care officials, Head Start collaboration directors, governors' early childhood…

What Lessons to Take from Educational Reforms in Asia-Pacific Region? Factors That May Influence the Restructuring of Secondary Education in East Timor

ERIC Educational Resources Information Center

Capelo, Ana; Pedrosa, Maria Arminda; Almeida, Patrícia Albergaria

2013-01-01

To better understand current curricular reforms in some Asia-Pacific countries that came out of conflict periods, documents and information posted on various national and international agency websites were analysed. In this paper we aimed to (i) present a brief description of the conditions under which new secondary education curricula are being…

The group employed model as a foundation for health care delivery reform.

PubMed

Minott, Jenny; Helms, David; Luft, Harold; Guterman, Stuart; Weil, Henry

2010-04-01

With a focus on delivering low-cost, high-quality care, several organizations using the group employed model (GEM)-with physician groups whose primary and specialty care physicians are salaried or under contract-have been recognized for creating a culture of patient-centeredness and accountability, even in a toxic fee-for-service environment. The elements that leaders of such organizations identify as key to their success are physician leadership that promotes trust in the organization, integration that promotes teamwork and coordination, governance and strategy that drive results, transparency and health information technology that drive continual quality improvement, and a culture of accountability that focuses providers on patient needs and responsibility for effective care and efficient use of resources. These organizations provide important lessons for health care delivery system reform.

Health care delivery system reform: accountable care organizations.

PubMed

Dove, James T; Weaver, W Douglas; Lewin, Jack

2009-09-08

Health care reform is moving forward at a frantic pace. There have been 3 documents released from the Senate Finance Committee and proposed legislation from the Senate HELP Committee and the House of Representatives Tri-Committee on Health Reform. The push for legislative action has not been sidetracked by the economic conditions. Integrated health care delivery is the current favored approach to aligning resource use and cost. Accountable care organizations (ACOs), a concept included in health care reform legislation before both the House and Senate, propose to translate the efficiencies and lessons learned from large integrated systems and apply them to nonintegrated practices. The ACO design could be real or virtual integration of local delivery providers. This new structure is complicated, and clinicians, patients, and payers should have input regarding the design and function of it. Because most of health care is delivered in the ambulatory setting, it remains to be determined whether the ACOs are best developed in parallel among physician practices and hospitals or as partnerships between hospitals and physicians. Many are concerned that hospital-led ACOs will force physician employment by hospitals with possible unintended negative consequences for physicians, hospitals, and patients. Patients, physicians, other providers, and payers are in a better position to guide the redesign of the health care delivery system than government agencies, policy organizations, or elected officials, no matter how well intended. We strongly believe-and ACC has proclaimed-that change in health care delivery must be accomplished with patients and physicians at the table.

Rekindling Reform—How Goes Business?

PubMed Central

Maher, Walter B.

2003-01-01

Employers were a major cause of the failure of President Clinton’s Health Security bill. This did not have to be so. The substantive and political factors that caused employers to turn against the Clinton Plan could prove instructive in the next reform effort. The unwillingness of employers who do provide benefits to engage seriously in the struggle over health care reform contributes to maintaining the status quo that penalizes them while rewarding employers who fail to provide coverage. The lessons that can be learned from the Clinton Plan debate, if heeded by both employers and health reform advocates, raise hope that key elements of the business community can play a positive role in the next comprehensive health reform effort. PMID:12511392

Lessons to Be Learned from the History of Anatomical Teaching in the United States: The Example of the University of Michigan

ERIC Educational Resources Information Center

Hildebrandt, Sabine

2010-01-01

Although traditional departments of anatomy are vanishing from medical school rosters, anatomical education still remains an important part of the professional training of physicians. It is of some interest to examine whether history can teach us anything about how to reform modern anatomy. Are there lessons to be learned from the history of…

[Bridging the divide: global lessons from evidence-based health policy in Mexico].

PubMed

Frenk, Julio

2007-01-01

During the past six years, Mexico has undergone a large-scale transformation of its health system. This paper provides an overview of the main features of the Mexican reform experience. Because of its high degree of social inequality, Mexico is a microcosm of the range of problems that affect countries at all levels of development. Its health system had not kept up with the pressures of the double burden of disease, whereby malnutrition, common infections, and reproductive health problems coexist with non-communicable disease and injury. With half of its population uninsured, Mexico was facing an unacceptable paradox: whereas health is a key factor in the fight against poverty, a large number of families became impoverished by expenditures in health care and drugs. The reform was designed to correct this paradox by introducing a new scheme called Popular Health Insurance (Seguro Popular). This innovative initiative is gradually protecting the 50 million Mexicans, most of them poor, who had until now been excluded from formal social insurance. This paper reports encouraging results in the achievement of the ultimate objective of the reform: universal access to high-quality services with social protection for all.

Bridging the divide: global lessons from evidence-based health policy in Mexico.

PubMed

Frenk, Julio

2006-09-09

During the past 6 years, Mexico has undergone a large-scale transformation of its health system. This paper provides an overview of the main features of the Mexican reform experience. Because of its high degree of social inequality, Mexico is a microcosm of the range of problems that affect countries at all levels of development. Its health system had not kept up with the pressures of the double burden of disease, whereby malnutrition, common infections, and reproductive health problems coexist with non-communicable disease and injury. With half of its population uninsured, Mexico was facing an unacceptable paradox: whereas health is a key factor in the fight against poverty, a large number of families became impoverished by expenditures in health care and drugs. The reform was designed to correct this paradox by introducing a new scheme called Popular Health Insurance (Seguro Popular). This innovative initiative is gradually protecting the 50 million Mexicans, most of them poor, who had until now been excluded from formal social insurance. This paper reports encouraging results in the achievement of the ultimate objective of the reform: universal access to high-quality services with social protection for all.

An exploration of the impact of reform-based science instruction on second graders' academic achievement

NASA Astrophysics Data System (ADS)

Ellis, Valeisha Michelle

The purpose of this study was to examine whether possible relationships might exist between the quality of reform-based science instruction and science and reading achievement in second grade. The study also examined separately possible interactions between quality of instruction and gender and race. The study involved an analysis of data previously collected in a larger one-group pre/post test study of a science instructional intervention (ISI Science) (Connor et al., 2010). In the original study, six teachers and two graduate assistants taught two science units designed based upon constructivist principles and reform-based practices. Using the 5-E Learning Cycle (Bybee, 1997), reading and science were integrated into each lesson. Videotapes were made of all lessons and science and reading achievement data were collected. For the current study, dependent achievement variables were science achievement measured by the Iowa Science Test; reading comprehension, by the Woodcock Passage Comprehension; and vocabulary, by the Iowa Vocabulary. Pre- and post-tests scores on the dependent measures were available for 96 children from the original study. Quality of instruction was measured using the Reformed Teaching Observation Protocol (RTOP) (Sawanda & Piburn, 2000). Videotapes of 24 science lessons from the larger study were analyzed using the RTOP. Reliability of ratings for the RTOP in the study was determined to be .96. No significant results were found for relations between instructional quality (RTOP) and any of the achievement variables although significant pre to post increases on all three measures were observed. No differences by race or gender were found. This latter finding was noteworthy given the research in science identifying both gender and race differences in science achievement. Recommendations for future research and teacher education are discussed.

Lessons from local engagement in Latin American health systems.

PubMed

Meads, Geoffrey D; Griffiths, Frances E; Goode, Sarah D; Iwami, Michiyo

2007-12-01

To examine the management of recent policies for stronger patient and public involvement in Latin American health systems, identifying common features and describing local practice examples of relevance to the UK. Participation is a core principle of many contemporary policies for health system reform. In Latin America, as in the UK, it is frequently associated with innovations in primary care services and their organizational developments. This shared interest in alternative models of local engagement offers new opportunities for collaborative research and policy development. Commissioned by UK policy makers, a 4-year research programme was designed to promote exchanges with international counterparts focusing on how modern reform policies are being implemented. The selected countries possessed comparable principles and timeframes for their reforms. A series of individual country case studies were undertaken. Data were drawn from literature and documentary reviews; semi-structured interviews with national policy makers and expert advisers; and with management representatives at local exemplar sites. The aggregate data were subjected to thematic analysis applying a model for sustainable development. Six common factors were identified in Latin American policies for stronger patient and public involvement. From these the most significant transferable learning for the UK relates to the position and status of professions and non-governmental agencies. Illustrative case exemplars were located in each of the eight countries studied.

Ten years of integrated care for the older in France

PubMed Central

Somme, Dominique; de Stampa, Matthieu

2011-01-01

Background This paper analyzes progress made toward the integration of the French health care system for the older and chronically ill population. Policies Over the last 10 years, the French health care system has been principally influenced by two competing linkage models that failed to integrate social and health care services: local information and coordination centers, governed by the social field, and the gerontological health networks governed by the health field. In response to this fragmentation, Homes for the Integration and Autonomy for Alzheimer patients (MAIAs) is currently being implemented at experimental sites in the French national Alzheimer plan, using an evidence-based model of integrated care. In addition, the state’s reforms recently created regional health agencies (ARSs) by merging seven strategic institutions to manage the overall delivery of care. Conclusion The French health care system is moving from a linkage-based model to a more integrated care system. We draw some early lessons from these changes, including the importance of national leadership and governance and a change management strategy that uses both top-down and bottom-up approaches to implement these reforms. PMID:22375101

From instinct to evidence: the role of data in country decision-making in Chile

PubMed Central

Aguilera, Ximena Paz; Espinosa-Marty, Consuelo; Castillo-Laborde, Carla; Gonzalez, Claudia

2016-01-01

Background The Chilean health system has undergone profound reforms since 1990, while going through many political upheavals, and faced demographic, health, and economic transformations. The full information requirements to develop an evidence-informed process implied the best possible use of available data, as well as efforts for improving the information systems. Objective To examine, from a historical perspective, the use of data during the health reforms undertaken in Chile since 1990, and to identify the factors that have determined its utilization and improvement. Design A qualitative methodological approach was followed to review the case study of the Chilean experience with data on decision-making. We use as the primary source our first-hand experience as officials of the Ministry of Health (MOH) and the Ministry of Finance during the reform period considered. Second, a literature review was conducted, using documents from official sources, historical accounts, books, policy reports, and articles about the reform process, looking for the use of data. Findings The Chilean health care reform process was intensive in utilization and production of information. In this context, the MOH conducted several studies, from the burden of disease, efficacy of interventions, cost-effectiveness, out-of-pocket payments, and fiscal impact to social preferences, among others. Policy and prioritization frameworks developed by international agencies influenced the use of data and the studies’ agenda. Conclusions Health systems in Latin America have struggled to adapt to changing health needs caused by demographic transition and economic growth. Health reforms in Chile provide lessons of this sustained effort, based on data and scientific grounds, with lights and shadows. Tradition, receptiveness to foreign ideas, and benchmarking with international data determined this approach, facilitated by the political influence of physicians and other technocrats. Besides, internationally comparable statistics are shown to play a significant role in policy debate. PMID:27887667

Walsh McDermott and changing conceptions of tuberculosis antibiotic therapy: latent lessons for health care reform.

PubMed

Pohl, Barbara; Fins, Joseph J

2014-04-01

Although health care reform efforts are laudably directed at promoting quality and efficiency, added bureaucracy may have the unintended consequence of constraining physicians' creativity. This has the potential to undermine clinicians' freedom to reframe their thinking in response to unfolding biological knowledge, a defining feature of academic medicine. In this Perspective, the authors illustrate the confluence of creativity, context, and discovery through a historical example: the evolution of tuberculosis (TB) multidrug chemotherapy as espoused by Walsh McDermott and his colleagues during the 1940s and 1950s.Before the discovery of streptomycin in 1943, clinician-researchers aimed to identify a "magic bullet" that would rapidly eradicate tubercle bacilli from the body. In the years following the discovery of streptomycin, it became clear that the biology of TB did not conform to researchers' expectations. The recognition that treatment would neither be simple nor quick prompted further attempts to devise an optimal streptomycin regimen, which would enable the host's immune system to suppress infection and prevent the emergence of streptomycin-resistant strains. By the late 1950s, investigators clarified the limits of streptomycin's effectiveness, which led to combined chemotherapy. In so doing, they gained a better understanding of drug-bacilli-host interactions and shifted attention from the host to the drug-resistant microbe.The authors argue that this tale of discovery offers a latent lesson for academic medicine: As the health care system undergoes systemic restructuring, it is essential to preserve the freedom to reframe thinking and creatively solve translational problems in research and practice.

Seriously Implementing Health Capacity Strengthening Programs in Africa: Comment on "Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique".

PubMed

Lapão, Luís Velez

2015-07-14

Faced with the challenges of healthcare reform, skills and new capabilities are needed to support the reform and it is of crucial importance in Africa where shortages affects the health system resilience. Edwards et al provides a good example of the challenge of implementing a mentoring program in one province in a sub-Saharan country. From this example, various aspects of strengthening the capacity of managers in healthcare are examined based on our experience in action-training in Africa, as mentoring shares many characteristics with action-training. What practical lessons can be drawn to promote the strengthening so that managers can better intervene in complex contexts? Deeper involvement of health authorities and more rigorous approaches are seriously desirable for the proper development of health capacity strengthening programs in Africa. © 2015 by Kerman University of Medical Sciences.

Settling into the midstream? Lessons for governance from the decade of nanotechnology

NASA Astrophysics Data System (ADS)

Bosso, Christopher

2016-06-01

This paper analyzes scholarly papers published from 2003 through 2013 on the general theme of nanotechnology and governance. It considers three general points: (1) the "problem" of nanotechnology; (2) general lessons for governance obtained; and (3) prospects for aligning the US regulatory system to the next generation of complex engineered nano-materials. It argues that engineered nano-materials and products are coming to market within an already mature regulatory framework of decade-old statutes, long-standing bureaucratic rules and routines, narrowly directive judicial decisions, and embedded institutional norms. That extant regulatory regime shapes how policymakers perceive, define, and address the relative benefits and risks of both proximate and yet-to-be idealized nano-materials and applications. The paper concludes that fundamental reforms in the extant regime are unlikely short of a perceived crisis.

A sustainable primary care system: lessons from the Netherlands.

PubMed

Faber, Marjan J; Burgers, Jako S; Westert, Gert P

2012-01-01

The Dutch primary care system has drawn international attention, because of its high performance at low cost. Primary care practices are easily accessible during office hours and collaborate in a unique out-of-hours system. After the reforms in 2006, there are no copayments for patients receiving care in the primary care practice in which they are registered. Financial incentives support the transfer of care from hospital specialists to primary care physicians, and task delegation from primary care physicians to practice nurses. Regional collaborative care groups of primary care practices offer disease management programs. The quality assessment system and the electronic medical record system are predominantly driven by health care professionals. Bottom-up and top-down activities contributed to a successful Dutch primary care system.

Configuring a fuel cell based residential combined heat and power system

NASA Astrophysics Data System (ADS)

Ahmed, Shabbir; Papadias, Dionissios D.; Ahluwalia, Rajesh K.

2013-11-01

The design and performance of a fuel cell based residential combined heat and power (CHP) system operating on natural gas has been analyzed. The natural gas is first converted to a hydrogen-rich reformate in a steam reformer based fuel processor, and the hydrogen is then electrochemically oxidized in a low temperature polymer electrolyte fuel cell to generate electric power. The heat generated in the fuel cell and the available heat in the exhaust gas is recovered to meet residential needs for hot water and space heating. Two fuel processor configurations have been studied. One of the configurations was explored to quantify the effects of design and operating parameters, which include pressure, temperature, and steam-to-carbon ratio in the fuel processor, and fuel utilization in the fuel cell. The second configuration applied the lessons from the study of the first configuration to increase the CHP efficiency. Results from the two configurations allow a quantitative comparison of the design alternatives. The analyses showed that these systems can operate at electrical efficiencies of ∼46% and combined heat and power efficiencies of ∼90%.

Protect the sick: health insurance reform in one easy lesson.

PubMed

Stone, Deborah

2008-01-01

In thinking about how to expand insurance coverage, the issue that matters is whether insurance enables sick and high-risk people to get medical care. Over the course of three decades, market-oriented insurance reforms have shifted more costs of illness onto people who need and use medical care. By making the users of care pay for it (or even some of it), cost-sharing discourages sick people from getting care, even if they have insurance, and for people with low-incomes and tight budgets, cost-sharing can effectively deny them access to care. Thus, covering or not covering sick people is the core issue of health insurance reform, both as a determinant of support and opposition to proposals, and as the proper yardstick for evaluating reform ideas.

Moving mountains together: strategic community leadership and systems change.

PubMed

Nissen, Laura Burney; Merrigan, Daniel M; Kraft, M Katherine

2005-01-01

Traditional leadership practice frameworks to guide systems change often fall short in today's practice environment. Reclaiming Futures is a national initiative to create an integrated, comprehensive, seamless system of care for teens with substance abuse problems involved in juvenile justice. It uses leadership and systems reform strategies to improve public health institutions. The premise is that interruption of the destructive cycle of drugs and delinquency can only be attained through the cultivation of shared strategic leadership. This article presents the limitations of traditional practice frameworks of leadership, describes the theory of this new approach to leadership development, and clarifies collaborative leadership and system change. The article includes an example of the framework in action, a discussion of lessons learned, and recommendations for community leadership development initiatives.

Excellence through Special Education? Lessons from the Finnish School Reform

NASA Astrophysics Data System (ADS)

Kivirauma, Joel; Ruoho, Kari

2007-05-01

The present article focuses on connections between part-time special education and the good results of Finnish students in PISA studies. After a brief summary of the comprehensive school system and special education in Finland, PISA results are analysed. The analysis shows that the relative amount of special education targeted at language problems is highest in Finland among those countries from which comparative statistics are available. The writers argue that this preventive language-oriented part-time special education is an important factor behind the good PISA results.

Movement Advocacy, Personal Relationships, and Ending Health Care Disparities

PubMed Central

Chin, Marshall H.

2017-01-01

Deep-rooted structural problems drive health care disparities. Compounding the difficulty of attaining health equity, solutions in clinics and hospitals require the cooperation of clinicians, administrators, patients, and the community. Recent protests over police brutality and racism on campuses across America have opened fresh wounds over how best to end racism, with lessons for achieving health equity. Movement advocacy, the mobilizing of the people to raise awareness of an injustice and to advocate for reform, can break down ingrained structural barriers and policies that impede health equity. However, simultaneously advocates, clinicians, and health care organizations must build trusting relationships and resolve conflict with mutual respect and honesty. Tension is inherent in discussions about racial and ethnic disparities. Yet, tension can be constructive if it forces self-examination and spurs systems change and personal growth. We must simultaneously advocate for policy reform, build personal relationships across diverse groups, and honestly examine our biases. PMID:28259213

Communication-and-resolution programs: the challenges and lessons learned from six early adopters.

PubMed

Mello, Michelle M; Boothman, Richard C; McDonald, Timothy; Driver, Jeffrey; Lembitz, Alan; Bouwmeester, Darren; Dunlap, Benjamin; Gallagher, Thomas

2014-01-01

In communication-and-resolution programs (CRPs), health systems and liability insurers encourage the disclosure of unanticipated care outcomes to affected patients and proactively seek resolutions, including offering an apology, an explanation, and, where appropriate, reimbursement or compensation. Anecdotal reports from the University of Michigan Health System and other early adopters of CRPs suggest that these programs can substantially reduce liability costs and improve patient safety. But little is known about how these early programs achieved success. We studied six CRPs to identify the major challenges in and lessons learned from implementing these initiatives. The CRP participants we interviewed identified several factors that contributed to their programs' success, including the presence of a strong institutional champion, investing in building and marketing the program to skeptical clinicians, and making it clear that the results of such transformative change will take time. Many of the early CRP adopters we interviewed expressed support for broader experimentation with these programs even in settings that differ from their own, such as systems that do not own and control their liability insurer, and in states without strong tort reforms.

Subsidized then scrutinized. Reform will bring billions of dollars to the industry, but it could also deliver added examination of executive pay.

PubMed

Galloro, Vince; Vesely, Rebecca; Zigmond, Jessica

2010-08-16

With more government involvement comes more government attention. That's the lesson about executive pay healthcare CEOs could learn as the reform law and its ramifications settle into place. "It's important for the people who are scraping together the dollars to pay their health insurance premiums to know what luxurious lives these CEOs are leading. They're living in a parallel universe", says U.S. Rep. Jan Schakowsky, left.

Brigade Combat Team the World’s Police: Understanding the United States Army Brigade Combat Team’s role in Developing Foreign Police

DTIC Science & Technology

2014-06-13

September 2013, fifteen gunmen associated with the terrorist group Al- Shabaab conducted an attack in the Westgate Shopping Mall in Nairobi, Kenya. The... theory , current U.S. Army doctrine, and the lessons learned from the police development efforts in Iraq, a foreign police development model is...civilian police enablers and an understanding of police theory and the lessons learned from previous police reform efforts. 15. SUBJECT TERMS

United States Health Care Reform Progress to Date and Next Steps

PubMed Central

Obama, Barack

2016-01-01

IMPORTANCE The Affordable Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care. OBJECTIVES To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act. EVIDENCE Analysis of publicly available data, data obtained from government agencies, and published research findings. The period examined extends from 1963 to early 2016. FINDINGS The Affordable Care Act has made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care. Since the Affordable Care Act became law, the uninsured rate has declined by 43%, from 16.0% in 2010 to 9.1% in 2015, primarily because of the law’s reforms. Research has documented accompanying improvements in access to care (for example, an estimated reduction in the share of nonelderly adults unable to afford care of 5.5 percentage points), financial security (for example, an estimated reduction in debts sent to collection of $600–$1000 per person gaining Medicaid coverage), and health (for example, an estimated reduction in the share of nonelderly adults reporting fair or poor health of 3.4 percentage points). The law has also begun the process of transforming health care payment systems, with an estimated 30% of traditional Medicare payments now flowing through alternative payment models like bundled payments or accountable care organizations. These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending and improvements in health care quality. Despite this progress, major opportunities to improve the health care system remain. CONCLUSIONS AND RELEVANCE Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs. Although partisanship and special interest opposition remain, experience with the Affordable Care Act demonstrates that positive change is achievable on some of the nation’s most complex challenges. PMID:27400401

United States Health Care Reform: Progress to Date and Next Steps.

PubMed

Obama, Barack

2016-08-02

The Affordable Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care. To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act. Analysis of publicly available data, data obtained from government agencies, and published research findings. The period examined extends from 1963 to early 2016. The Affordable Care Act has made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care. Since the Affordable Care Act became law, the uninsured rate has declined by 43%, from 16.0% in 2010 to 9.1% in 2015, primarily because of the law's reforms. Research has documented accompanying improvements in access to care (for example, an estimated reduction in the share of nonelderly adults unable to afford care of 5.5 percentage points), financial security (for example, an estimated reduction in debts sent to collection of $600-$1000 per person gaining Medicaid coverage), and health (for example, an estimated reduction in the share of nonelderly adults reporting fair or poor health of 3.4 percentage points). The law has also begun the process of transforming health care payment systems, with an estimated 30% of traditional Medicare payments now flowing through alternative payment models like bundled payments or accountable care organizations. These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending and improvements in health care quality. Despite this progress, major opportunities to improve the health care system remain. Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs. Although partisanship and special interest opposition remain, experience with the Affordable Care Act demonstrates that positive change is achievable on some of the nation's most complex challenges.

Lessons for health care reform from the less developed world: the case of the Philippines.

PubMed

Obermann, Konrad; Jowett, Matthew R; Taleon, Juanito D; Mercado, Melinda C

2008-11-01

International technical and financial cooperation for health-sector reform is usually a one-way street: concepts, tools and experiences are transferred from more to less developed countries. Seldom, if ever, are experiences from less developed countries used to inform discussions on reforms in the developed world. There is, however, a case to be made for considering experiences in less developed countries. We report from the Philippines, a country with high population growth, slow economic development, a still immature democracy and alleged large-scale corruption, which has embarked on a long-term path of health care and health financing reforms. Based on qualitative health-related action research between 2002 and 2005, we have identified three crucial factors for achieving progress on reforms in a challenging political environment: (1) strive for local solutions, (2) make use of available technology and (3) work on the margins towards pragmatic solutions whilst having your ethical goals in mind. Some reflection on these factors might stimulate and inform the debate on how health care reforms could be pursued in developed countries.

The policy and politics of the 2015 long-term care reform in the Netherlands.

PubMed

Maarse, J A M Hans; Jeurissen, P P Patrick

2016-03-01

As of 2015 a major reform in LTC is taking place in the Netherlands. An important objective of the reform is to reign in expenditure growth to safeguard the fiscal sustainability of LTC. Other objectives are to improve the quality of LTC by making it more client-tailored. The reform consists of four interrelated pillars: a normative reorientation, a shift from residential to non-residential care, decentralization of non-residential care and expenditure cuts. The article gives a brief overview of these pillars and their underlying assumptions. Furthermore, attention is paid to the political decision-making process and the politics of implementation and evaluation. Perceptions of the effects of the reform so far widely differ: positive views alternate with critical views. Though the reform is radical in various aspects, LTC care will remain a largely publicly funded provision. A statutory health insurance scheme will remain in place to cover residential care. The role of municipalities in publicly funded non-residential care is significantly upgraded. The final section contains a few policy lessons. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Health care system change and the cross-border transfer of ideas: influence of the Dutch model on the 2007 German health reform.

PubMed

Leiber, Simone; Gress, Stefan; Manouguian, Maral-Sonja

2010-08-01

To increase understanding of the cross-border transfer of ideas through a case study of the 2007 German health reform, this article draws on Kingdon's approach of streams and follows two main objectives: first, to understand the extent to which the German health reform was actually influenced by the Dutch model and, second, in theoretical terms, to inform inductively on how ideas from abroad enter government agendas. The results show that the streams of problem recognition and policy proposals have not been predominantly influenced by the cross-border transfer of ideas from the Netherlands to Germany. The Dutch experience was taken into consideration only after a policy window opened by a shift in politics in the third, the political, stream: the change of government in 2005. In many respects, the way Germany learned from the Netherlands in this case sharply contrasts with an image of solving policy problems by either lesson drawing or transnational deliberation. Instead, the process was dominated by problem solving in the sphere of politics, that is, finding a way to prove the grand coalition was capable of acting.

[Policies encouraging price competition in the generic drug market: Lessons from the European experience].

PubMed

Puig-Junoy, Jaume

2010-01-01

To describe alternative policies aimed at encouraging price competition in generic drug markets in countries with strict price regulation, and to present some case studies drawn from the European experience. Systematic literature review of articles and technical reports published after 1999. The shortcomings in consumer price competition observed in some European generic markets, including Spain, may be reduced through three types of public reimbursement or financing reforms: policies aimed at improving the design of current maximum reimbursement level policies; policies aimed at monitoring competitive prices in order to reimburse real acquisition cost to pharmacies; and, more radical and market-oriented policies such as competitive tendering of public drug purchases. The experience of recent reforms adopted in Germany, Belgium, Holland, Norway, and Sweden offers a useful guide for highly price-regulated European countries, such as Spain, currently characterized by limited consumer price competition and the high discounts offered to pharmacy purchases. Direct price regulation and/or the generic reference pricing systems used to reduce generic drug prices in many European countries can be successfully reformed by adopting measures more closely aimed at encouraging consumer price competition in generic drug markets. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

What can we learn from international comparisons of health systems and health system reform?

PubMed Central

McPake, B.; Mills, A.

2000-01-01

Most commonly, lessons derived from comparisons of international health sector reform can only be generalized in a limited way to similar countries. However, there is little guidance as to what constitutes "similarity" in this respect. We propose that a framework for assessing similarity could be derived from the performance of individual policies in different contexts, and from the cause and effect processes related to the policies. We demonstrate this process by considering research evidence in the "public-private mix", and propose variables for an initial framework that we believe determine private involvement in the public health sector. The most influential model of public leadership places the private role in a contracting framework. Research in countries that have adopted this model suggests an additional list of variables to add to the framework. The variables can be grouped under the headings "demand factors", "supply factors", and "strength of the public sector". These illustrate the nature of a framework that could emerge, and which would help countries aiming to learn from international experience. PMID:10916918

Grand Junction, Colorado: how a community drew on its values to shape a superior health system.

PubMed

Thorson, Marsha; Brock, Jane; Mitchell, Jason; Lynn, Joanne

2010-09-01

For the past decade, the high-quality, relatively low-cost health care delivered in Grand Junction, Colorado, has led that community to outperform most others in the United States. Medicare patients in Grand Junction have fewer hospitalizations, shorter hospitalizations, and lower mortality rates after hospitalization than do Medicare patients in comparison hospitals. Effective, efficient care is delivered in Grand Junction through separate, self-governing organizations that perceive health care as a community resource. This article describes how the various stakeholders in Grand Junction have addressed problems and set standards for the system. The lessons could apply to broader health reform efforts in communities around the country.

What We Know about School Choice.

ERIC Educational Resources Information Center

Froese-Germain, Bernie

1998-01-01

School choice is a market-driven reform in which schools compete for students. Discusses characteristics of choice and lessons drawn from the international experience: increased segregation, unimproved learning, low participation, parental criteria, inequity, lack of options, administrative emphasis on management, and right-wing support. Describes…

Myths And Misconceptions About U.S. Health Insurance

PubMed Central

Baicker, Katherine; Chandra, Amitabh

2009-01-01

Several myths about health insurance interfere with the diagnosis of problems in the current system and impede the development of productive reforms. Although many are built on a kernel of truth, complicated issues are often simplified to the point of being false or misleading. Several stem from the conflation of health, health care, and health insurance, while others attempt to use economic arguments to justify normative preferences. We apply a combination of economic principles and lessons from empirical research to examine the policy problems that underlie the myths and focus attention on addressing these fundamental challenges. PMID:18940834

Reforming the 4th-Year Curriculum as a Springboard to Graduate Medical Training: One School's Experiences and Lessons Learned.

PubMed

Wackett, Andrew; Daroowalla, Feroza; Lu, Wei-Hsin; Chandran, Latha

2016-01-01

Concerns regarding the quality of training in the 4th year of medical school and preparation of graduates to enter residency education persist and are borne out in the literature. We reviewed the published literature regarding Year 4 concerns as well as institutional efforts to improve the 4th-year curriculum from several schools. Based on input from key stakeholders, we established 4 goals for our Year 4 curriculum reform: (a) standardize the curricular structure, (b) allow flexibility and individualization, (c) improve the preparation for residency, and (d) improve student satisfaction. After the reform, we evaluated the outcomes using results from the Association of American Medical Colleges Questionnaire, student focus groups, and program director surveys. This article describes the context, process, and outcomes of the reform of the Year 4 curriculum at Stony Brook University School of Medicine. We were able to achieve all four stated goals for the reform. The significant components of the change included a flexible adaptable curriculum based on individual needs and preferences, standardized learning objectives across the year, standardized competency-based evaluations regardless of discipline, reinforcement of clinical skills, and training for the transition to the workplace as an intern. The reform resulted in increased student satisfaction, increased elective time, and increased preparedness for residency training as perceived by the graduates. The Program Director survey showed significant changes in ability to perform a medical history and exam, management of common medical conditions and emergencies, clinical reasoning and problem-solving skills, working and communication with the healthcare team, and overall professionalism in meeting obligations inherent in the practice of medicine. Lessons learned from our 4th-year reform process are discussed. Listening to the needs of the stakeholders was an important step in ensuring buy-in, having an institutional champion with an organizational perspective on the overall institutional mission was helpful in building the guiding coalition for change, building highly interactive collaborative interdisciplinary teams to work together addressed departmental silos and tunnel vision early on, and planning a curriculum is exciting but planning the details of the implementation can be quite tedious.

Methodological approach and tools for systems thinking in health systems research: technical assistants' support of health administration reform in the Democratic Republic of Congo as an application.

PubMed

Ribesse, Nathalie; Bossyns, Paul; Marchal, Bruno; Karemere, Hermes; Burman, Christopher J; Macq, Jean

2017-03-01

In the field of development cooperation, interest in systems thinking and complex systems theories as a methodological approach is increasingly recognised. And so it is in health systems research, which informs health development aid interventions. However, practical applications remain scarce to date. The objective of this article is to contribute to the body of knowledge by presenting the tools inspired by systems thinking and complexity theories and methodological lessons learned from their application. These tools were used in a case study. Detailed results of this study are in process for publication in additional articles. Applying a complexity 'lens', the subject of the case study is the role of long-term international technical assistance in supporting health administration reform at the provincial level in the Democratic Republic of Congo. The Methods section presents the guiding principles of systems thinking and complex systems, their relevance and implication for the subject under study, and the existing tools associated with those theories which inspired us in the design of the data collection and analysis process. The tools and their application processes are presented in the results section, and followed in the discussion section by the critical analysis of their innovative potential and emergent challenges. The overall methodology provides a coherent whole, each tool bringing a different and complementary perspective on the system.

Transforming Teacher Education: Lessons in Professional Development.

ERIC Educational Resources Information Center

Sockett, Hugh T., Ed.; DeMulder, Elizabeth K., Ed.; LePage, Pamela C., Ed.; Wood, Diane R., Ed.

This book investigates many aspects of educational reform, pivoting around an innovative master's degree program for teachers. After "Foreword" (David T. Hansen), there are 14 papers: (1) "Transforming Teacher Education" (Hugh T. Sockett); (2) "From Educational Rhetoric to Program Reality" (Hugh T. Sockett and Pamela…

Redesigning Personnel Preparation: Lessons Learned and Considerations for Program Enhancement

ERIC Educational Resources Information Center

Little, Mary E.; Sobel, Donna; McCray, Erica D.; Wang, Jun

2015-01-01

Changing legal requirements, economic demands, accountability, and student demographics focus the need for reform among personnel preparation programs. Although redesign efforts in general and special education teacher preparation programs have increased, little evidence from research describes enhancement initiatives. In this article, the authors…

Adapting to social and political transitions - the influence of history on health policy formation in the Republic of the Union of Myanmar (Burma).

PubMed

Grundy, John; Annear, Peter; Ahmed, Shakil; Biggs, Beverley-Ann

2014-04-01

The Republic of the Union of Myanmar (Burma) has a long and complex history characterized by internal conflict and tense international relations. Post-independence, the health sector has gradually evolved, but with health service development and indicators lagging well behind regional expectations. In recent years, the country has initiated political reforms and a reorientation of development policy towards social sector investment. In this study, from a systems and historical perspective, we used publicly available data sources and grey literature to describe and analyze links between health policy and history from the post-independence period up until 2012. Three major periods are discernable in post war health system development and political history in Myanmar. The first post-independence period was associated with the development of the primary health care system extending up to the 1988 political events. The second period is from 1988 to 2005, when the country launched a free market economic model and was arguably experiencing its highest levels of international isolation as well as very low levels of national health investment. The third period (2005-2012) represents the first attempts at health reform and recovery, linked to emerging trends in national political reform and international politics. Based on the most recent period of macro-political reform, the central state is set to transition from a direct implementer of a command and control management system, towards stewardship of a significantly more complex and decentralized administrative order. Historical analysis demonstrates the extent to which these periodic shifts in the macro-political and economic order acts to reset the parameters for health policy making. This case demonstrates important lessons for other countries in transition by highlighting the extent to which analysis of political history can be instructive for determination of more feasible boundaries for future health policy action. Copyright © 2014 Elsevier Ltd. All rights reserved.

General practice and the New Zealand health reforms – lessons for Australia?

PubMed Central

McAvoy, Brian R; Coster, Gregor D

2005-01-01

New Zealand's health sector has undergone three significant restructures within 10 years. The most recent has involved a Primary Health Care Strategy, launched in 2001. Primary Health Organisations (PHOs), administered by 21 District Health Boards, are the local structures for implementing the Primary Health Care Strategy. Ninety-three percent of the New Zealand population is now enrolled within 79 PHOs, which pose a challenge to the well-established Independent Practitioner Associations (IPAs). Although there was initial widespread support for the philosophy underlying the Primary Health Care Strategy, there are concerns amongst general practitioners (GPs) and their professional organisations relating to its implementation. These centre around 6 main issues: 1. Loss of autonomy 2. Inadequate management funding and support 3. Inconsistency and variations in contracting processes 4. Lack of publicity and advice around enrolment issues 5. Workforce and workload issues 6. Financial risks On the other hand, many GPs are feeling positive regarding the opportunities for PHOs, particularly for being involved in the provision of a wider range of community health services. Australia has much to learn from New Zealand's latest health sector and primary health care reforms. The key lessons concern: • the need for a national primary health care strategy • active engagement of general practitioners and their professional organisations • recognition of implementation costs • the need for infrastructural support, including information technology and quality systems • robust management and governance arrangements • issues related to critical mass and population/distance trade offs in service delivery models PMID:16262908

Role of Australian primary healthcare organisations (PHCOs) in primary healthcare (PHC) workforce planning: lessons from abroad.

PubMed

Naccarella, Lucio; Buchan, James; Newton, Bill; Brooks, Peter

2011-08-01

To review international experience in order to inform Australian PHC workforce policy on the role of primary healthcare organisations (PHCOs/Medicare Locals) in PHC workforce planning. A NZ and UK study tour was conducted by the lead author, involving 29 key informant interviews with regard to PHCOs roles and the effect on PHC workforce planning. Interviews were audio-taped with consent, transcribed and analysed thematically. Emerging themes included: workforce planning is a complex, dynamic, iterative process and key criteria exist for doing workforce planning well; PHCOs lacked a PHC workforce policy framework to do workforce planning; PHCOs lacked authority, power and appropriate funding to do workforce planning; there is a need to align workforce planning with service planning; and a PHC Workforce Planning and Development Benchmarking Database is essential for local planning and evaluating workforce reforms. With the Australian government promoting the role of PHCOs in health system reform, reflections from abroad highlight the key action within PHC and PHCOs required to optimise PHC workforce planning.

Movement Advocacy, Personal Relationships, and Ending Health Care Disparities.

PubMed

Chin, Marshall H

2017-01-01

Deep-rooted structural problems drive health care disparities. Compounding the difficulty of attaining health equity, solutions in clinics and hospitals require the cooperation of clinicians, administrators, patients, and the community. Recent protests over police brutality and racism on campuses across America have opened fresh wounds over how best to end racism, with lessons for achieving health equity. Movement advocacy, the mobilizing of the people to raise awareness of an injustice and to advocate for reform, can break down ingrained structural barriers and policies that impede health equity. However, simultaneously advocates, clinicians, and health care organizations must build trusting relationships and resolve conflict with mutual respect and honesty. Tension is inherent in discussions about racial and ethnic disparities. Yet, tension can be constructive if it forces self-examination and spurs systems change and personal growth. We must simultaneously advocate for policy reform, build personal relationships across diverse groups, and honestly examine our biases. Copyright © 2016 National Medical Association. Published by Elsevier Inc. All rights reserved.

Oregon's Medicaid Reform And Transition To Global Budgets Were Associated With Reductions In Expenditures.

PubMed

McConnell, K John; Renfro, Stephanie; Lindrooth, Richard C; Cohen, Deborah J; Wallace, Neal T; Chernew, Michael E

2017-03-01

In 2012 Oregon initiated an ambitious delivery system reform, moving the majority of its Medicaid enrollees into sixteen coordinated care organizations, a type of Medicaid accountable care organization. Using claims data, we assessed measures of access, appropriateness of care, utilization, and expenditures for five service areas (evaluation and management, imaging, procedures, tests, and inpatient facility care), comparing Oregon to the neighboring state of Washington. Overall, the transformation into coordinated care organizations was associated with a 7 percent relative reduction in expenditures across the sum of these services, attributable primarily to reductions in inpatient utilization. The change to coordinated care organizations also demonstrated reductions in avoidable emergency department visits and improvements in some measures of appropriateness of care, but also exhibited reductions in primary care visits, a potential area of concern. Oregon's coordinated care organizations could provide lessons for controlling health care spending for other state Medicaid programs. Project HOPE—The People-to-People Health Foundation, Inc.

Leading Environmental Education: Lessons from a Case Study of School Change.

ERIC Educational Resources Information Center

Beresford, Rodney; Wallace, John

1998-01-01

Reports on the process of reform in a school environmental education program from the perspective of a staff member hired at a high school under construction. Focuses on the recognition that a swamp area on the property is an important curriculum resource. (DDR)

TennCare and academic medical centers: the lessons from Tennessee.

PubMed

Meyer, G S; Blumenthal, D

1996-09-04

To ascertain the potential impact of public-sector-driven health system reform (Medicaid and Medicare programs) on academic medical centers (AMCs). A qualitative, case-study investigation of how 2 of Tennessee's 4 AMCs were affected by the TennCare program, which enrolled all of the state's Medicaid recipients and a sizable portion of its uninsured in managed care organizations (MCOs) in January 1994. We reviewed pertinent documents related to the AMCs, response to TennCare; interviewed AMC executives and staff, state officials, and representatives of MCOs serving TennCare beneficiaries; and conducted site visits at both AMCs. Changes in clinical revenues, clinical volume, patient selection, support for the AMCs, teaching and research missions, and the AMCs' response to these changes. Both AMCs studied experienced large revenue shortfalls, the closure of some specialty services, adverse patient selection, and loss of the patient volume needed to do clinical research, and had to reduce the number of training program positions. Longer-term consequences of TennCare for AMCs may include the integration of community-based services into academic missions, the acceleration of clinical diversification, and the attainment of experience in managed care, anticipating the evolution of the private-sector market. The consequences of public-sector health system reform for AMCs are similar to, and equally as challenging as, the effects of private-sector changes in health care delivery. Important differences include the rapidity with which public-sector reforms can transform the AMC market, the vulnerability of special payments to AMCs, such as graduate medical education funding, and the accountability of managers of public-sector initiatives to the political process. It remains to be seen whether public-sector reforms will afford some competitive advantage to AMCs over the long term.

The Politics of Universal Health Coverage in Low- and Middle-Income Countries: A Framework for Evaluation and Action.

PubMed

Fox, Ashley M; Reich, Michael R

2015-10-01

Universal health coverage has recently become a top item on the global health agenda pressed by multilateral and donor organizations, as disenchantment grows with vertical, disease-specific health programs. This increasing focus on universal health coverage has brought renewed attention to the role of domestic politics and the interaction between domestic and international relations in the health reform process. This article proposes a theory-based framework for analyzing the politics of health reform for universal health coverage, according to four stages in the policy cycle (agenda setting, design, adoption, and implementation) and four variables that affect reform (interests, institutions, ideas, and ideology). This framework can assist global health policy researchers, multilateral organization officials, and national policy makers in navigating the complex political waters of health reforms aimed at achieving universal health coverage. To derive the framework, we critically review the theoretical and applied literature on health policy reform in developing countries and illustrate the framework with examples of health reforms moving toward universal coverage in low- and middle-income countries. We offer a series of lessons stemming from these experiences to date. Copyright © 2015 by Duke University Press.

Pediatric Care Coordination: Lessons Learned and Future Priorities.

PubMed

Cady, Rhonda G; Looman, Wendy S; Lindeke, Linda L; LaPlante, Bonnie; Lundeen, Barbara; Seeley, Amanda; Kautto, Mary E

2015-09-30

A fundamental component of the medical home model is care coordination. In Minnesota, this model informed design and implementation of the state's health care home (HCH) model, a key element of statewide healthcare reform legislation. Children with medical complexity (CMC) often require care from multiple specialists and community resources. Coordinating this multi-faceted care within the HCH is challenging. This article describes the need for specialized models of care coordination for CMC. Two models of care coordination for CMC were developed to address this challenge. The TeleFamilies Model of Pediatric Care Coordination uses an advanced practice registered nurse care (APRN) coordinator embedded within an established HCH. The PRoSPer Model of Pediatric Care Coordination uses a registered nurse/social worker care coordinator team embedded within a specialty care system. We describe key findings from implementation of these models, and conclude with lessons learned. Replication of the models is encouraged to increase the evidence base for care coordination for the growing population of children with medical complexities.

Exploration on teaching reform of theory curriculum for engineering specialties

NASA Astrophysics Data System (ADS)

Zhang, Yan; Shen, Wei-min; Shen, Chang-yu; Li, Chen-xia; Jing, Xu-feng; Lou, Jun; Shi, Yan; Jin, Shang-zhong

2017-08-01

The orientation of talents cultivation for local colleges is to train engineering application-oriented talents, so the exploration and practice on teaching reform of theory curriculum was carried out. We restructured the knowledge units basing on numerical solution problems, and chose the software to build algorithm models for improving the analytical and designed ability. Relying on micro video lessons platform, the teacher-student interaction was expanded from class to outside. Also, we programmed new experimental homework, which was suited for process evaluation. The new teaching mode has achieved good effect, and the students' application ability was significantly improved.

Interest groups and health reform: lessons from California.

PubMed

Oliver, T R; Dowell, E B

We review the 1992 policy choices in California for expanding health insurance coverage, focusing on the rejection of an employer mandate by legislators and voters. We analyze how interest-group politics, gubernatorial politics, and national politics shaped those choices. Although public opinion and the shift of organized medicine showed considerable support for extending health insurance coverage, the opposition of liberal and conservative groups and a foundering economy prevented a significant change in public policy. The president's health reform plan appears to address many of the unresolved concerns in California, but overcoming resistance to any kind of mandate will require skilled leadership and negotiation.

An academic health center sees both challenges and enabling forces as it creates an accountable care organization.

PubMed

Tallia, Alfred F; Howard, Jenna

2012-11-01

Health care reform presents academic health centers with an opportunity to test new systems of care, such as accountable care organizations (ACOs), that are intended to improve patients' health and well-being, mitigate the anticipated shortage in primary care providers, and bend the cost curve. In its ongoing efforts to develop an ACO, the Robert Wood Johnson Medical School, an academic health center, has found helpful a rapidly evolving competitive environment and insurers willing to experiment with new models of care. But the center has also encountered six types of barriers: conceptual, financial, cultural, regulatory, organizational, and historical. How this academic health center has faced these barriers offers valuable lessons to other health systems engaged in creating ACOs.

Universities, Dependency and the Market: Innovative Lessons from Kenya

ERIC Educational Resources Information Center

Johnson, Ane Turner; Hirt, Joan B.

2014-01-01

Higher education in developing nations is typically viewed from a dependency perspective--institutions are seen as merely recipients of Western knowledge, aid and reform efforts. Nevertheless, universities in both the centre and the periphery are dealing with tensions between protecting the public good and embracing neoliberal values based on a…

Schools Achieving Gender Equity.

ERIC Educational Resources Information Center

Revis, Emma

This guide is designed to assist teachers presenting the Schools Achieving Gender Equity (SAGE) curriculum for vocational education students, which was developed to align gender equity concepts with the Kentucky Education Reform Act (KERA). Included in the guide are lesson plans for classes on the following topics: legal issues of gender equity,…

School Leadership and Technology Challenges: Lessons from a New American High School

ERIC Educational Resources Information Center

Peck, Craig; Mullen, Carol A.; Lashley, Carl; Eldridge, John A.

2011-01-01

In this evidence-based practice article the authors investigate the challenges that leaders (administrators, staff, and teachers) face in high schools where personnel navigate technology reform. We studied an American comprehensive high school within a large school district in southeastern United States. School administrators and teachers faced…

Lessons for School-Based Reform.

ERIC Educational Resources Information Center

McCollum, Heather

Beginning in 1990, the United States and the Organisation for Economic Cooperation and Development (OECD) conducted an international, 14-nation study of programs for at-risk children. This report presents findings from the second year of the study, during which the Planning and Evaluation Service of the U.S. Department of Education reviewed the…

Factors Influencing Science Content Accuracy in Elementary Inquiry Science Lessons

ERIC Educational Resources Information Center

Nowicki, Barbara L.; Sullivan-Watts, Barbara; Shim, Minsuk K.; Young, Betty; Pockalny, Robert

2013-01-01

Elementary teachers face increasing demands to engage children in authentic science process and argument while simultaneously preparing them with knowledge of science facts, vocabulary, and concepts. This reform is particularly challenging due to concerns that elementary teachers lack adequate science background to teach science accurately. This…

Education through Occupations in American High Schools. Volume II. The Challenges of Implementing Curriculum Integration.

ERIC Educational Resources Information Center

Grubb, W. Norton, Ed.

This book contains the following papers examining the challenges of integrating high school vocational and academic curricula to provide education through occupations: "Components of a Complex Reform" (W. Norton Grubb); "Integrating Vocational and Academic Education: Lessons from Early Innovators" (Kimberly Ramsey et al.);…

South Korean Digital Textbook Project

ERIC Educational Resources Information Center

Kim, Jackie Hee-Young; Jung, Hye-Yoon

2010-01-01

South Korea has adopted the widespread use of digital textbooks. Part school reform and part an effort to prepare today's children for tomorrow's challenging world, the way in which this effort was implemented and the lessons learned are valuable. This article highlights the history of the digital textbook project and compares printed textbooks…

Mexico's "Telesecundaria" Program and Equitable Access to Resources

ERIC Educational Resources Information Center

Craig, Dana; Etcheverry, Jose; Ferris, Stefan

2016-01-01

This Note provides an analysis of Mexico's "Telesecundaria" program within the context of Mexico's new education reform framework offering a succinct background of the project, as well as key policy lessons that can be useful for other jurisdictions interested in the development of distance education programs. This Note uses a literature…

Building Schools, Rethinking Quality? Early Lessons from Los Angeles

ERIC Educational Resources Information Center

Fuller, Bruce; Dauter, Luke; Hosek, Adrienne; Kirschenbaum, Greta; McKoy, Deborah; Rigby, Jessica; Vincent, Jeffrey M.

2009-01-01

Purpose: Newly designed schools for centuries have projected fresh ideals regarding how children should learn and how human settlements should be organized. But under what conditions can forward-looking architects or education reformers trump the institutionalized practices of teachers or the political-economic constraints found within urban…

Describing Physics Student Teachers' Orientations through Lesson Planning

ERIC Educational Resources Information Center

Karal, Isik Saliha

2017-01-01

Recent educational reforms realized in teacher education programs (TEPs) and secondary physics syllabus were aimed at placing the learning and teaching approaches in a constructivist framework. For this reason, student teachers in pre-service TEPs are expected to develop orientations adopting student-centred teaching approaches. The purpose of…

Toward a social justice theory of demographic transition: lessons from India's Kerala State.

PubMed

Ratcliffe, J W

1983-06-01

Recent research evidence, which suggests that observed demographic trends and patterns are largely consequences of broad structural changes in society, has raised serious doubts about the validity of traditional demographic theory and the framework for action it has generated. This theoretical essay 1st recasts classical demographic transition theory in general systems terms in order to make it consistent with the evidence and to place the processes of fertility and mortality in a larger social context. The demographic transition experience of Kerala State, India is then recounted to provide a concrete example of the demographic response in society to structural reforms based primarily on equity considerations.

Applying a Cognitive-Affective Model of Conceptual Change to Professional Development

NASA Astrophysics Data System (ADS)

Ebert, Ellen K.; Crippen, Kent J.

2010-04-01

This study evaluated Gregoire’s (2003) Cognitive-Affective Conceptual Change model (CAMCC) for predicting and assessing conceptual change in science teachers engaged in a long-term professional development project set in a large school district in the southwestern United States. A multiple case study method with data from three teacher participants was used to understand the process of integrating and applying a reform message of inquiry based science teaching. Data sources included: responses to example teaching scenarios, reflective essays, lesson plans, classroom observations, and action research projects. Findings show that the CAMCC functioned well in predicting how these teachers made decisions that impacted how they processed the reform message. When the reform message was communicated in such a way as to initiate stress appraisal, conceptual change occurred, producing changes in classroom practice. If the reform message did not initiate stress appraisal, teachers rejected the professional development message and developed heuristic responses. In order to further research and improve practice, propositions for assessments related to the CAMCC are provided.

HIPAA and the military health system: organizing technological and organizational reform in large enterprises

NASA Astrophysics Data System (ADS)

Collmann, Jeff R.

2001-08-01

The global scale, multiple units, diverse operating scenarios and complex authority structure of the Department of Defense Military Health System (MHS) create social boundaries that tend to reduce communication and collaboration about data security. Under auspices of the Defense Health Information Assurance Program (DHIAP), the Telemedicine and Advanced Technology Research Center (TATRC) is contributing to the MHS's efforts to prepare for and comply with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 through organizational and technological innovations that bridge such boundaries. Building interdisciplinary (clinical, administrative and information technology) medical information security readiness teams (MISRT) at each military treatment facility (MTF) constitutes the heart of this process. DHIAP is equipping and training MISRTs to use new tools including 'OCTAVE', a self-directed risk assessment instrument and 'RIMR', a web-enabled Risk Information Management Resource. DHIAP sponsors an interdisciplinary, triservice workgroup for review and revision of relevant DoD and service policies and participates in formal DoD health information assurance activities. These activities help promote a community of proponents across the MHS supportive of improved health information assurance. The MHS HIPAA-compliance effort teaches important general lessons about organizational reform in large civilian or military enterprises.

Lessons in Character Impact Evaluation. Final Report. NCEE 2012-4004

ERIC Educational Resources Information Center

Hanson, Thomas; Dietsch, Barbara; Zheng, Hong

2012-01-01

Character education has become one of the fastest growing reform movements in K-12 education today, partially in response to unacceptable levels of student misbehavior and inadequate endorsement of good character values (Williams 2000). Between 1993 and 2009, 36 states passed laws mandating or recommending some aspect of character education in…

Changing American Education. Recapturing the Past or Inventing the Future?

ERIC Educational Resources Information Center

Borman, Kathryn M., Ed.; Greenman, Nancy P., Ed.

This book examines the nature of comprehensive, large scale historical and social changes that contextualize educational reform, and it amplifies the meaning of lessons learned by those who have assisted in change efforts. It also examines how the rhetoric of educational change may fall short of the reality, as translated to processes and…

Environmentalization of the Physical Education Curriculum in Brazilian Universities: Culturally Comparative Lessons from Critical Outdoor Education in Australia

ERIC Educational Resources Information Center

Rodrigues, Cae; Payne, Phillip G.

2017-01-01

'Environmentalizing' curriculum in Brazil is a worthy goal of global educational reform for sustainability but is challenging given the limits to rational change thesis already argued in critical social science and post-structural deconstructionism. The federal government mandate to environmentalize undergraduate physical education programs poses…

School Inspection as a Method of Accountability: Lessons from New Zealand 1989-1999.

ERIC Educational Resources Information Center

Kenen, Marc

2000-01-01

During the first 10 years of reforms, New Zealand schools had two kinds of inspections: assurance (compliance) audits and effectiveness reviews to measure academic performance and contributing factors. In 1998, accountability reviews were introduced to judge whether schools were satisfying their charter (contract) objectives. The program is…

The Wizards of Odds: Leadership Journeys of Education Deans.

ERIC Educational Resources Information Center

Bowen, Larry S., Ed.

This monograph contains reflections by current and former deans of schools of education on their experiences in providing leadership for change, their attempts at reform, their perceived successes and failures, and the lessons they learned. It opens with a preface by Larry S. Bowen describing the conference that led to the monograph, the…

Relief, Recovery, Reform: The New Deal Congressional Reaction to the Great Depression.

ERIC Educational Resources Information Center

Koman, Rita G.

1998-01-01

Summarizes the relationship of President Franklin Roosevelt to Congress and its role in creating New Deal legislation. Presents a lesson plan using primary documents that allows students to explore congressional responsibility for enabling the Great Depression and for legislation to deal with its consequences. Includes copies of the documents.…

Robust Implementation of MDC: Teacher Perceptions of Tool Use and Outcomes. Brief Three

ERIC Educational Resources Information Center

Lawrence, Nancy; Sanders, Felicia

2012-01-01

The Bill and Melinda Gates Foundation has invested in the development and dissemination of high-quality instructional and formative assessment tools to support teachers' incorporation of the Common Core State Standards (CCSS) into their classroom instruction. Lessons from the first generation of standards-based reforms suggest that intense…

Robust Implementation of LDC: Teacher Perceptions of Tool Use and Outcomes. Brief Two

ERIC Educational Resources Information Center

Reumann-Moore, Rebecca; Sanders, Felicia

2012-01-01

The Bill and Melinda Gates Foundation has invested in the development and dissemination of high-quality instructional and formative assessment tools to support teachers' incorporation of the Common Core State Standards (CCSS) into their classroom instruction. Lessons from the first generation of standards-based reforms suggest that intense…

Teacher to Teacher: Model Lessons for K-8 Foreign Language.

ERIC Educational Resources Information Center

Redmond, Mary Lynn, Ed.; Lorenz, Eileen, Ed.

This book provides resources for foreign language teachers, supervisors, and others involved in developing and implementing a curriculum. It is the outcome of a 1997 institute, "National Standards for Foreign Language Learning: Curriculum Reform for K-8 Foreign Language Education." The model shows how the national standards can be used…

Planning in Public Education: Lessons from Horace Mann and Henry Barnard

ERIC Educational Resources Information Center

Henkin, Alan B.; Ignasias, C. Dennis

1978-01-01

A handful of educational reformers from each generation effectively muster and sustain public support in efforts to advance their visions for education. Here is an account of the efforts of Horace Mann and Henry Barnard acting as educational advocates and consensus builders who evoked public responsiveness and guided their constituencies toward…

Investigating Technology-Enhanced Teacher Professional Development in Rural, High-Poverty Middle Schools

ERIC Educational Resources Information Center

Blanchard, Margaret R.; LePrevost, Catherine E.; Tolin, A. Dell; Gutierrez, Kristie S.

2016-01-01

This 3-year, mixed-methods study investigated the effects of teacher technology-enhanced professional development (TPD) on 20 teachers' beliefs and practices. Teachers in two middle schools located in neighboring rural, high-poverty districts in the southeastern United States participated in reform-based lessons and learned how to integrate…

State of the States: Trends and Early Lessons on Teacher Evaluation and Effectiveness Policies

ERIC Educational Resources Information Center

National Council on Teacher Quality, 2011

2011-01-01

Each year, the National Council on Teacher Quality (NCTQ) publishes the "State Teacher Policy Yearbook," a comprehensive examination of the state laws, rules and regulations that govern the teaching profession, measured against a realistic set of reform goals. For five years running, the full "Yearbook" compendium…

An Examination of the Implementation of Mathematics Lessons in a Chinese Kindergarten Classroom in the Setting of Standards Reform

ERIC Educational Resources Information Center

Hu, Bi Ying; Quebec Fuentes, Sarah; Ma, Jingjing; Ye, Feiwei; Roberts, Sherron Killingsworth

2017-01-01

In China, the "2001 Kindergarten Education Guidelines (Trial)", or "New Outline", delineates what constitutes high-quality, developmentally appropriate practices in all early childhood education curriculum domains, including mathematics. The "New Outline" is known for advocating a child-centered, play-based approach…

Three Presentations: From the Third National Conference on Assessment in Higher Education. (Chicago, Illinois, June 8-11, 1988).

ERIC Educational Resources Information Center

Astin, Alexander W.; And Others

Three presentations from the Third National Conference on Assessment in Higher Education are included. In "Assessment and Human Values: Confessions of a Reformed Number Cruncher," Alexander W. Astin, focuses on measuring education productivity, assessment lessons from the Cooperative Institutional Research Program, a talent-development…

Interactive Problem-Solving Geography: An Introduction in Chinese Classrooms to Locational Analysis

ERIC Educational Resources Information Center

Wai, Nu Nu; Giles, John H.

2006-01-01

Reform in geography education, as reflected in "Geography for Life: National Geography Standards" (1994) for the U.S.A., favors a constructivist approach to learning. This study examines the acceptance of this approach among students in two upper secondary schools in China. A lesson was developed to illustrate interactive problem solving…

Open Lessons: A Practice to Develop a Learning Community for Teachers

ERIC Educational Resources Information Center

Shen, Jianping; Zhen, Jinzhou; Poppink, Sue

2007-01-01

Interest in improving the quality of professional development in this age of educational reform has intensified as a growing body of research suggests that teaching practices matter in terms of student achievement. Some have argued for embedding professional development in the context of teachers' work in order to transform both teaching practices…

Collaborative Professional Learning through Lesson Study: Identifying the Challenges of Inquiry-Based Teaching

ERIC Educational Resources Information Center

Gutierez, Sally Baricaua

2015-01-01

In the Philippines, inquiry-based teaching has been promoted and implemented together with recently instigated curriculum reforms. Serious teacher professional development efforts are being used extensively to properly orient and present the benefits of inquirybased teaching. Despite these efforts, there still exists a big gap in the effective…

The Early Assessment Conundrum: Lessons from the Past, Implications for the Future

ERIC Educational Resources Information Center

Bordignon, Catherine M.; Lam, Tony C. M.

2004-01-01

The early childhood educational field has garnered attention with initiatives to foster skill acquisition in young children prior to kindergarten entry. These initiatives, in conjunction with the rigorous demands of curricular reform and a burgeoning accountability movement, invoke questions regarding the adequacy of the instruments used to assess…

Financial Decentralization in Malaysian Schools: Strategies for Effective Implementation

ERIC Educational Resources Information Center

Radzi, Norfariza Mohd; Ghani, Muhammad Faizal A.; Siraj, Saedah; Afshari, Mojgan

2013-01-01

This article presents findings on the essential strategies required at the school site and the relevant people responsible for the effective implementation of school-based financial management in Malaysia. Many lessons have been learned since more than a decade of the school-based financial management reform in Malaysia through the establishment…

The Role of Foundations and Philanthropy in Supporting School Libraries.

ERIC Educational Resources Information Center

DeVita, M. Christine

2002-01-01

Addresses the Wallace-Reader's Digest Funds' experiences working with school libraries and the lessons learned from the Library Power initiative, including: how school libraries can support national education goals, particularly in meeting the challenges outlined in the No Child Left Behind Act of 2001; current threats to library reform; and how…

Educative Mentoring: Promoting Reform-Based Science Teaching through Mentoring Relationships

ERIC Educational Resources Information Center

Bradbury, Leslie Upson

2010-01-01

Educative mentoring is an idea developed by Feiman-Nemser [Feiman-Nemser, S. (1998). Teachers as teacher educators. "European Journal of Teacher Education," 21(1), 63-74; (2001). Helping novices learn to teach: Lessons from an exemplary support teacher. "Journal of Teacher Education," 52(1), 17-30] to reflect current conceptions of mentoring that…

Guiding Students towards Sensemaking: Teacher Questions Focused on Integrating Scientific Practices with Science Content

ERIC Educational Resources Information Center

Benedict-Chambers, Amanda; Kademian, Sylvie M.; Davis, Elizabeth A.; Palincsar, Annemarie Sullivan

2017-01-01

Science education reforms articulate a vision of ambitious science teaching where teachers engage students in sensemaking discussions and emphasise the integration of scientific practices with science content. Learning to teach in this way is complex, and there are few examples of sensemaking discussions in schools where textbook lessons and…

Inculcating Character Education through EFL Teaching in Indonesian State Schools

ERIC Educational Resources Information Center

Qoyyimah, Uswatun

2016-01-01

This paper describes how English as a Foreign Language (EFL) teachers in Indonesia have implemented the recent character education policy within an era of school-based curriculum reform. The character education policy required all teachers, EFL teachers included, to instil certain values in every lesson whilst the school-based curriculum reform…

Secondary Science Teachers' and Students' Beliefs about Engaging in Whole-Class Discussions

ERIC Educational Resources Information Center

Silva Pimentel, Diane

2012-01-01

Reform movements in science education have repeatedly called for more dialogic and student-centered discussions during science lessons. The approach secondary science teachers take towards talk during whole-class discussions continues to be predominantly teacher-centered even when curriculum materials are designed to support a shift in discourse.…

Renewables-Friendly Grid Development Strategies. Experience in the United States, Potential Lessons for China

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hurlbut, David; Zhou, Ella; Porter, Kevin

2015-10-01

This report aims to help China's reform effort by providing a concise summary of experience in the United States with "renewables-friendly"" grid management, focusing on experiences that might be applicable to China. It focuses on utility-scale renewables and sets aside issues related to distributed generation.

Implications of lessons learned from tobacco control for tanning bed reform.

PubMed

Sinclair, Craig; Makin, Jennifer K

2013-01-01

Tanning beds used according to the manufacturer's instructions expose the user to health risks, including melanoma and other skin cancers. Applying the MPOWER model (monitor, protect, offer alternatives, warn, enforce, and raise taxes), which has been used in tobacco control, to tanning bed reform could reduce the number of people at risk of diseases associated with tanning bed use. Among the tactics available to government are restricting the use of tanning beds by people under age 18 and those with fair skin, increasing the price of tanning bed services through taxation, licensing tanning bed operators, and banning unsupervised tanning bed operations.

Implications of Lessons Learned From Tobacco Control for Tanning Bed Reform

PubMed Central

Sinclair, Craig

2013-01-01

Tanning beds used according to the manufacturer’s instructions expose the user to health risks, including melanoma and other skin cancers. Applying the MPOWER model (monitor, protect, offer alternatives, warn, enforce, and raise taxes), which has been used in tobacco control, to tanning bed reform could reduce the number of people at risk of diseases associated with tanning bed use. Among the tactics available to government are restricting the use of tanning beds by people under age 18 and those with fair skin, increasing the price of tanning bed services through taxation, licensing tanning bed operators, and banning unsupervised tanning bed operations. PMID:23449282

The use of private-sector contracts for primary health care: theory, evidence and lessons for low-income and middle-income countries.

PubMed Central

Palmer, N.

2000-01-01

Contracts for the delivery of public services are promoted as a means of harnessing the resources of the private sector and making publicly funded services more accountable, transparent and efficient. This is also argued for health reforms in many low- and middle-income countries, where reform packages often promote the use of contracts despite the comparatively weaker capacity of markets and governments to manage them. This review highlights theories and evidence relating to contracts for primary health care services and examines their implications for contractual relationships in low- and middle-income countries. PMID:10916919

SOFIA Program SE and I Lessons Learned

NASA Technical Reports Server (NTRS)

Ray, Ronald J.; Fobel, Laura J.; Brignola, Michael P.

2011-01-01

Once a "Troubled Project" threatened with cancellation, the Stratospheric Observatory for Infrared Astronomy (SOFIA) Program has overcome many difficult challenges and recently achieved its first light images. To achieve success, SOFIA had to overcome significant deficiencies in fundamental Systems Engineering identified during a major Program restructuring. This presentation will summarize the lessons learn in Systems Engineering on the SOFIA Program. After the Program was reformulated, an initial assessment of Systems Engineering established the scope of the problem and helped to set a list of priorities that needed to be work. A revised Systems Engineering Management Plan (SEMP) was written to address the new Program structure and requirements established in the approved NPR7123.1A. An important result of the "Technical Planning" effort was the decision by the Program and Technical Leadership team to re-phasing the lifecycle into increments. The reformed SOFIA Program Office had to quickly develop and establish several new System Engineering core processes including; Requirements Management, Risk Management, Configuration Management and Data Management. Implementing these processes had to consider the physical and cultural diversity of the SOFIA Program team which includes two Projects spanning two NASA Centers, a major German partnership, and sub-contractors located across the United States and Europe. The SOFIA Program experience represents a creative approach to doing "System Engineering in the middle" while a Program is well established. Many challenges were identified and overcome. The SOFIA example demonstrates it is never too late to benefit from fixing deficiencies in the System Engineering processes.

The impact of healthcare reform on HMO administrators.

PubMed

Bolduc, C R

1996-01-01

Over the years, congressional legislation toward healthcare reform has evolved, moving toward channeling indigent populations into managed care plans. Health Maintenance Organizations (HMOs) will have to respond to increased competition caused by this shift enrollment as each entity attempts to funnel these patients into its own provider network. It is likely that some HMOs may bid too low when contracting for patients, putting these organizations at risk for financial insolvency. This paper discusses the impact of Medicaid waivers on HMO administrators. HMO executives need to develop a strategy for monitoring the financial integrity and contractual performance of new and existing HMOs in light of changes taking place with respect to healthcare reform. The transition to managed care and the shift in enrollment pose many challenges for directors of HMOs as will be discussed by analyzing lessons learned from Medicaid managed care plans in Arizona and Oregon.

Developing Teachers' Models for Assessing Students' Competence in Mathematical Modelling through Lesson Study

ERIC Educational Resources Information Center

Aydogan Yenmez, Arzu; Erbas, Ayhan Kursat; Cakiroglu, Erdinc; Alacaci, Cengiz; Cetinkaya, Bulent

2017-01-01

Applications and modelling have gained a prominent role in mathematics education reform documents and curricula. Thus, there is a growing need for studies focusing on the effective use of mathematical modelling in classrooms. Assessment is an integral part of using modelling activities in classrooms, since it allows teachers to identify and manage…

Cultures of the Western World. Grade Ten. Instructional Guide.

ERIC Educational Resources Information Center

West Chester School District, PA.

This curriculum guide presents nine units for the study of western cultures in the tenth grade. The units contain up to 13 lessons each and comprise a two-semester course. Content includes ancient Greece and Rome, the Middle Ages, the Renaissance and Reformation, Great Britain, France as a case study of revolution, Russia, and nationalism and the…

Establishing a Strong Foundation: District and School Supports for Classroom Implementation of the MDC Framework

ERIC Educational Resources Information Center

Lawrence, Nancy; Sanders, Felicia; Christman, Jolley Bruce; Duffy, Mark

2011-01-01

The Bill and Melinda Gates Foundation has invested in the development and dissemination of high-quality formative assessment tools to support teachers' incorporation of the Core Common State Standards (CCSS) into their classroom instruction. Lessons from the first generation of standards-based reforms suggest that intense attention to high quality…

The Nature of Discourse throughout 5E Lessons in a Large Enrolment College Biology Course

ERIC Educational Resources Information Center

Sickel, Aaron J.; Witzig, Stephen B.; Vanmali, Binaben H.; Abell, Sandra K.

2013-01-01

Large enrolment science courses play a significant role in educating undergraduate students. The discourse in these classes usually involves an instructor lecturing with little or no student participation, despite calls from current science education reform documents to elicit and utilize students' ideas in teaching. In this study, we used the 5E…

Education, Inc.: Turning Learning into a Business. A Collection of Articles.

ERIC Educational Resources Information Center

Kohn, Alfie, Ed.

From first-grade lessons promoting the products of Fortune 500 companies to education reform designed to suit the interests of big business, corporations are being granted more and more power to determine what happens in our schools. This book explores the implications of this trend, examining everything from advertising aimed at children to…

Community Organizing as Educational Leadership: Lessons from Chicago on the Politics of Racial Justice

ERIC Educational Resources Information Center

Welton, Anjalé D.; Freelon, Rhoda

2018-01-01

The collective power of community members has the potential to shape education reform efforts through activism and community organizing. In this article, we present two cases where community organizers exhibited key leadership strategies designed to influence district decision-making about school closures in Chicago. Employing a mix of interviews,…

Student Motivation: An Overlooked Piece of School Reform. Summary

ERIC Educational Resources Information Center

Usher, Alexandra; Kober, Nancy

2012-01-01

This summary report by the Center on Education Policy (CEP) pulls together findings from a wide array of studies on student motivation by scholars in a range of disciplines, as well as lessons from programs around the country intended to increase motivation. It is intended to start a conversation about the importance of motivation and the policies…

Kaleidoscope Feature. Experiencing a Learning Community: Lessons from Interns Learning to Teach in a Yearlong Professional Development School Internship

ERIC Educational Resources Information Center

Mule, Lucy

2005-01-01

University-school partnerships are increasingly being viewed as optimal contexts for preparing future teachers. Professional Development School partnerships have especially been extolled or creating learning communities in which preservice teachers learn to teach. The reform literature, however, does not adequately address how interns understand,…

School Reform for Positive Behaviour Support through Collaborative Learning: Utilising Lesson Study for a Learning Community

ERIC Educational Resources Information Center

Saito, Eisuke; Watanabe, Miki; Gillies, Robyn; Someya, Ikuo; Nagashima, Takashi; Sato, Masaaki; Murase, Masatsugu

2015-01-01

Recent research has emphasised educating children about positive behaviours to overcome delinquency issues, but there is little clarification of what factors lead to positive behaviours. This study analyses factors that led to children's positive behaviours at a junior high school in Japan, which experienced a dramatic turnaround after…

Lessons Learned: How Early College High Schools Offer a Pathway for High School Reform

ERIC Educational Resources Information Center

Kaniuka, Theodore Stefan; Vickers, Melinda

2010-01-01

In 2002, Early College High Schools Initiative became a reality across the United States for students and educators looking for ways to improve student graduation rates, college attendance, and overall student achievement. This mixed method case study found that (a) the early college high school environment supported the academic success of…

A Cultural Historical Activity Theory Approach in Natural Sciences Education Laboratory Lessons towards Reforming Teachers Training

ERIC Educational Resources Information Center

Kolokouri, Eleni; Theodoraki, Xarikleia; Plakitsi, Katerina

2012-01-01

This paper focuses on connecting natural sciences education with Cultural Historical Activity Theory (CHAT). In this sense, natural sciences education is considered as a lifelong learning procedure, not seen as an individual but as a collective activity. Moreover, learning becomes a human activity in which theory and praxis are strongly connected…

Autonomy and School Improvement: What Do We Know and Where Do We Go from Here?

ERIC Educational Resources Information Center

Honig, Meredith I.; Rainey, Lydia R.

2012-01-01

New "autonomy initiatives" aim to increase schools' decision-making authority as a strategy to leverage school improvement. These policies build on lessons of previous reforms such as site-based management in ways that bode well for their success. However, how are these policies actually faring in implementation? The authors addressed that…

We Modify Each Other's Lessons: The Role of Literacy Work Circles in Developing Professional Community

ERIC Educational Resources Information Center

Wardrip, Peter Samuelson; Gomez, Louis M.; Gomez, Kimberley

2015-01-01

To address teacher isolation in schools, more reform leaders are finding hope in establishing professional communities as a way to promote continuous school improvement. This case study presents one approach for developing teacher professional community: a teacher work circle. Using the characteristics of professional community created by Kruse,…

Assessing the Impact of Lesson Study on the Teaching Practice of Middle School Science Teachers

ERIC Educational Resources Information Center

Grove, Michael C.

2011-01-01

Despite wave after wave of educational reform in the United States our students continue to lag behind their peers in other industrialized countries on virtually all measures of academic achievement. Effective professional development (PD) is seen as a key to improving instructional practice and therefore student learning, but traditional forms of…

Primary School English Reform in Japan: Policies, Progress and Challenges

ERIC Educational Resources Information Center

Ng, Chin Leong Patrick

2016-01-01

In April 2011, the Ministry of Education in Japan formally introduced Primary School English (PSE) language teaching in Japanese elementary schools. The PSE policy made it mandatory for fourth- and fifth-graders to attend English lessons once a week. Using the theoretical framework on why educational language plans fail [Kaplan, R. B., Baldauf, R.…

Investigating Problem-Solving Perseverance Using Lesson Study

ERIC Educational Resources Information Center

Bieda, Kristen N.; Huhn, Craig

2017-01-01

Problem solving has long been a focus of research and curriculum reform (Kilpatrick 1985; Lester 1994; NCTM 1989, 2000; CCSSI 2010). The importance of problem solving is not new, but the Common Core introduced the idea of making sense of problems and persevering in solving them (CCSSI 2010, p. 6) as an aspect of problem solving. Perseverance is…

Should Parents Get Involved in Educational Reform?

ERIC Educational Resources Information Center

Blodget, Alden S.

2012-01-01

People tend to do things because that's how they have always done them or because that's the way others have done them. Schools are no different. The rigid factory model of education--a conveyor belt that moves children through a standard curriculum of books and lessons in a strict sequence--assumes that all brains are basically the same. They…

Public Costs, Relative Subsidies, and Repayment Burdens of Federal US Student Loan Plans: Lessons for Reform

ERIC Educational Resources Information Center

Hauser, Daniel C.; Johnston, Alison

2016-01-01

American students graduate from college with tens of thousands of dollars in debt, leading to substantial repayment burdens and potentially inefficient shifts in spending patterns and career choices. A political trend towards austerity coupled with the rising student debt make the effective allocation of federal higher education resources and…

Security Sector Reform in Timor-Leste: Missed Opportunities and Hard Lessons in Empowering the Host-Nation

DTIC Science & Technology

2012-04-01

policing’: Voices of Australian po- lice peacekeepers in Operation Serene , Timor-Leste 2006," Policing and Society, Vol. 19, No. 2, pp. 119-133. 23...of Australian police peacekeepers in Operation Serene , Timor-Leste 2006," Policing and Society, Vol. 19, No. 2, pp. 119- 133. Hänggi, Heiner (2004

Fear and Loathing in Elementary School: Lessons from a Third Grader about Better Assessments

ERIC Educational Resources Information Center

Militello, Matthew; Militello, Luke

2013-01-01

Recent educational accountability efforts have married student assessments with reform mandates and sanctions. As a result, students--beginning in early elementary grades--are feeling the pressures of this new era of high-stakes accountability. This article chronicles a story of the consequences of high-stakes testing on a father and his son.…

Learning to Teach Primary Geography in the Context of School Placement: Lessons from an All-Ireland Study

ERIC Educational Resources Information Center

Dolan, Anne M.; Waldron, Fionnuala; Pike, Susan; Greenwood, Richard

2016-01-01

Teaching education is Ireland is currently undergoing significant structural and conceptual changes. School placement is at the centre of these reforms. This article reports the findings of an all-Ireland study which investigates student teachers' experiences of teaching geography during their school placements. Based on data collected from…

The Cost of Changing Lives? Lessons from the Making Waves Foundation

ERIC Educational Resources Information Center

Scully, John H.; Holsclaw, Glenn W.

2011-01-01

The prevailing school reform dogma is wrong: Schools alone can't be expected to make up for the impediments to learning that are commonly associated with poverty, the authors say. Disadvantaged children need and deserve great teachers and schools, and they need many other sources of support. The question though, is how much would those extra…

Analysis of Korean Elementary Pre-Service Teachers' Changing Attitudes about Integrated STEAM Pedagogy through Developing Lesson Plans

ERIC Educational Resources Information Center

Kim, Dongryeul; Bolger, Molly

2017-01-01

Integrated curricula have become a major educational focus in Korea. Policy changes began in 2009 when the Korea Ministry of Education, Science, and Technology announced a new curriculum incorporating Science, Technology, Engineering, Arts, and Mathematics (STEAM). Various stages of educational reform have occurred since that time. This study…

A well-started beginning elementary teacher's beliefs and practices in relation to reform recommendations about inquiry-based science

NASA Astrophysics Data System (ADS)

Avraamidou, Lucy

2017-06-01

Given reform recommendations emphasizing scientific inquiry and empirical evidence pointing to the difficulties beginning teachers face in enacting inquiry-based science, this study explores a well-started beginning elementary teacher's (Sofia) beliefs about inquiry-based science and related instructional practices. In order to explore Sofia's beliefs and instructional practices, several kinds of data were collected in a period of 9 months: a self-portrait and an accompanying narrative, a personal philosophy assignment, three interviews, three journal entries, ten lesson plans, and ten videotaped classroom observations. The analysis of these data showed that Sofia's beliefs and instructional practices were reform-minded. She articulated contemporary beliefs about scientific inquiry and how children learn science and was able to translate these beliefs into practice. Central to Sofia's beliefs about science teaching were scientific inquiry and engaging students in investigations with authentic data, with a prevalent emphasis on the role of evidence in the construction of scientific claims. These findings are important to research aiming at supporting teachers, especially beginning ones, to embrace reform recommendations.

Going "all in" to transform the Tulsa community's health and health care workforce.

PubMed

Clancy, Gerard P; Duffy, F Daniel

2013-12-01

Oklahoma's health status ranks among the lowest of the states', yet many Oklahomans oppose the best-known aspects of federal health reform legislation. To address this situation, the University of Oklahoma College of Medicine's School of Community Medicine in Tulsa adopted an "all-in," fully committed approach to transform the Tulsa region's health care delivery system and health care workforce teaching environment by leading community-wide initiatives that took advantage of lesser-known health reform provisions. Medical school leaders shared a vision of improved health for the region with a focus on equity in care for underserved populations. They engaged Tulsa stakeholders to implement health system changes to improve care access, quality, and efficiency. A partnership between payers, providers, and health systems transformed primary care practices into patient-centered medical homes (PCMHs) and instituted both community-wide care coordination and a regional health information exchange. To emphasize the importance of these new approaches to improving the health of an entire community, the medical school began to transform the teaching environment by adding several interdependent experiences. These included an annual interdisciplinary summer institute in which students and faculty from across the university could explore firsthand the social determinants of health as well as student-run PCMH clinics for the uninsured to teach systems-based practice, team-based learning, and health system improvement. The authors share lessons learned from these collaborations. They conclude that working across competitive boundaries and going all in are necessary to improve the health of a community.

Health care financing in Asia: key issues and challenges.

PubMed

Kwon, Soonman

2011-09-01

This article examines the major elements of health care financing such as financial risk protection, resource generation, resource pooling, and purchasing and payment; provides key lessons; and discusses the challenges for health care financing systems of Asian countries. With the exception of Japan, Korea, Taiwan, and Thailand, most health care systems of Asia provide very limited financial risk protection. The role of public prepaid schemes such as tax and social health insurance is minimal, and out-of-pocket payment is a major source of financing. The large informal sector is a major challenge to the extension of population coverage in many low-income countries of Asia, which must seek the optimal mix of tax subsidy and health insurance for universal coverage. Implementation of effective payment systems to control the behavior of health care providers is also a key factor in the success of health care financing reform in Asia.

Health care cost containment strategies used in four other high-income countries hold lessons for the United States.

PubMed

Stabile, Mark; Thomson, Sarah; Allin, Sara; Boyle, Seán; Busse, Reinhard; Chevreul, Karine; Marchildon, Greg; Mossialos, Elias

2013-04-01

Around the world, rising health care costs are claiming a larger share of national budgets. This article reviews strategies developed to contain costs in health systems in Canada, England, France, and Germany in 2000-10. We used a comprehensive analysis of health systems and reforms in each country, compiled by the European Observatory on Health Systems and Policies. These countries rely on a number of budget and price-setting mechanisms to contain health care costs. Our review revealed trends in all four countries toward more use of technology assessments and payment based on diagnosis-related groups and the value of products or services. These policies may result in a more efficient use of health care resources, but we argue that they need to be combined with volume and price controls--measures unlikely to be adopted in the United States--if they are also to meet cost containment goals.

Canada's public health system: is the pace of progress sufficient?

PubMed

Lozon, Jeffrey C; Alikhan, L Miin

2007-01-01

Tilson and Berkowitz review the Institute of Medicine reports that catalyzed the serious re-examination of the United States public health enterprise. For Canada, a similar catalyst stemmed from the lessons learned during the 2003 severe acute respiratory syndrome outbreak. While strong policy statements of commitment to strengthen the public health system are a necessary first step to stewarding change, they are insufficient without defined accountabilities, operationalized relationships and supporting legislation. Investments in critical enablers of sustainable reform, such as inter-sectoral partnerships, human capacity building and an electronic backbone, are also required. To support the value added by public health functions and services, both from a health benefit and economic perspective, a performance management system is necessary. While the 2004 establishment of the Public Health Agency of Canada was a progressive step, persistent political will and leadership are required to ensure this agency's effectiveness and preparedness before the next crisis hits.

Meeting the challenges to European healthcare: lessons learned from the 'Stockholm Revolution'.

PubMed

Hjertqvist, Johan

2002-01-01

Healthcare is a political 'hot potato' in Sweden, just as it is throughout Europe. Regardless of whether the focus is on the 'Swedish model' or a 'European model', the operative term should be 'Culture - a set of values common to European healthcare systems'. An analysis of change and challenge in European healthcare systems must examine these values in the context of technological and societal forces before addressing the overarching concerns of where the money will come from. Discussion of the reform evidenced by the 'Stockholm Revolution' will serve as a model of how European healthcare systems can adapt to new conditions by the following approaches: modernising services through incentives; making the consumer a partner by focusing on consumer-related outcomes; building employee networks that encourage responsibility and problem solving; making healthcare an attractive labour market; and creating self-employment opportunities in the healthcare market to increase efficiency and emphasis on consumer satisfaction.

Ethical and Human Rights Foundations of Health Policy: Lessons from Comprehensive Reform in Mexico.

PubMed

Frenk, Julio; Gómez-Dantés, Octavio

2015-12-10

This paper discusses the use of an explicit ethical and human rights framework to guide a reform intended to provide universal and comprehensive social protection in health for all Mexicans, independently of their socio-economic status or labor market condition. This reform was designed, implemented, and evaluated by making use of what Michael Reich has identified as the three pillars of public policy: technical, political, and ethical. The use of evidence and political strategies in the design and negotiation of the Mexican health reform is briefly discussed in the first part of this paper. The second part examines the ethical component of the reform, including the guiding concept and values, as well as the specific entitlements that gave operational meaning to the right to health care that was enshrined in Mexico's 1983 Constitution. The impact of this rights-based health reform, measured through an external evaluation, is discussed in the final section. The main message of this paper is that a clear ethical framework, combined with technical excellence and political skill, can deliver major policy results. Copyright © 2015 Frenk and Gómez-Dantés. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

A case study of secondary teachers facilitating a historical problem-based learning instructional unit

NASA Astrophysics Data System (ADS)

Pecore, John L.

Current curriculum trends promote inquiry-based student-centered strategies as a way to foster critical thinking and learning. Problem-based learning (PBL), a type of inquiry focusing on an issue or "problem," is an instructional approach taught on the basis that science reform efforts increase scientific literacy. PBL is a constructivist approach to learning real life problems where understanding is a function of content, context, experiences, and learner goals; historical PBL situates the lesson in a historical context and provides opportunities for teaching NOS concepts. While much research exists on the benefits of historical PBL to student learning in general, more research is warranted on how teachers implement PBL in the secondary science curriculum. The purpose of this study was to examine the classroom-learning environment of four science teachers implementing a historical PBL instructional unit to identify the teachers' understandings, successes and obstacles. By identifying teachers' possible achievements and barriers with implementing a constructivist philosophy when executing historical PBL, educators and curriculum designers may improve alignment of the learning environment to constructivist principles. A qualitative interpretive case study guided this research study. The four participants of this study were purposefully and conveniently selected from biology teachers with at least three years of teaching experience, degrees in education, State Licensure, and completion of a PBL workshop. Data collection consisted of pre and post questionnaires, structured interviews, a card sort activity in which participants categorized instructional outcomes, and participant observations. Results indicated that the four teachers assimilated reform-based constructivist practices to fit within their preexisting routines and highlighted the importance of incorporating teachers' current systems into reform-based teacher instruction. While participating teachers addressed a few NOS tenets, emphasizing the full range of possible NOS objectives included in historical PBL is warranted. This study also revealed the importance of creating a collaborative classroom culture and building positive student-teacher relationships when implementing PBL instruction. The four teachers agreed that the historical PBL instructional unit provided a context for learning state standards, and they positively viewed their experiences teaching the lesson. Thus findings from this study suggest that teaching science in a historical context using PBL can be effective.

The Lessons Learned from Developing an Inclusive Learning and Teaching Community of Practice

ERIC Educational Resources Information Center

Brandon, Toby; Charlton, Joyce

2011-01-01

This paper explores the development, in both practical and theoretical terms, of the Centre for Excellence in Teacher Training (CETT) based at Northumbria University. This is the only one of 11 new centres in England focusing on inclusive learning. CETTs are a critical component of a range of government reforms to teacher training within the…

Language Ideology Change over Time: Lessons for Language Policy in the U.S. State of Arizona and Beyond

ERIC Educational Resources Information Center

Fitzsimmons-Doolan, Shannon

2018-01-01

In the U.S. state of Arizona, language minority students who are English learners attend schools governed by a restrictive medium of instruction (MOI) language policy (LP). Educators and educational researchers widely agree that effective reforms of this policy are urgently needed (e.g., Arias & Faltis, 2012; Lawton, 2012; Lillie, 2016).…

Messy but Meaningful: Exploring the Transition to Reform-Based Pedagogy with Teachers of Mathematics and Coordinators in Ontario, Canada

ERIC Educational Resources Information Center

Jarvis, Daniel

2016-01-01

The RE4MUL8 Project involved the creation of an online/mobile resource for Intermediate Division (Grade 7 and 8) teachers of mathematics. This resource showcases video documentaries of seven key mathematics topic lessons (fractions, integers, proportional reasoning, composite shapes and solids, solving equations, and, patterning and algebraic…

Reform of Budgeting for Acquisition: Lessons from Private Sector Capital Budgeting for the Department of Defense

DTIC Science & Technology

2006-09-30

President Provost The Acquisition Chair, Graduate School of Business & Public Policy, Naval Postgraduate School supported the funding of the...Jerry L. McCaffery, Professor Graduate School of Business & Public Policy ________________________________ Lawrence R. Jones, Professor, Wagner...Chair Graduate School of Business & Public Policy Reviewed by: ________________________________ Robert N. Beck Dean, Graduate School of Business

"Doing School": A New Unit of Analysis for Schools Serving Marginalized Students

ERIC Educational Resources Information Center

Atkinson, Helen

2009-01-01

This study asserts a new unit of analysis for school reform that goes beyond the mental representations of individuals, beyond the isolated lesson, and beyond the confines of a school building. I argue that the special case of expanding time and space as a method of engagement for marginalized students requires that the unit of analysis change to…

Computer Science Lesson Study: Building Computing Skills among Elementary School Teachers

ERIC Educational Resources Information Center

Newman, Thomas R.

2017-01-01

The lack of diversity in the technology workforce in the United States has proven to be a stubborn problem, resisting even the most well-funded reform efforts. With the absence of computer science education in the mainstream K-12 curriculum, only a narrow band of students in public schools go on to careers in technology. The problem persists…

Autonomy and Religious Education: Lessons from a Six-Year Evaluation of an Educational Reform in an Israeli School Network

ERIC Educational Resources Information Center

Paul-Binyamin, Ilana; Gindi, Shahar

2017-01-01

This study investigated the tension that exists between promoting an educational agenda and practising an educational approach which emphasises autonomy within the framework of religious education. Our main thesis is that every educational deed contains a dialectical tension between endorsing an educational agenda and the promotion of autonomy.…

A Study of Equity in Mathematics Education: Lessons from Japan for U.S. Teacher Preparation

ERIC Educational Resources Information Center

Furuto, Linda H. L.

2015-01-01

This study comes at an opportune moment for Japanese and U.S. educators, policymakers, and researchers given the trends of global policy and equity-based reform. Discussions of academic achievement in both societies allow us to examine accessibility in mathematics education in order to best prepare teachers to serve the needs of students.…

Lessons along the Cultural Spectrum: Educators Can Build on the Variety of Cultures and Daily Experiences to Shape Students' Learning and Development

ERIC Educational Resources Information Center

Williams, Belinda

2006-01-01

Although economically disadvantaged and minority students made some gains in their academic achievement performance, education reforms still fail to close the academic achievement gap between them. A discussion of the factors that influence the achievement gap is presented and provides some professional development implications. According to the…

Quality and Quality Assurance in Vocational Education and Training in the Mediterranean Countries: Lessons from the European Approach

ERIC Educational Resources Information Center

Masson, Jean-Raymond; Baati, Mounir; Seyfried, Erwin

2010-01-01

This article reflects on the development of the European approach towards quality and quality assurance in vocational education and training (VET) and its relevance for VET reforms in the European Training Foundation (ETF) partner countries. The analysis is based on an ETF project conducted in 2007-2008 in the Mediterranean partner countries to…

Looking Backward: Parting Reflections on Higher Education Reform from NAS's Founding President

ERIC Educational Resources Information Center

Balch, Stephen H.

2012-01-01

Twenty-five years at the helm of the National Association of Scholars (NAS) have left the author with vivid memories: of knocks and bruises, peaks of exhilaration and, especially, unforgettable characters. But as for lessons learned, that's a very different story. In this article, the author shares some of the successes that happened in NAS for…

Excerpts from inside the Black Box School District Spending on Professional Development in Education: Lessons from Five Urban Districts

ERIC Educational Resources Information Center

Miles, Karen Hawley; Odden, Allan; Fermanich, Mark; Archibald, Sarah

2005-01-01

As districts struggle to meet the demands of standards-based reform and requirements for "highly qualified" teachers in the face of increasing fiscal constraints, professional development has the potential to be a significant part of a district's improvement strategy. To use dollars effectively, districts need to think about how to best integrate…

Lessons and Impressions of the Czech Capital Markets

DTIC Science & Technology

2012-02-13

violently broke up a peaceful pro- democracy demonstration and brutally beat many student participants. In the days that followed, political groups ...united to become the Civic Forum, an umbrella group championing bureaucratic reform and civil liberties. Faced with an overwhelming popular...banks. Belgian KBC Bank acquired ČSOB in 1999 and Erste Group , a leading Austrian financial institution, acquired Ceska Sporitelna in 2000

Leadership for Transformative Change: Lessons from Technology-Mediated Reform in Broad-Access Colleges. CCRC Working Paper No. 8

ERIC Educational Resources Information Center

Klempin, Serena; Karp, Melinda Mechur

2015-01-01

Community colleges and broad-access four-year institutions have a crucial role to play in increasing educational equity in the United States. In order to fulfill this role, however, institutions must engage in organizational change to address their low completion rates. Drawing on qualitative case studies of six colleges, this study explores the…

Engaging Students in Science Courses: Lessons of Change from the Arctic

ERIC Educational Resources Information Center

Duffy, Lawrence K.; Godduhn, Anna; Fabbri, Cindy E.; van Muelken, Mary; Nicholas-Figueroa, Linda; Middlecamp, Catherine Hurt

2011-01-01

Where you live should have something to do with what you teach. In the Arctic, the idea of place-based education--teaching and sharing knowledge that is needed to live well--is central to the UARCTIC consortium and the 4th International Polar Year educational reform effort. A place-based issue oriented context can engage students in chemistry…

Charter Schools and "Customer" Satisfaction: Lessons from Field Testing a Parent Survey

ERIC Educational Resources Information Center

Wohlstetter, Priscilla; Nayfack, Michelle B.; Mora-Flores, Eugenia

2008-01-01

Since the development of magnet schools in the 1960s--and more recently, the proliferation of charter schools in the last fifteen years--school choice has been a pervasive element on the education reform landscape. With this growth has come the need for information tools to help site-based educators manage, grow, and improve their schools. This is…

More Technology, Better Learning Resources, Better Learning? Lessons from Adopting Virtual Microscopy in Undergraduate Medical Education

ERIC Educational Resources Information Center

Helle, Laura; Nivala, Markus; Kronqvist, Pauliina

2013-01-01

The adoption of virtual microscopy at the University of Turku, Finland, created a unique real-world laboratory for exploring ways of reforming the learning environment. The purpose of this study was to evaluate the students' reactions and the impact of a set of measures designed to boost an experimental group's understanding of abnormal histology…

Lessons to be learned from the history of anatomical teaching in the United States: the example of the University of Michigan.

PubMed

Hildebrandt, Sabine

2010-01-01

Although traditional departments of anatomy are vanishing from medical school rosters, anatomical education still remains an important part of the professional training of physicians. It is of some interest to examine whether history can teach us anything about how to reform modern anatomy. Are there lessons to be learned from the history of anatomical teaching in the United States that can help in the formulation of contents and purposes of a new anatomy? This question is explored by a review of US anatomical teaching with special reference to Franklin Paine Mall and the University of Michigan Medical School. An historical perspective reveals that there is a tradition of US anatomical teaching and research that is characterized by a zeal for reform and innovation, scientific endeavor, and active, student-driven learning. Further, there is a tradition of high standards in anatomical teaching through the teachers' engagement in scientific anatomy and of adaptability to new requirements. These traditional strengths can inform the innovation of modern anatomy in terms of its two duties--its duty to anatomy as a science and its duty toward anatomical education. Copyright 2010 American Association of Anatomists.

Understanding the United States and Brazil's response to obesity: institutional conversion, policy reform, and the lessons learned.

PubMed

Gómez, Eduardo J

2015-06-10

In the United States (US) and Brazil, obesity has emerged as a health epidemic. This article is driven by the following research questions: how did the US and Brazil's federal institutions respond to obesity? And how did these responses affect policy implementation? The aim of this article is therefore to conduct a comparative case study analysis of how these nations' institutions responded in order to determine the key lessons learned. This study uses primary and secondary qualitative data to substantiate causal arguments and factual claims. Brazil shows that converting preexisting federal agencies working in primary healthcare to emphasize the provision of obesity prevention services can facilitate policy implementation, especially in rural areas. Brazil also reveals the importance of targeting federal grant support to the highest obesity prevalence areas and imposing grant conditionalities, while illustrating how the incorporation of social health movements into the bureaucracy facilitates the early adoption of nutrition and obesity policies. None of these reforms were pursued in the US. Brazil's government has engaged in innovative institutional conversion processes aiding its ability to sustain its centralized influence when implementing obesity policy. The US government's adoption of Brazil's institutional innovations may help to strengthen its policy response.

Attention to Intentions—How to Stimulate Strong Intentions to Change

NASA Astrophysics Data System (ADS)

Dam, M.; Janssen, F. J. J. M.; van Driel, J. H.

2017-04-01

The implementation of educational reforms requires behavioral changes from the teachers involved. Theories on successful behavioral change prescribe the following conditions: teachers need to possess the necessary knowledge and skills, form strong positive intentions to perform the new behavior, and have a supporting environment for change. However, existing approaches to teacher professional development in the context of educational reforms are predominantly aimed at the development of knowledge and skills and at creating a supporting environment, but lack attention to teachers' intentions to change. In the study described in this article, we performed "motivating-for-educational-change" interviews (MECI) and explored the influence on teachers' intentions to change in the direction of the proposed national biology education reform, that is, the introduction of a context-based curriculum. The MECI comprised two tools: building on earlier successful experiences and using lesson segments to rearrange instructional approaches. We explored the influence of the MECI technique on the strength and specificity of participating teachers' intentions. When conducting the MECI, many participants expressed that they now realized how they had already implemented aspects of the reform in their regular instructional approaches. Furthermore, all the participants formulated stronger and more specific intentions to change their regular instructional approach towards that of the proposed reform while taking their regular instructional approach as a starting point.

Emerging lessons from regional and state innovation in value-based payment reform: balancing collaboration and disruptive innovation.

PubMed

Conrad, Douglas A; Grembowski, David; Hernandez, Susan E; Lau, Bernard; Marcus-Smith, Miriam

2014-09-01

In recent decades, practitioners and policymakers have turned to value-based payment initiatives to help contain spending on health care and to improve the quality of care. The Robert Wood Johnson Foundation funded 7 grantees across the country to design and implement value-based, multistakeholder payment reform projects in 6 states and 3 regions of the United States. As the external evaluator of these projects, we reviewed documents, conducted Internet searches, interviewed key stakeholders, cross-validated factual and narrative interpretation, and performed qualitative analyses to derive cross-site themes and implications for policy and practice. The nature of payment reform and its momentum closely reflects the environmental context of each project. Federal legislation such as the Patient Protection and Affordable Care Act and federal and state support for the development of the patient-centered medical home and accountable care organizations encourage value-based payment innovation, as do local market conditions for payers and providers that combine a history of collaboration with independent innovation and experimentation by individual organizations. Multistakeholder coalitions offer a useful facilitating structure for galvanizing payment reform. But to achieve the objectives of reduced cost and improved quality, multistakeholder payment innovation must overcome such barriers as incompatible information systems, the technical difficulties and transaction costs of altering existing billing and payment systems, competing stakeholder priorities, insufficient scale to bear population health risk, providers' limited experience with risk-bearing payment models, and the failure to align care delivery models with the form of payment. From the evidence adduced in this article, multistakeholder, value-based payment reform requires a trusted, widely respected "honest broker" that can convene and maintain the ongoing commitment of health plans, providers, and purchasers. Change management is complex and challenging, and coalition governance requires flexibility and stable leadership, as market conditions and stakeholder engagement and priorities shift over time. Another significant facilitator of value-based payment reform is outside investment that enables increased investment in human resources, information infrastructure, and care management by provider organizations and their collaborators. Supportive community and social service networks that enhance population health management also are important enablers of value-based payment reform. External pressure from public and private payers is fueling a "burning bridge" between the past of fee-for-service payment models and the future of payments based on value. Robust competition in local health plan and provider markets, coupled with an appropriate mix of multistakeholder governance, pressure from organized purchasers, and regulatory oversight, has the potential to spur value-based payment innovation that combines elements of "reformed" fee-for-service with bundled payments and global payments. © 2014 Milbank Memorial Fund.

Investigating the Impact of NGSS-Aligned Professional Development on PreK-3 Teachers' Science Content Knowledge and Pedagogy

NASA Astrophysics Data System (ADS)

Tuttle, Nicole; Kaderavek, Joan N.; Molitor, Scott; Czerniak, Charlene M.; Johnson-Whitt, Eugenia; Bloomquist, Debra; Namatovu, Winnifred; Wilson, Grant

2016-11-01

This pilot study investigates the impact of a 2-week professional development Summer Institute on PK-3 teachers' knowledge and practices. This Summer Institute is a component of [program], a large-scale early-childhood science project that aims to transform PK-3 science teaching. The mixed-methods study examined concept maps, lesson plans, and classroom observations to measure possible changes in PK-3 teachers' science content knowledge and classroom practice from 11 teachers who attended the 2014 Summer Institute. Analysis of the concept maps demonstrated statistically significant growth in teachers' science content knowledge. Analysis of teachers' lesson plans demonstrated that the teachers could design high quality science inquiry lessons aligned to the Next Generation Science Standards following the professional development. Finally, examination of teachers' pre- and post-Summer Institute videotaped inquiry lessons showed evidence that teachers were incorporating new inquiry practices into their teaching, especially regarding classroom discourse. Our results suggest that an immersive inquiry experience is effective at beginning a shift towards reform-aligned science and engineering instruction but that early elementary educators require additional support for full mastery.

Nursing education reform in South Africa – lessons from a policy analysis study

PubMed Central

Blaauw, Duane; Ditlopo, Prudence; Rispel, Laetitia C.

2014-01-01

Background Nursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013. Objective We undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa. Design We used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software. Results The revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa. Conclusions The study found significant weaknesses in the policy capacity of the main institutions responsible for the leadership and governance of nursing in South Africa, which will need to be addressed if important nursing education reforms are to be realised. PMID:25537941

Science teachers' beliefs about teaching and reform: Case studies from a restructured high school

NASA Astrophysics Data System (ADS)

King, Elizabeth A.

A qualitative research study of the beliefs of three science teachers about teaching and educational reform was carried out at a restructured high school belonging to the Coalition of Essential Schools (CES), a nationally prominent restructuring movement. One problem of educational reform is to sustain change in the science classroom. A new wave of reform is shifting the focus away from curriculum changes and towards professionalism of teachers empowered to restructure schools. The beliefs of the teachers are key to decisions made in the classroom. The teachers and staff of Metro High School adopted the Ten Common Principles of CES as their guide to restructuring and sustaining change. Changes included increased authority for teachers in shared decision making, increased staff time for professional development, grouping students heterogeneously, grouping students and faculty in teams for extended time periods, and organizing instruction around small group and individual student study (student-centered). The theoretical framework centers on the constructivist theory of learning, particularly Vygotsky's socio-cultural model, and Bakhtin's dialogic function of language. Nespor's belief system model was used to describe the four characteristic features of beliefs: episodic memories, alternativity, existential presumption, and evaluative loading. My research questions were: What memories of teaching have influenced the teachers? What are the teachers' beliefs about the learning environment? What are the teachers' beliefs about their students? What are the teachers' beliefs about student activities? Interviews were the primary data source for the case studies of the three teachers, with additional data from lesson plans, photo-voice, and other artifacts. The teachers shared many common beliefs including that strong peer support is necessary for reform. The teachers' beliefs allied themselves to the majority of the common principles of CES, especially personalization and that students are the central focus of a school. They disagreed, however, with the principle of teacher as generalist. The teachers' beliefs were echoed by the students, resulting in a strong school culture in support of restructuring.

Nursing education reform in South Africa--lessons from a policy analysis study.

PubMed

Blaauw, Duane; Ditlopo, Prudence; Rispel, Laetitia C

2014-01-01

Nursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013. We undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa. We used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software. The revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa. The study found significant weaknesses in the policy capacity of the main institutions responsible for the leadership and governance of nursing in South Africa, which will need to be addressed if important nursing education reforms are to be realised.

Adapting Pharmacoeconomics to Shape Efficient Health Systems en Route to UHC - Lessons from Two Continents.

PubMed

Miot, Jacqui; Thiede, Michael

2017-01-01

Background: Pharmacoeconomics is receiving increasing attention globally as a set of tools ensuring efficient use of resources in health systems, albeit with different applications depending on the contextual, cultural and development stages of each country. The factors guiding design, implementation and optimisation of pharmacoeconomics as a steering tool under the universal health coverage paradigm are explored using case studies of Germany and South Africa. Findings: German social health insurance is subject to the efficiency precept. Pharmaco-regulatory tools reflect the respective framework conditions under which they developed at particular points in time. The institutionalization and integration of pharmacoeconomics into the remit of the Institute for Quality and Efficiency in Health Care occurred only rather recently. The road has not been smooth, requiring political discourse and complex processes of negotiation. Although enshrined in the National Drug Policy, South Africa has had a more fragmented approach to medicine selection and pricing with different policies in private and public sectors. The regulatory reform for use of pharmacoeconomic tools is ongoing and will be further shaped by the introduction of National Health Insurance. Conclusion: A clear vision or framework is essential as the regulatory introduction of pharmacoeconomics is not a single event but rather a growing momentum. The path will always be subject to influences of politics, economics and market forces beyond the healthcare system so delays and modifications to pharmacoeconomic tools are to be expected. Health systems are dynamic and pharmacoeconomic reforms need to be sufficiently flexible to evolve alongside.

Primary care-led commissioning and public involvement in the English National Health Service. Lessons from the past.

PubMed

Petsoulas, Christina; Peckham, Stephen; Smiddy, Jane; Wilson, Patricia

2015-05-01

Patient and Public involvement (PPI) in health care occupies a central place in Western democracies. In England, this theme has been continuously prominent since the introduction of market reforms in the early 1990s. The health care reforms implemented by the current Coalition Government are making primary care practitioners the main commissioners of health care services in the National Health Service, and a duty is placed on them to involve the public in commissioning decisions and strategies. Since implementation of PPI initiatives in primary care commissioning is not new, we asked how likely it is that the new reforms will make a difference. We scanned the main literature related to primary care-led commissioning and found little evidence of effective PPI thus far. We suggest that unless the scope and intended objectives of PPI are clarified and appropriate resources are devoted to it, PPI will continue to remain empty rhetoric and box ticking. To examine the effect of previous PPI initiatives on health care commissioning and draw lessons for future development. We scanned the literature reporting on previous PPI initiatives in primary care-led commissioning since the introduction of the internal market in 1991. In particular, we looked for specific contexts, methods and outcomes of such initiatives. 1. PPI in commissioning has been constantly encouraged by policy makers in England. 2. Research shows limited evidence of effective methods and outcomes so far. 3. Constant reconfiguration of health care structures has had a negative impact on PPI. 4. The new structures look hardly better poised to bring about effective public and patient involvement.

Solid oxide fuel cell steam reforming power system

DOEpatents

Chick, Lawrence A.; Sprenkle, Vincent L.; Powell, Michael R.; Meinhardt, Kerry D.; Whyatt, Greg A.

2013-03-12

The present invention is a Solid Oxide Fuel Cell Reforming Power System that utilizes adiabatic reforming of reformate within this system. By utilizing adiabatic reforming of reformate within the system the system operates at a significantly higher efficiency than other Solid Oxide Reforming Power Systems that exist in the prior art. This is because energy is not lost while materials are cooled and reheated, instead the device operates at a higher temperature. This allows efficiencies higher than 65%.

Lessons from Early Medicaid Expansions Under Health Reform: Interviews with Medicaid Officials

PubMed Central

Sommers, Benjamin D; Arntson, Emily; Kenney, Genevieve M; Epstein, Arnold M

2013-01-01

Background The Affordable Care Act (ACA) dramatically expands Medicaid in 2014 in participating states. Meanwhile, six states have already expanded Medicaid since 2010 to some or all of the low-income adults targeted under health reform. We undertook an in-depth exploration of these six “early-expander” states—California, Connecticut, the District of Columbia, Minnesota, New Jersey, and Washington—through interviews with high-ranking Medicaid officials. Methods We conducted semi-structured interviews with 11 high-ranking Medicaid officials in six states and analyzed the interviews using qualitative methods. Interviews explored enrollment outreach, stakeholder involvement, impact on beneficiaries, utilization and costs, implementation challenges, and potential lessons for 2014. Two investigators independently analyzed interview transcripts and iteratively refined the codebook until reaching consensus. Results We identified several themes. First, these expansions built upon pre-existing state-funded insurance programs for the poor. Second, predictions about costs and enrollment were challenging, indicating the uncertainty in projections for 2014. Other themes included greater than anticipated need for behavioral health services in the expansion population, administrative challenges of expansions, and persistent barriers to enrollment and access after expanding eligibility—though officials overall felt the expansions increased access for beneficiaries. Finally, political context—support or opposition from stakeholders and voters—plays a critical role in shaping the success of Medicaid expansions. Conclusions Early Medicaid expansions under the ACA offer important lessons to federal and state policymakers as the 2014 expansions approach. While the context of each state’s expansion is unique, key shared experiences were significant implementation challenges and opportunities for expanding access to needed services. PMID:24834369

Commitment among state health officials & its implications for health sector reform: lessons from Gujarat.

PubMed

Maheshwari, Sunil; Bhat, Ramesh; Saha, Somen

2008-02-01

Commitment, competencies and skills of people working in the health sector can significantly impact the performance and its reform process. In this study we attempted to analyse the commitment of state health officials and its implications for human resource practices in Gujarat. A self-administered questionnaire was used to measure commitment and its relationship with human resource (HR) variables. Employee's organizational commitment (OC) and professional commitment (PC) were measured using OC and PC scale. Fifty five medical officers from Gujarat participated in the study. Professional commitment of doctors (3.21 to 4.01) was found to be higher than their commitment to the organization (3.01 to 3.61). Doctors did not perceive greater fairness in the system on promotion (on the scale of 5, score: 2.55) and were of the view that the system still followed seniority based promotion (score: 3.42). Medical officers were upset about low autonomy in the department with regard to reward and recognition, accounting procedure, prioritization and synchronization of health programme and other administrative activities. Our study provided some support for positive effects of progressive HR practices on OC, specifically on affective and normative OC. Following initiatives were identified to foster a development climate among the health officials: providing opportunities for training, professional competency development, developing healthy relationship between superiors and subordinates, providing useful performance feedback, and recognising and rewarding performance. For reform process in the health sector to succeed, there is a need to promote high involvement of medical officers. There is a need to invest in developing leadership quality, supervision skills and developing autonomy in its public health institutions.

Regime Changes and Uprisings in the Middle East and Parts of North Africa: Some Lessons to Be Learnt

ERIC Educational Resources Information Center

Muftau, Rufai

2016-01-01

The event leading to the death of Mohammed Bouzazi in Tunisia in 2009 brought to light the dehumanized conditions which an average Tunis had been subjected to at the hands of the Tunisian government. The death of Bouzazi lead to street protests and demonstrations by thousands of demonstrators, calling for political reforms, free speech, improved…

Challenging Common Sense: Cases of School Reform for Learning Community under an International Cooperation Project in Bac Giang Province, Vietnam

ERIC Educational Resources Information Center

Saito, Eisuke; Tsukui, Atsushi

2008-01-01

This paper aims to discuss the challenges in the process of building a learning community in Vietnamese primary schools. Five lessons emerge from the cases. First, changing teachers' beliefs is time-consuming. Second, because of the reluctance of teachers to change, large-scale delivery of the educational project should be critically revisited…

Disseminating Success for All: Lessons for Policy and Practice. Report No. 30.

ERIC Educational Resources Information Center

Slavin, Robert E.; Madden, Nancy A.

Success for All, a comprehensive schoolwide reform program for elementary schools serving many children placed at risk of school failure, was first piloted in one Baltimore (Maryland) elementary school in the 1987-88 school year. Since then, the program has expanded rapidly; as of 1998-99, it was in more than 1,100 schools in 300 districts in 44…

Liberal Arts in China's Modern Universities: Lessons from the Great Catholic Educator and Statesman, Ma Xiangbo

ERIC Educational Resources Information Center

Jiang, You Guo

2012-01-01

Ma Xiangbo was born in 1840 and became a pioneer of educational reform during the republican period. He was responsible for introducing the idea that science and humanities should be valued equally in liberal arts education, a concept that became key to the model of university education. Ma's view of education combined Western humanism and science…

Medical Robotic and Telesurgical Simulation and Education Research

DTIC Science & Technology

2016-09-01

learning , learning science, surgical training, medical education ABOUT THE AUTHORS Roger Smith, Ph.D., is an expert in the development of simulation...needs to be reformed, a major criticism of the current practice. BLENDED LEARNING While medical and surgical educators search for effective...can contribute to military training programs. Their work and lessons learned appear to be much more similar to adult medical and surgical training

Lessons from the Past: Three Modest Suggestions toward School Reform for Poor Students

ERIC Educational Resources Information Center

Davis, Matthew D.

2007-01-01

At the end of August 2005, Hurricane Katrina laid bare a wide swath of the U.S. Gulf Coast. The devastation left in the wake of this natural disaster and the all-too-slow governmental response to it shocked the nation. Hidden even deeper in the media aftermath of Katrina were the stories of the particularly harsh fury that the hurricane had…

A Study of the Privatization of Mathematics Education in Japan and Lessons for the U.S.

ERIC Educational Resources Information Center

Furuto, Linda H. L.

2014-01-01

This study comes at an opportune moment for Japanese and U.S. educators, policymakers, and researchers given the trends of global policy and equity-based reform. Discussions of academic achievement in both societies allows us to examine mathematics education as a public good versus private commodity in order to best serve the needs of students.…

"Regressed Experts" as a New State in Teachers' Professional Development: Lessons from Computer Science Teachers' Adjustments to Substantial Changes in the Curriculum

ERIC Educational Resources Information Center

Liberman, Neomi; Kolikant, Yifat Ben-David; Beeri, Catriel

2012-01-01

Due to a program reform in Israel, experienced CS high-school teachers faced the need to master and teach a new programming paradigm. This situation served as an opportunity to explore the relationship between teachers' content knowledge (CK) and their pedagogical content knowledge (PCK). This article focuses on three case studies, with emphasis…

Reconceptualised Life Skills in Secondary Education in the African Context: Lessons Learnt from Reforms in Ghana

ERIC Educational Resources Information Center

Akyeampong, Kwame

2014-01-01

Early notions of life skills in Africa did not take into account the importance of a flexible and portable set of skills that would enable youth to adapt to changes in the world of work and lay the foundations for productive well-being and behaviour. Rather, life skills education in many secondary education curricula in Africa started with an…

Managing Mathematics: How Does Classroom Management Affect the Maintenance of High Cognitive Demand Tasks during Lessons with Standards-Based Instructional Materials?

ERIC Educational Resources Information Center

Barriteau Phaire, Candace

2013-01-01

The teaching and learning of mathematics has been the subject of debate for over 30 years and the most recent reform efforts are in response to concerns regarding the mathematical competence of students in the United States (Ball, Hill, & Bass, 2005; Battista, 1994; Cavanagh, 2008). Standards-based Instructional Materials (SBIM) allows…

Schooling and Subject Disengagement in Year 10 Science in Four Maintained Schools in Northern England

ERIC Educational Resources Information Center

Butroyd, Robert

2008-01-01

The reform of curriculum and assessment in the 14-19 age range in England seeks to address the failure of schools to engage substantial cohorts of pupils, as measured by truancy rates, disruption of lessons and GCSE pass rates. The new statutory orders for Science are motivated in part by similar concerns. Four schools, already in partnership for…

Categorising the Imagination in the Age of Standards-Based Reforms: Teaching, Learning and Culture in the English Classroom

ERIC Educational Resources Information Center

Wood, Heather

2014-01-01

In this essay I explore the tensions between the static nature of standardised assessment and the dynamic student-focussed approach to appreciating literature that I value. I have closely analysed two of a series of lessons on the gothic literary genre taught by a student teacher on her first placement. By reflecting critically on my own journey…

Connecting Past, Present and Future: How African American Teacher Candidates' School Experiences Inform Their Motivations to Teach, Educational Philosophies, and Identities as Future Teachers

ERIC Educational Resources Information Center

Wilson, Brandy

2012-01-01

The stories of students and teacher candidates of Color hold powerful lessons and tremendous insight for educational reform efforts. Yet, rarely do educators and policymakers solicit or critically engage the educational narratives of students of Color. Indeed, despite resurgence in a four-decade long conversation regarding the shortage of teachers…

Lessons Learned from FIPSE Projects: 15 Directors of Reform Projects in Postsecondary Education Draw Conclusions about What Worked, What Didn't, and Why.

ERIC Educational Resources Information Center

Marcus, Dora, Ed.

This monograph describes what worked and what did not in 15 college and university programs sponsored by the Fund for the Improvement of Postsecondary Education from 1984 to 1987. Each description includes information on the project's purpose, innovative features, evaluation, impact or changes from the grant activities, what worked unexpectedly,…

Fighting Corruption in Mexico: Lessons from Colombia

DTIC Science & Technology

2011-06-01

combat the growing threat. The strategy presented by President Alvaro Uribe in 2003, albeit not perfect, made important strides towards the reform...Edivision Compania Editorial, 1987), 119–120; Andres Lopez- Restrepo and Alvaro Camacho-Guizado, ―From Smugglers to Drug-Lords to ‗Traquetos...of President Uribe in 2002, the GOC viewed the security threat posed by drug trafficking organizations, the FARC and the paramilitaries, as a

Teachers' Perceptions of Culturally Responsive Pedagogy and the Impact on Leadership Preparation: Lessons for Future Reform Efforts

ERIC Educational Resources Information Center

Mette, Ian M.; Nieuwenhuizen, Lisa; Hvidston, David J.

2016-01-01

The purpose of this study was to investigate the impact of one school's teacher-driven professional development effort to address culturally responsive teaching practices in a large district in a Midwestern state. During the 2011-2012 school year, a team of teachers and principals began a three-year long effort to provide job-embedded professional…

The Power of Chameleonic Ideas in the Policy Decision-Making Process: The Case of the "Students' Revolution" in Chile

ERIC Educational Resources Information Center

Cabieses, Baltica; Espinoza, Manuel

2012-01-01

Chile is facing a major intellectual revolution: organised college students are arguing for the most significant educational reform since the period of dictatorship (1973-1990). Thousands of high-school and university students have refused to go to lessons since early June 2011, calling for better and more affordable education and an end to a…

Electric power industry restructuring in Australia: Lessons from down-under. Occasional paper No. 20

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ray, D.

1997-01-01

Australia`s electric power industry (EPI) is undergoing major restructuring. This restructuring includes commercialization of state-owned electric organization through privatization and through corporatization into separate governmental business units; structural unbundling of generation, transmission, retailing, and distribution; and creation of a National Electricity Market (NEM) organized as a centralized, market-based trading pool for buying and selling electricity. The principal rationales for change in the EPI were the related needs of enhancing international competitiveness, improving productivity, and lowering electric rates. Reducing public debt through privatization also played an important role. Reforms in the EPI are part of the overall economic reform package thatmore » is being implemented in Australia. Enhancing efficiency in the economy through competition is a key objective of the reforms. As the need for reform was being discussed in the early 1990s, Australia`s previous prime minister, Paul Keating, observed that {open_quotes}the engine which drives efficiency is free and open competition.{close_quotes} The optimism about the economic benefits of the full package of reforms across the different sectors of the economy, including the electricity industry, is reflected in estimated benefits of a 5.5 percent annual increase in real gross domestic product and the creation of 30,000 more jobs. The largest source of the benefits (estimated at 25 percent of total benefits) was projected to come from reform of the electricity and gas sectors.« less

Planning for Reform-Based Science: Case Studies of Two Urban Elementary Teachers

NASA Astrophysics Data System (ADS)

Mangiante, Elaine Silva

2018-02-01

The intent of national efforts to frame science education standards is to promote students' development of scientific practices and conceptual understanding for their future role as scientifically literate citizens (NRC 2012). A guiding principle of science education reform is that all students receive equitable opportunities to engage in rigorous science learning. Yet, implementation of science education reform depends on teachers' instructional decisions. In urban schools serving students primarily from poor, diverse communities, teachers typically face obstacles in providing reform-based science due to limited resources and accountability pressures, as well as a culture of teacher-directed pedagogy, and deficit views of students. The purpose of this qualitative research was to study two white, fourth grade teachers from high-poverty urban schools, who were identified as transforming their science teaching and to investigate how their beliefs, knowledge bases, and resources shaped their planning for reform-based science. Using the Shavelson and Stern's decision model for teacher planning to analyze evidence gathered from interviews, documents, planning meetings, and lesson observations, the findings indicated their planning for scientific practices was influenced by the type and extent of professional development each received, each teacher's beliefs about their students and their background, and the mission and learning environment each teacher envisioned for the reform to serve their students. The results provided specific insights into factors that impacted their planning in high-poverty urban schools and indicated considerations for those in similar contexts to promote teachers' planning for equitable science learning opportunities by all students.

Challenging the neoliberal trend: the Venezuelan health care reform alternative.

PubMed

Muntaner, Carles; Salazar, René M Guerra; Rueda, Sergio; Armada, Francisco

2006-01-01

Throughout the 1990s, all Latin American countries but Cuba implemented to varying degrees health care sector reforms underpinned by a neoliberal paradigm that redefined health care as less of a social right and more of a market commodity. These health care sector reforms were couched in the broader structural adjustment of Latin American welfare states prescribed consistently by international financial institutions since the mid-1980s. However, since 2003, Venezuela has been developing an alternative to this neoliberal trend through its health care reform program called Misión Barrio Adentro (Inside the Neighbourhood). In this article, we introduce Misión Barrio Adentro in its historical, political, and economic contexts. We begin by analyzing Latin American neoliberal health sector reforms in their political economic context, with a focus on Venezuela. The analysis reveals that the major beneficiaries of both broader structural adjustment of Latin American welfare states and neoliberal health reforms have been transnational capital interests and domestic Latin American elites. We then provide a detailed description of Misión Barrio Adentro as a challenge to neoliberalism in health care in its political economic context, noting the role played in its development by popular resistance to neoliberalism and the unique international cooperation model upon which it is based. Finally, we suggest that the Venezuelan experience may offer valuable lessons not only to other low- to middle-income countries, but also to countries such as Canada.

Defining a competency framework: the first step toward competency-based medical education.

PubMed

Mirzazadeh, Azim; Mortaz Hejri, Sara; Jalili, Mohammad; Asghari, Fariba; Labaf, Ali; Sedaghat Siyahkal, Mojtaba; Afshari, Ali; Saleh, Narges

2014-01-01

Despite the existence of a large variety of competency frameworks for medical graduates, there is no agreement on a single set of outcomes. Different countries have attempted to define their own set of competencies to respond to their local situations. This article reports the process of developing medical graduates' competency framework as the first step in the curriculum reform in Tehran University of Medical Sciences (TUMS). A participatory approach was applied to develop a competency framework in Tehran University of Medical Sciences (TUMS). Following literature review, nominal group meetings with students and faculty members were held to generate the initial list of expectations, and 9 domains was proposed. Then, domains were reviewed, and one of the domains was removed. The competency framework was sent to Curriculum Reform Committee for consideration and approval, where it was decided to distribute electronic and paper forms among all faculty members and ask them for their comments. Following incorporating some of the modifications, the document was approved by the committee. The TUMS competency framework consists of 8 domains: Clinical skills; Communication skills; Patient management; Health promotion and disease prevention; Personal development; Professionalism, medical ethics and law; Decision making, reasoning and problem-solving; and Health system and the corresponding role of physicians. Development of a competency framework through a participatory approach was the first step towards curriculum reform in TUMS, aligned with local needs and conditions. The lessons learned through the process may be useful for similar projects in the future.

Jointness for the Rest of Us: Reforming Joint Professional Development

DTIC Science & Technology

2016-06-10

where service capabilities are combined to maximize effectiveness while minimizing vulnerabilities. However, despite the passage of thirty years ...staff of the Joint Advance Warfighting School and the Joint Forces Staff College for their support during the academic year . Special thanks to my...seminar faculty Colonel Chris Rogers, Dr. Mike Pavlec, and Captain Miguel “Boo” Peko for the lessons and laughs that have made this year so enjoyable

'Renewables-Friendly' Grid Development Strategies: Experience in the United States, Potential Lessons for China (Chinese Translation) (in Chinese)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hurlbut, David; Zhou, Ella; Porter, Kevin

2015-10-03

This is a Chinese translation of NREL/TP-6A20-64940. This report aims to help China's reform effort by providing a concise summary of experience in the United States with 'renewables-friendly' grid management, focusing on experiences that might be applicable to China. It focuses on utility-scale renewables and sets aside issues related to distributed generation.

The politics of comparative effectiveness research: lessons from recent history.

PubMed

Sorenson, Corinna; Gusmano, Michael K; Oliver, Adam

2014-02-01

Efforts to support and use comparative effectiveness research (CER), some more successful than others, have been promulgated at various times over the last forty years. Following a resurgence of interest in CER, recent health care reforms provided substantial support to strengthen its role in US health care. While CER has generally captured bipartisan support, detractors have raised concerns that it will be used to ration services and heighten government control over health care. Such concerns almost derailed the initiative during passage of the health care reform legislation and are still present today. Given recent investments in CER and the debates surrounding its development, the time is ripe to reflect on past efforts to introduce CER in the United States. This article examines previous initiatives, highlighting their prescribed role in US health care, the reasons for their success or failure, and the political lessons learned. Current CER initiatives have corrected for many of the pitfalls experienced by previous efforts. However, past experiences point to a number of issues that must still be addressed to ensure the long-term success and sustainability of CER, including adopting realistic aims about its impact, demonstrating the impact of Patient-Centered Outcomes Research Institute (PCORI) and communicating the benefits of CER, and maintaining strong political and stakeholder support.

Factors Influencing Science Content Accuracy in Elementary Inquiry Science Lessons

NASA Astrophysics Data System (ADS)

Nowicki, Barbara L.; Sullivan-Watts, Barbara; Shim, Minsuk K.; Young, Betty; Pockalny, Robert

2013-06-01

Elementary teachers face increasing demands to engage children in authentic science process and argument while simultaneously preparing them with knowledge of science facts, vocabulary, and concepts. This reform is particularly challenging due to concerns that elementary teachers lack adequate science background to teach science accurately. This study examined 81 in-classroom inquiry science lessons for preservice education majors and their cooperating teachers to determine the accuracy of the science content delivered in elementary classrooms. Our results showed that 74 % of experienced teachers and 50 % of student teachers presented science lessons with greater than 90 % accuracy. Eleven of the 81 lessons (9 preservice, 2 cooperating teachers) failed to deliver accurate science content to the class. Science content accuracy was highly correlated with the use of kit-based resources supported with professional development, a preference for teaching science, and grade level. There was no correlation between the accuracy of science content and some common measures of teacher content knowledge (i.e., number of college science courses, science grades, or scores on a general science content test). Our study concluded that when provided with high quality curricular materials and targeted professional development, elementary teachers learn needed science content and present it accurately to their students.

The practice of problem-based investigative teaching reform in semiconductor physics course

NASA Astrophysics Data System (ADS)

Chen, Aiping; Wu, Gaojian; Gu, Dawei; Jiang, Hongying; Wang, Lei

2017-08-01

Semiconductor physics is an important basic course for the students of the majors of applied physics, optoelectronics, and microelectronics. The authors have been carrying out investigative-teaching reform in semiconductor physics teaching. Firstly, the teaching content was re-structured based on scientific problems. Secondly, the students were placed in groups to discuss different scientific problems and to present a few short science-reports. Thirdly, micro-lesson videos were produced for the students to study and analyze before or after class. With comparative analysis, we find out that the semiconductor-physics curriculum content was greatly enriched. In addition, the students' learning motivation and scientific thinking ability increased, and their innovation ability was improved. Overall, the teaching quality of the semiconductor physics course could be significantly improved.

Regionalization Lessons from Denmark.

PubMed

Vrangbaek, Karsten

2016-01-01

Denmark is a small Northern European country with an extensive welfare state and a strong commitment to maintaining a universal healthcare system. Like the other countries in the Nordic region, Denmark has a long tradition of democratically governed local and regional governments with extensive responsibilities in organizing welfare state services. The Danish healthcare system has demonstrated an ability to increase productivity, while at the same time maintaining a high level of patient satisfaction. Ongoing reforms have contributed to these results, as well as a firm commitment to innovation and coordination. Regions and municipalities in Denmark are governed by directly elected democratic councils. The Danish case is thus an example of democratic decentralization, but within a framework of national coordination and fiscal control. In spite of the difference in size and historical traditions there are also many similarities between Canada and Denmark, particularly in terms of health and social policy goals and aspirations, and in terms of the commitment to a comprehensive, universal healthcare system. These similarities provide interesting opportunities for comparison.

Positive impact of integrating histology and physiology teaching at a medical school in China.

PubMed

Sherer, Renslow; Wan, Yu; Dong, Hongmei; Cooper, Brian; Morgan, Ivy; Peng, Biwen; Liu, Jun; Wang, Lin; Xu, David

2014-12-01

To modernize its stagnant, traditional curriculum and pedagogy, the Medical School of Wuhan University in China adopted (with modifications) the University of Chicago's medical curriculum model. The reform effort in basic sciences was integrating histology and physiology into one course, increasing the two subjects' connection to clinical medicine, and applying new pedagogies and assessment methods. This study assessed the results of the reform by comparing the attitudes and academic achievements of students in the reform curriculum (n = 41) and their traditional curriculum peers (n = 182). An attitude survey was conducted to obtain students' views of their respective histology and physiology instruction. Survey items covered lectures, laboratory teaching, case analyses and small-group case discussions, assessment of students, and overall quality of the courses and instruction. A knowledge test consisting of questions from three sources was given to measure students' mastery of topics that they had learned. Results showed that reform curriculum students were rather satisfied with their course and new teaching methods in most cases. When these students' attitudes were compared with those of their traditional curriculum peers, several significant differences favoring the reform were identified regarding physiology teaching. No other significant difference was found for physiology or histology teaching. Reform curriculum students outperformed their peers on four of five subcategories of the knowledge test questions. These findings support the benefits of integration and state-of-the-art teaching methods. Our study may offer lessons to medical schools in China and other countries whose medical education is in need of change. Copyright © 2014 The American Physiological Society.

Plants and Photosynthesis: Level III, Unit 3, Lesson 1; The Human Digestive System: Lesson 2; Functions of the Blood: Lesson 3; Human Circulation and Respiration: Lesson 4; Reproduction of a Single Cell: Lesson 5; Reproduction by Male and Female Cells: Lesson 6; The Human Reproductive System: Lesson 7; Genetics and Heredity: Lesson 8; The Nervous System: Lesson 9; The Glandular System: Lesson 10. Advanced General Education Program. A High School Self-Study Program.

ERIC Educational Resources Information Center

Manpower Administration (DOL), Washington, DC. Job Corps.

This self-study program for the high-school level contains lessons in the following subjects: Plants and Photosynthesis; The Human Digestive System; Functions of the Blood; Human Circulation and Respiration; Reproduction of a Single Cell; Reproduction by Male and Female Cells; The Human Reproductive System; Genetics and Heredity; The Nervous…

Conceptual Change and Science Achievement Related to a Lesson Sequence on Acids and Bases among African American Alternative High School Students: A Teacher's Practical Arguments and the Voice of the "Other"

ERIC Educational Resources Information Center

Wood, Lynda Charese

2012-01-01

The study of teaching and learning during the period of translating ideals of reform into classroom practice enables us to understand student-teacher-researcher symbiotic learning. In line with this assumption, the purpose of this study is threefold:(1) observe effects of the "Common Knowledge Construction Model" (CKCM), a conceptual…

Lessons from Burundi’s Security Sector Reform Process

DTIC Science & Technology

2014-11-01

Defense University,Africa Center for Strategic Studies,300 Fifth Avenue, Building 20 Fort McNair,Washington ,DC,20319-5066 8. PERFORMING ORGANIZATION...Fifth Avenue, Building 20 Fort McNair Washington, D.C. 20319-5066 Phone: + 1 202-685-7300 Website: www.africacenter.org AfricA Security briefS Director...Official Complicity and Impunity (New York: Human Rights Watch, March 2010). 4 Louis- Alexandre Berg, “Security Governance and the Recurrence of

Equity in Reform: Case Studies of Five Middle Schools Involved in Systemic Reform

NASA Astrophysics Data System (ADS)

Kahle, Jane Butler; Kelly, Mary Kay

Science and mathematics education reform documents of the last decade have called for improved teaching and learning for all children. To overcome inequalities, a systemic approach to reform has been adopted. The case studies synthesized in this analysis arc part of a larger effort to reform science and mathematics education systemically and assess the progress of systemic reform. The purpose of this study was to assess the progress toward achieving equitable systemic reform in five middle schools. A multiple-case study design was used, and qualitative data were collected. Kahle's Equity Metric was used to analyze the schools' progress toward achieving equitable systemic reform of mathematics and science. Two results occurred: Various equity issues were identified in the five case studies, and the metric proved efficacious in identifying barriers to or facilitators of equitable reform in the schools. Overall, the study illustrates how schools might assess their commitments to providing high-quality science and mathematics education to all students.

Sustaining Reform-Based Science Teaching of Preservice and Inservice Elementary School Teachers

NASA Astrophysics Data System (ADS)

Sullivan-Watts, Barbara K.; Nowicki, Barbara L.; Shim, Minsuk K.; Young, Betty J.

2013-08-01

This study examined the influence of a professional development program based around commercially available inquiry science curricula on the teaching practices of 27 beginning elementary school teachers and their teacher mentors over a 2 year period. A quantitative rubric used to score inquiry elements and use of data in videotaped lessons indicated that education students assigned to inquiry-based classrooms during their methods course or student teaching year outperformed students without this experience. There was also a significant positive effect of multi-year access to the kit-based program on mentor teaching practice. Recent inclusion of a "writing in science" program in both preservice and inservice training has been used to address the lesson element that received lowest scores—evaluation of data and its use in scientific explanation.

Reform of abortion law in Uruguay: context, process and lessons learned.

PubMed

Wood, Susan; Abracinskas, Lilián; Correa, Sonia; Pecheny, Mario

2016-11-01

In October 2012, a new law was approved in Uruguay that allows abortion on demand during the first 12 weeks of pregnancy, 14 weeks in the case of rape, and without a time limit when the woman's health is at risk or in the case of foetal anomalies. This paper analyses this legal reform. It is based on 27 individual and group interviews with key informants, and on review of primary documents and the literature. The factors explaining the reform include: secular values in society, favourable public opinion, a persistent feminist movement, effective coalition building, particular party politics, and a vocal public health sector. The content of the new law reflects the tensions between a feminist perspective of women's rights and public health arguments that stop short of fully recognizing women's autonomy. The Uruguayan reform shows that, even in Latin America, abortion can be addressed politically without electoral cost to the parties that promote it. On the other hand, the prevailing public health rationale and conditionalities built into the law during the negotiation process resulted in a law that cannot be interpreted as a full recognition of women's rights, but rather as a modified protectionist approach that circumscribes women's autonomy. Copyright © 2016 Elsevier Inc. All rights reserved.

System for adding sulfur to a fuel cell stack system for improved fuel cell stability

DOEpatents

Mukerjee, Subhasish [Pittsford, NY; Haltiner, Jr., Karl J; Weissman, Jeffrey G [West Henrietta, NY

2012-03-06

A system for adding sulfur to a fuel cell stack, having a reformer adapted to reform a hydrocarbon fuel stream containing sulfur contaminants, thereby providing a reformate stream having sulfur; a sulfur trap fluidly coupled downstream of the reformer for removing sulfur from the reformate stream, thereby providing a desulfurized reformate stream; and a metering device in fluid communication with the reformate stream upstream of the sulfur trap and with the desulfurized reformate stream downstream of the sulfur trap. The metering device is adapted to bypass a portion of the reformate stream to mix with the desulfurized reformate stream, thereby producing a conditioned reformate stream having a predetermined sulfur concentration that gives an acceptable balance of minimal drop in initial power with the desired maximum stability of operation over prolonged periods for the fuel cell stack.

Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity.

PubMed

Stasse, Stéphanie; Vita, Dany; Kimfuta, Jacques; da Silveira, Valèria Campos; Bossyns, Paul; Criel, Bart

2015-01-01

Comzmercialization of health care has contributed to widen inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo. Between 2008 and 2011, the Belgian development aid agency (BTC) launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalization of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalize the use of resources. The results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country.

Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity

PubMed Central

Stasse, Stéphanie; Vita, Dany; Kimfuta, Jacques; da Silveira, Valèria Campos; Bossyns, Paul; Criel, Bart

2015-01-01

Background Comzmercialization of health care has contributed to widen inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo. Methods and Results Between 2008 and 2011, the Belgian development aid agency (BTC) launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalization of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalize the use of resources. Conclusions The results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country. PMID:25563450

Reforming of natural gas—hydrogen generation for small scale stationary fuel cell systems

NASA Astrophysics Data System (ADS)

Heinzel, A.; Vogel, B.; Hübner, P.

The reforming of natural gas to produce hydrogen for fuel cells is described, including the basic concepts (steam reforming or autothermal reforming) and the mechanisms of the chemical reactions. Experimental work has been done with a compact steam reformer, and a prototype of an experimental reactor for autothermal reforming was tested, both containing a Pt-catalyst on metallic substrate. Experimental results on the steam reforming system and a comparison of the steam reforming process with the autothermal process are given.

Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

PubMed

Zhao, Lue-Ping; Yu, Guo-Pei; Liu, Hui; Ma, Xie-Min; Wang, Jing; Kong, Gui-Lan; Li, Yi; Ma, Wen; Cui, Yong; Xu, Beibei; Yu, Na; Bao, Xiao-Yuan; Guo, Yu; Wang, Fei; Zhang, Jun; Li, Yan; Xie, Xue-Qin; Jiang, Bao-Guo; Ke, Yang

2013-01-01

With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS), cost per day (CPD), inpatient mortality rate (IMR), and length of stay (LOS), using a generalized additive model. There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001), from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role. However, purely market-oriented health-care reform could also misguide future healthcare reform.

Viewpoint: methanol poisoning outbreak in Libya: a need for policy reforms.

PubMed

Taleb, Ziyad Ben; Bahelah, Raed

2014-11-01

We address the controversies surrounding a 2013 outbreak of methanol poisoning in Tripoli, Libya. We critically examine and systematically analyze the outbreak to highlight the lessons learned from this disaster and how to act properly to prevent similar outbreaks in future. Many health problems have been directly attributed to drinking alcohol; the type and quality of alcohol determines the detrimental effects. An unregulated and flourishing black market in alcohol is among the factors behind the Libyan tragedy, where approximately 90 deaths and about 1000 hospital admissions were reported. We reviewed gaps in local and regional alcohol policy, and highlighted the issue of illegally produced and home-made alcohol. Collaboration between countries in the region plus critical health and policy reforms in Libya, with emphasis on public health preparedness, can dramatically decrease morbidity and mortality associated with such outbreaks.

Health care consumerism: incentives, behavior change and uncertainties.

PubMed

Domaszewicz, Sander; Havlin, Linda; Connolly, Susan

2010-01-01

Employers affected by the recession's 2009 peak must press for cost containment in 2010, especially in health care benefits. Encouraging employee consumerism--through consumer-directed health plans and other strategies--can be enhanced by incentives, but federal efforts at health care reform add some element of uncertainty to the consumer-directed solution. This article provides some lessons to guide the course of action for employers considering implementing a consumerist approach to improve employee health and control the cost trend.

Health reform and out-of-pocket payments: lessons from China.

PubMed

Zhang, Lufa; Liu, Nan

2014-03-01

China's ongoing new health reform aims to reduce individual out-of-pocket (OOP) payments for healthcare services. The aim of this article is to analyse the impact of this reform and to draw policy implications. Data are retrieved from the relevant government publications. Polynomial regression models are used to predict future health expenditures. An extensive sensitivity analysis is conducted to investigate the ratios of OOP payments to the total health expenditures (THEs) and to the disposable personal income (DPI) for 2009-11 under different scenarios of cost projections and personal income distributions. Both quantitative and qualitative analyses are carried out to draw conclusions. The ratios of OOP payments to THE and DPI vary significantly across scenarios tested. Only if all committed government investments and social health expenditure are realized can China's new health reform reduce both ratios and achieve its target goals. In particular, the ratio of OOP payments to DPI can also be significantly reduced by improving income distribution. Due to the complicated interplay among different cost components in health expenditures, these two ratios may not change in the same direction, indicating that both need to be examined when evaluating the reform. The new health reform in China aims to alleviate the high OOP payments for healthcare services, but it has not yet been able to reduce both OOP-to-THE and OOP-to-DPI ratios simultaneously. Major reasons include (1) inability of local governments to fulfil their responsible investments due to health finance decentralization and uneven economic development in China and (2) a serious cost inflation in health expenditures coupled with a low level of income distribution. It is suggested that the central government should bear more financial responsibility and assist local governments to fully invest, and should improve individual incomes, in particular for the poor.

Management commitments and primary care: another lesson from Costa Rica for the world?

PubMed

Soors, Werner; De Paepe, Pierre; Unger, Jean-Pierre

2014-01-01

Maintained dedication to primary care has fostered a public health delivery system with exceptional outcomes in Costa Rica. For more than a decade, management commitments have been part of Costa Rican health reform. We assessed the effect of the Costa Rican management commitments on access and quality of care and on compliance with their intended objectives. We constructed seven hypotheses on opinions of primary care providers. Through a mixed qualitative and quantitative approach, we tested these hypotheses and interpreted the research findings. Management commitments consume an excessive proportion of consultation time, inflate recordkeeping, reduce comprehensiveness in primary care consultations, and induce a disproportionate consumption of hospital emergency services. Their formulation relies on norms in need of optimization, their control on unreliable sources. They also affect professionalism. In Costa Rica, management commitments negatively affect access and quality of care and pose a threat to the public service delivery system. The failures of this pay-for-performance-like initiative in an otherwise well-performing health system cast doubts on the appropriateness of pay-for-performance for health systems strengthening in less advanced environments.

Analysis Of The Health Care System Of Pakistan: Lessons Learnt And Way Forward.

PubMed

Kurji, Zohra; Premani, Zahra Shaheen; Mithani, Yasmin

2016-01-01

Pakistani health care system is in progress and since last year, Pakistan has tried to make much improvement in its health care delivery system and has brought out many reforms. A systematic search of national and international literature was looked from peerreviewed databases form MEDLINE, CINAHL, and PubMed. There is little strength in health care delivery system in Pakistan like making health policies, participating in Millennium Development Goals program, initiating vertical programs and introducing Public Private Partnership, improving human resource development and infrastructure by making Basic Health Unit and Rural Health Centres. However, these all programs are very limited in its scope and that is the reason that Pakistan's healthcare system is still not very efficient. There are numerous weaknesses like poor governance, lack of access and unequal resources, poor quality of Health Information Management System, corruption in health system, lack of monitoring in health policy and health planning and lack of trained staff. Pakistan is improving very slowly in the health sector for the last five decades as is evident by its health indicators and above mentioned strengths and weaknesses. Therefore, the Government needs to take strong initiatives to change the current health care system.

Thermal chemical recuperation method and system for use with gas turbine systems

DOEpatents

Yang, W.C.; Newby, R.A.; Bannister, R.L.

1999-04-27

A system and method are disclosed for efficiently generating power using a gas turbine, a steam generating system and a reformer. The gas turbine receives a reformed fuel stream and an air stream and produces shaft power and exhaust. Some of the thermal energy from the turbine exhaust is received by the reformer. The turbine exhaust is then directed to the steam generator system that recovers thermal energy from it and also produces a steam flow from a water stream. The steam flow and a fuel stream are directed to the reformer that reforms the fuel stream and produces the reformed fuel stream used in the gas turbine. 2 figs.

Thermal chemical recuperation method and system for use with gas turbine systems

DOEpatents

Yang, Wen-Ching; Newby, Richard A.; Bannister, Ronald L.

1999-01-01

A system and method for efficiently generating power using a gas turbine, a steam generating system (20, 22, 78) and a reformer. The gas turbine receives a reformed fuel stream (74) and an air stream and produces shaft power and exhaust. Some of the thermal energy from the turbine exhaust is received by the reformer (18). The turbine exhaust is then directed to the steam generator system that recovers thermal energy from it and also produces a steam flow from a water stream. The steam flow and a fuel stream are directed to the reformer that reforms the fuel stream and produces the reformed fuel stream used in the gas turbine.

What can the World Health Organization learn from EU lessons in civil society engagement and participation for health?

PubMed

Battams, Samantha

2014-01-01

This article explores challenges for and the development of civil society engagement and stakeholder representation, transparency, and accountability measures in the European Union, with a specific focus on health policy. The stance of the European Union on stakeholder participation within reform debates of the World Health Organization (WHO) is also considered, along with EU lessons for multi-stakeholders at the WHO. The European Commission has developed a number of measures for stakeholder engagement and transparency; however, the European Union has been prone to lobbying interests and has found difficulty in leading and making accountable the private sector when it comes to achieving its own health policy goals. The strong influence of corporate lobbyists on the European Union has come to light, with concerns about a lack of transparency and accountability in decision-making processes. While the WHO could learn from the European Union in terms of its strategies for stakeholder engagement, it could also heed some of the important lessons for the European Union when it comes to working with a broad range of stakeholders.

Global health security: the wider lessons from the west African Ebola virus disease epidemic

PubMed Central

Heymann, David L; Chen, Lincoln; Takemi, Keizo; Fidler, David P; Tappero, Jordan W; Thomas, Mathew J; Kenyon, Thomas A; Frieden, Thomas R; Yach, Derek; Nishtar, Sania; Kalache, Alex; Olliaro, Piero L; Horby, Peter; Torreele, Els; Gostin, Lawrence O; Ndomondo-Sigonda, Margareth; Carpenter, Daniel; Rushton, Simon; Lillywhite, Louis; Devkota, Bhimsen; Koser, Khalid; Yates, Rob; Dhillon, Ranu S; Rannan-Eliya, Ravi P

2018-01-01

The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. Out of this human calamity has come renewed attention to global health security—its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? In the context of the governance of global health, including WHO reform, it will be important to distil lessons learned from the Ebola outbreak. The Lancet invited a group of respected global health practitioners to reflect on these lessons, to explore the idea of global health security, and to offer suggestions for next steps. Their contributions describe some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed. Their common goal is a more sustainable and resilient society for human health and wellbeing. PMID:25987157

Steam Methane Reformation Testing for Air-Independent Solid Oxide Fuel Cell Systems

NASA Technical Reports Server (NTRS)

Mwara, Kamwana N.

2015-01-01

Recently, NASA has been looking into utilizing landers that can be propelled by LOX-CH (sub 4), to be used for long duration missions. Using landers that utilize such propellants, also provides the opportunity to use solid oxide fuel cells as a power option, especially since they are able to process methane into a reactant through fuel reformation. One type of reformation, called steam methane reformation, is a process to reform methane into a hydrogen-rich product by reacting methane and steam (fuel cell exhaust) over a catalyst. A steam methane reformation system could potentially use the fuel cell's own exhaust to create a reactant stream that is hydrogen-rich, and requires less internal reforming of the incoming methane. Also, steam reformation may hold some advantages over other types of reforming, such as partial oxidation (PROX) reformation. Steam reformation does not require oxygen, while up to 25 percent can be lost in PROX reformation due to unusable CO (sub 2) reformation. NASA's Johnson Space Center has conducted various phases of steam methane reformation testing, as a viable solution for in-space reformation. This has included using two different types of catalysts, developing a custom reformer, and optimizing the test system to find the optimal performance parameters and operating conditions.

Exploring the interaction of personal and contextual factors during the induction period of science teachers and how this interaction shapes their enactment of science reform

NASA Astrophysics Data System (ADS)

Saka, Yavuz

The first years of teaching are demanding as the novice works to gain a degree of familiarity in her/his professional work. It is during this period that many teachers decide to leave the teaching profession or move away from the reform-minded beliefs and practices acquired during their teacher preparation programs. To understand what happens during induction requires a focus on both the cognitive and contextual issues related to science teaching. The goal of this qualitative, multi-case study was to describe the induction experiences of two reform-minded first year science teachers and the strategies they used to negotiate contradictions embedded the context of schooling. Using the frame of Cultural Historical Activity Theory, in this research I focused on changes in science teachers' personal and professional identities, self-efficacy and pedagogical discontentment, the manner in which these factors shaped science teaching practices, and beliefs and practices shaped and were shaped by the context of the novices' work. Data included a year of participant observations, surveys, open-ended questionnaires, interviews, classroom observations, and mediating artifacts such as lesson plans and assignments. Identities and dispositions of these teachers played significant role their attempts to become competent members of their school communities, attempts that influenced and were influenced by their teaching self-efficacy and pedagogical discontentment. Mild contradictions in the system allowed for the refinement of reform-minded science teaching practices, while extreme contradictions in the system served to change one teacher's goals and prevented his successful enactment of science education reform. Findings indicated that the successful enactment of reform-minded practice depends not just on contextual factors related to schools, or just on individual factors associated with science teaching. Instead, personal and contextual factors interact to shape a novice's first year experience. This research also demonstrated that participation in a professional community that both acknowledges the strengths novices bring into the community and recognizes the support novices need is essential if novices are to become successful members of a community of practice. One implication of this research is the need to move beyond a singular focus on science teaching and learning in teacher education programs to include an exploration of the affective and professional aspects of teaching. Because this research points to the important role professional development communities play in the development of reform minded science teachers, a second implication of this research is that teacher preparation programs should include a close examination of the role and importance of communities in a teacher's initial success and long term development. Clearly disbanding the professional community constructed throughout a preservice experience upon graduation is artificial and counterproductive. Instead, induction programs that include some members of the preservice science teacher's community may be invaluable for providing support, recognition, and critical lens needed for novices to examine their work as they move into schools as professionals engaged in practice of reform-based science teaching.

Systemic Reform: Defining Education in the '90s.

ERIC Educational Resources Information Center

Wasser, Judith Davidson

1998-01-01

Focuses on systemic reform with regard to standards and equity. Emphasizes the places of technology and curriculum in this reform. Concludes that bringing together different players in the educational system to help change practice and support new educational goals is a common goal of many reform efforts. (ASK)

Outline Guide to Educational Reform Initiatives. ERS Research Digest.

ERIC Educational Resources Information Center

Educational Research Service, Arlington, VA.

Many educational reform initiatives are being tried in an effort to restructure the American school system. This guide compares major educational reform efforts by goal, vision, teaching and learning, and system components. The first section of the guide covers major systemic educational reform initiatives, including Accelerated Schools Project,…

The equity impact of the universal coverage policy: lessons from Thailand.

PubMed

Prakongsai, Phusit; Limwattananon, Supon; Tangcharoensathien, Viroj

2009-01-01

This chapter assesses health equity achievements of the Thai health system before and after the introduction of the universal coverage (UC) policy. It examines five dimensions of equity: equity in financial contributions, the incidence of catastrophic health expenditure, the degree of impoverishment as a result of household out-of-pocket payments for health, equity in health service use and the incidence of public subsidies for health. The standard methods proposed by O'Donnell, van Doorslaer, and Wagstaff (2008b) were used to measure equity in financial contribution, healthcare utilization and public subsidies, and in assessing the incidence of catastrophic health expenditure and impoverishment. Two major national representative household survey datasets were used: Socio-Economic Surveys and Health and Welfare Surveys. General tax was the most progressive source of finance in Thailand. Because this source dominates total financing, the overall outcome was progressive, with the rich contributing a greater share of their income than the poor. The low incidence of catastrophic health expenditure and impoverishment before UC was further reduced after UC. Use of healthcare and the distribution of government subsidies were both pro-poor: in particular, the functioning of primary healthcare (PHC) at the district level serves as a "pro-poor hub" in translating policy into practice and equity outcomes. The Thai health financing reforms have been accompanied by nationwide extension of PHC coverage, mandatory rural health service by new graduates and systems redesign, especially the introduction of a contracting model and closed-ended provider payment methods. Together, these changes have led to a more equitable and more efficient health system. Institutional capacity to generate evidence and to translate it into policy decisions, effective implementation and comprehensive monitoring and evaluation are essential to successful system-level reforms.

Quality assurance guides health reform in Jordan.

PubMed

Abubaker, W; Abdulrahman, M

1996-01-01

In November 1995, a World Bank mission went to Jordan to conduct a study of the health sector. The study recommended three strategies to reform the health sector: decentralization of Ministry of Health (MOH) management; improvement of clinical practices, quality of care, and consumer satisfaction; and adoption of treatment protocols and standards. The MOH chose quality assurance (QA) methods and quality management (QM) techniques to accomplish these reforms. The Monitoring and QA Directorate oversees QA applications within MOH. It also institutes and develops the capacity of local QA units in the 12 governorates. The QA units implement and monitor day-to-day QA activities. The QM approach encompasses quality principles: establish objectives; use a systematic approach; teach lessons learned and applicable research; use QA training to teach quality care, quality improvement, and patient satisfaction; educate health personnel about QM approaches; use assessment tools and interviews; measure the needs and expectations of local health providers and patients; ensure feedback on QA improvement projects; ensure valid and reliable data; monitor quality improvement efforts; standardize systemic data collection and outcomes; and establish and disseminate QA standards and performance improvement efforts. The Jordan QA Project has helped with the successful institutionalization of a QA system at both the central and local levels. The bylaws of the QA councils and committees require team participation in the decision-making process. Over the last two years, the M&QA Project has adopted 21 standards for nursing, maternal and child health care centers, pharmacies, and medications. The Balqa pilot project has developed 44 such protocols. Quality improvement (COUGH) studies have examined hyper-allergy, analysis of patient flow rate, redistribution of nurses, vaccine waste, and anemic pregnant women. There are a considerable number of on-going clinical and non-clinical COUGH studies. Four epidemiological studies are examining maternal mortality, causes of death, morbidity, and perinatal mortality.

Managed care: the US experience.

PubMed Central

Sekhri, N. K.

2000-01-01

This article provides an overview of managed health care in the USA--what has been achieved and what has not--and some lessons for policy-makers in other parts of the world. Although the backlash by consumers and providers makes the future of managed care in the USA uncertain, the evidence shows that it has had a positive effect on stemming the rate of growth of health care spending, without a negative effect on quality. More importantly, it has spawned innovative technologies that are not dependent on the US market environment, but can be applied in public and private systems globally. Active purchasing tools that incorporate disease management programmes, performance measurement report cards, and alignment of incentives between purchasers and providers respond to key issues facing health care reform in many countries. Selective adoption of these tools may be even more relevant in single payer systems than in the fragmented, voluntary US insurance market where they can be applied more systematically with lower transaction costs and where their effects can be measured more precisely. PMID:10916920

From community-based pilot testing to region-wide systems change: lessons from a local quality improvement collaborative.

PubMed

Keyser, Donna J; Pincus, Harold Alan

2010-01-01

A community-based collaborative conducted a 2-year pilot study to inform efforts for improving maternal and child health care practice and policy in Allegheny County, Pennsylvania. (1) To test whether three small-scale versions of an evidence-based, systems improvement approach would be workable in local community settings and (2) to identify specific policy/infrastructure reforms for sustaining improvements. A mixed methods approach was used, including quantitative performance measurement supplemented with qualitative data about factors related to outcomes of interest, as well as key stakeholder interviews and a literature review/Internet search. Quantitative performance results varied; qualitative data revealed critical factors for the success and failure of the practices tested. Policy/infrastructure recommendations were developed to address specific practice barriers. This information was important for designing a region-wide quality improvement initiative focused on maternal depression. The processes and outcomes provide valuable insights for other communities interested in conducting similar quality improvement initiatives.

Mental health services commissioning and provision: Lessons from the UK?

PubMed

Ikkos, G; Sugarman, Ph; Bouras, N

2015-01-01

The commissioning and provision of healthcare, including mental health services, must be consistent with ethical principles - which can be summarised as being "fair", irrespective of the method chosen to deliver care. They must also provide value to both patients and society in general. Value may be defined as the ratio of patient health outcomes to the cost of service across the whole care pathway. Particularly in difficult times, it is essential to keep an open mind as to how this might be best achieved. National and regional policies will necessarily vary as they reflect diverse local histories, cultures, needs and preferences. As systems of commissioning and delivering mental health care vary from country to country, there is the opportunity to learn from others. In the future international comparisons may help identify policies and systems that can work across nations and regions. However a persistent problem is the lack of clear evidence over cost and quality delivered by different local or national models. The best informed economists, when asked about the international evidence do not provide clear answers, stating that it depends how you measure cost and quality, the national governance model and the level of resources. The UK has a centrally managed system funded by general taxation, known as the National Health Service (NHS). Since 2010, the UK's new Coalition* government has responded by further reforming the system of purchasing and providing NHS services - aiming to strengthen choice and competition between providers on the basis of quality and outcomes as well as price. Although the present coalition government's intention is to maintain a tax-funded system, free at the point of delivery, introducing market-style purchasing and provider-side reforms to encompass all of these bring new risks, whilst not pursuing reforms of a system in crisis is also seen to carry risks. Competition might bring efficiency, but may weaken cooperation between providers, and transparency too. On the other hand, it is hard to implement necessary governance and control without worsening bureaucracy and inefficiency. The pursuit of market efficiencies has been particularly contentious in mental health care, where many professionals are defensive about the risks to vulnerable patients and to traditional ways of professional working. Developments and debates in the UK may be instructive for others. We conclude this paper with a set of questions that may help inform debate and evaluation of mental health services internationally.

Metric System Unit.

ERIC Educational Resources Information Center

Maggi, Gayle J. B.

Thirty-six lessons for introducing the metric system are outlined. Appropriate grade level is not specified. The metric lessons suggested include 13 lessons on length, 7 lessons on mass, 11 lessons on capacity, and 5 lessons on temperature. Each lesson includes a list of needed materials, a statement of the lesson purpose, and suggested…

Supporting Beginning Teacher Planning and Enactment of Investigation-based Science Discussions: The Design and Use of Tools within Practice-based Teacher Education

NASA Astrophysics Data System (ADS)

Kademian, Sylvie M.

Current reform efforts prioritize science instruction that provides opportunities for students to engage in productive talk about scientific phenomena. Given the challenges teachers face enacting instruction that integrates science practices and science content, beginning teachers need support to develop the knowledge and teaching practices required to teach reform-oriented science lessons. Practice-based teacher education shows potential for supporting beginning teachers while they are learning to teach in this way. However, little is known about how beginning elementary teachers draw upon the types of support and tools associated with practice-based teacher education to learn to successfully enact this type of instruction. This dissertation addresses this gap by investigating how a practice-based science methods course using a suite of teacher educator-provided tools can support beginning teachers' planning and enactment of investigation-based science lessons. Using qualitative case study methodologies, this study drew on video-records, lesson plans, class assignments, and surveys from one cohort of 22 pre-service teachers (called interns in this study) enrolled in a year-long elementary education master of the arts and teaching certification program. Six focal interns were also interviewed at multiple time-points during the methods course. Similarities existed across the types of tools and teaching practices interns used most frequently to plan and enact investigation-based discussions. For the focal interns, use of four synergistic teaching practices throughout the lesson enactments (including consideration of students' initial ideas; use of open-ended questions to elicit, extend, and challenge ideas; connecting across students' ideas and the disciplinary core ideas; and use of a representation to organize and highlight students' ideas) appeared to lead to increased opportunities for students to share their ideas and engage in data analysis, argumentation and explanation construction. Student opportunities to engage in practices that prioritize scientific discourse also occurred when interns were using dialogic voice and the tools designed to foster development of teacher knowledge for facilitating investigation-based science discussions. However, several intern characteristics likely moderated or mediated intern use of tools, dialogic voice, and productive teaching practices to capitalize on student contributions. These characteristics included intern knowledge of the science content and practices and initial beliefs about science teaching. Missed opportunities to use a combination of several teaching practices and tools designed to foster the development of knowledge for science teaching resulted in fewer opportunities for students to engage in data analysis, argumentation based on evidence, and construction of scientific explanations. These findings highlight the potential of teacher-educator provided tools for supporting beginning teachers in learning to facilitate investigation-based discussions that capitalize on student contributions. These findings also help the field conceptualize how beginning teachers use tools and teaching practices to plan and enact investigation-based science lessons, and how intern characteristics relate to tool use and planned and enacted lessons. By analyzing the investigation-based science lessons holistically, this study begins to unpack the complexities of facilitating investigation-based discussions including the interplay between intern characteristics and tool use, and the ways intern engagement in synergistic teaching practices provide opportunities for students to engage in data analysis, explanation construction, and argumentation. This study also describes methodological implications for this type of whole-lesson analysis and comments on the need for further research investigating beginning teachers' use of tools over time. Finally, I propose the need for iterative design of scaffolds to further support beginning teacher facilitation of investigation-based science lessons.

Reconceptualised life skills in secondary education in the African context: Lessons learnt from reforms in Ghana

NASA Astrophysics Data System (ADS)

Akyeampong, Kwame

2014-04-01

Early notions of life skills in Africa did not take into account the importance of a flexible and portable set of skills that would enable youth to adapt to changes in the world of work and lay the foundations for productive well-being and behaviour. Rather, life skills education in many secondary education curricula in Africa started with an emphasis on developing specific technical vocational skills considered essential for employability or self-employment. Using Ghana as an example, this paper shows how secondary education curriculum reformers recommended shifts that embraced a new interpretation of life skills focused on 21st-century skills. This gradual move also reflected the difficulty that secondary education in general has had in networking with the world of work to provide work experience that would lead to the development of work-related skills and enhance employability. The author's main argument is that although the reconceptualisation of life skills in secondary education to reflect 21st-century skills is a welcome shift in the African context, this needs to be accompanied by reforms in teacher education. Classroom teaching and learning need to be adapted in a fundamental way in order to ensure that youth fully benefit from the inclusion of 21st-century life skills in secondary education curricula. Such reforms must include pedagogical practices which nurture communication, collaboration, creativity and critical thinking skills.

Reforming Districts: How Districts Support School Reform. A Research Report. Document R-03-6

ERIC Educational Resources Information Center

McLaughlin, Milbrey; Talbert, Joan

2003-01-01

School districts have participated in multiple rounds of education reform activity in the past few decades, yet few have made headway on system-wide school improvement. This paper addresses the questions of whether districts matter for school reform progress and what successful "reforming" districts do to achieve system change and to…

Urban simulation and gaming: Preliminary experience and perspectives, appendix F

NASA Technical Reports Server (NTRS)

Shostak, A. B.

1973-01-01

A three-month summer study of gaming, as applied to urban problems, was conducted. The results of the study are presented along with a series of recommendations aimed at guiding the warranted efforts of others to further explore the application of scientific gaming to the solution of some of America's urban problems. Three main topics are considered and are discussed in depth. These include: (1) gaming and urbanology, (2) methodology and lessons, and (3) reforms in the Cities Game.

Assessing a Suitable Contribution of the French Armor Branch to the Doctrinal Development of Violence: Mastering Operations in the Urban Environment

DTIC Science & Technology

2003-06-06

France : New Defense for a New Millennium,” Parameters, winter 1996-87, 99-108. 17George A. Bloch, “ French Military Reform: Lessons for America’s Army...ASSESSING A SUITABLE CONTRIBUTION OF THE FRENCH ARMOR BRANCH TO THE DOCTRINAL DEVELOPMENT OF VIOLENCE: MASTERING OPERATIONS IN THE URBAN ENVIRONMENT...MILITARY ART AND SCIENCE General Studies by Jean-Michel Millet, MAJ, FRENCH ARMY BTEMG, Paris, 2002 Fort Leavenworth, Kansas 2003 Approved for

How primary care reforms influenced health indicators in Manisa district in Turkey: Lessons for general practitioners.

PubMed

Cevik, Celalettin; Sozmen, Kaan; Kilic, Bulent

2018-12-01

Turkish health reforms began in 2003 and brought some significant changes in primary care services. Few studies in Turkey compare the shift from health centres (HC) to family physicians (FP) approach, which was initiated by reforms. This study compares health status indicators during the HC period before reforms (2003-2007) and the FP period after reforms (2008-2012) in Turkey. This study encompasses time series data consisting of the results of a 10-year assessment (2003-2012) in Manisa district. All the data were obtained electronically and by month. The intersection points of the regression curves of these two periods and the beta coefficients were compared using segmented linear regression analysis. The mean number of follow-up per person/year during the HC period in infants (10.5), pregnant women (6.6) and women (1.8) was significantly higher than the mean number of follow-up during the FP period in infants (6.7), pregnant women (5.6) and women (0.9). Rates of BCG and measles vaccinations were significantly higher during the FP period; however, rates of HBV and DPT were same. The mean number of outpatient services per person/year during the FP period (3.3) was significantly higher than HC period (2.8). Within non-communicable diseases, no difference was detected for hypertension prevalence. Within communicable diseases, there was no difference for rabies suspected bites but acute haemorrhagic gastroenteritis significantly decreased. The infant mortality rate and under five-year child mortality rate significantly increased during the FP period. Primary care services should be reorganized and integrated with public health services.

System for adding sulfur to a fuel cell stack system for improved fuel cell stability

DOEpatents

Mukerjee, Subhasish; Haltiner, Jr., Karl J; Weissman, Jeffrey G

2013-08-13

A system for adding sulfur to a reformate stream feeding a fuel cell stack, having a sulfur source for providing sulfur to the reformate stream and a metering device in fluid connection with the sulfur source and the reformate stream. The metering device injects sulfur from the sulfur source to the reformate stream at a predetermined rate, thereby providing a conditioned reformate stream to the fuel cell stack. The system provides a conditioned reformate stream having a predetermined sulfur concentration that gives an acceptable balance of minimal drop in initial power with the desired maximum stability of operation over prolonged periods for the fuel cell stack.

Mechanisms Affecting the Sustainability and Scale-up of a System-Wide Numeracy Reform

ERIC Educational Resources Information Center

Bobis, Janette

2011-01-01

With deliberate system-level reform now being acted upon around the world, both successful and unsuccessful cases provide a rich source of knowledge from which we can learn to improve large-scale reform. Research surrounding the effectiveness of a theory-based system-wide numeracy reform operating in primary schools across Australia is examined to…

From Toyota to the bedside: nurses can lead the lean way in health care reform.

PubMed

Johnson, Joyce E; Smith, Amy L; Mastro, Kari A

2012-01-01

The advent of health care reform means new pressures on American hospitals, which will be forced to do more with less. In the next decade, increased use of "Lean" principles and practices in hospitals can create real value by reducing waste and improving productivity, costs, quality, and the timely delivery of patient care services. In 2010, the Institute of Medicine recommended that nurses lead collaborative quality improvement efforts and assume a major role in redesigning health care in the United States. In this article, we provide an overview of the use of Lean techniques in health care and 2 case studies of successful, nurse-directed Lean initiatives at the Robert Wood Johnson University Hospital. The article concludes with some lessons we have learned and implications for nursing education in the future that must include the concepts, tools, and skills required for adapting Lean to the patient care environment.

Reviews Website: Online Graphing Calculator Video Clip: Learning From the News Phone App: Graphing Calculator Book: Challenge and Change: A History of the Nuffield A-Level Physics Project Book: SEP Sound Book: Reinventing Schools, Reforming Teaching Book: Physics and Technology for Future Presidents iPhone App: iSeismometer Web Watch

NASA Astrophysics Data System (ADS)

2011-01-01

WE RECOMMEND Online Graphing Calculator Calculator plots online graphs Challenge and Change: A History of the Nuffield A-Level Physics Project Book delves deep into the history of Nuffield physics SEP Sound Booklet has ideas for teaching sound but lacks some basics Reinventing Schools, Reforming Teaching Fascinating book shows how politics impacts on the classroom Physics and Technology for Future Presidents A great book for teaching physics for the modern world iSeismometer iPhone app teaches students about seismic waves WORTH A LOOK Teachers TV Video Clip Lesson plan uses video clip to explore new galaxies Graphing Calculator App A phone app that handles formulae and graphs WEB WATCH Physics.org competition finds the best websites

The reform of home care services in Ontario: opportunity lost or lesson learned?

PubMed

Randall, Glen

2007-06-01

With the release of the Romanow Commission report, Canadian governments are poised to consider the creation of a national home care program. If occupational and physical therapists are to have input in shaping such a program, they will need to learn from lost opportunities of the past. This paper provides an overview of recent reforms to home care in Ontario with an emphasis on rehabilitation services. Data were collected from documents and 28 key informant interviews with rehabilitation professionals. Home care in Ontario has evolved in a piecemeal manner without rehabilitation professionals playing a prominent role in program design. Rehabilitation services play a critical role in facilitating hospital discharges, minimizing readmissions, and improving the quality of peoples' lives. Canadians will benefit if occupational and physical therapists seize the unique opportunity before them to provide meaningful input into creating a national home care program.

Technology in military strategy: a realistic assessment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sanders, R.

1983-01-01

Today the Military Reform Movement strongly criticizes the United States military for being mesmerized by technology to the detriment of other, including human, factors. Only in this century have writers given great attention to war technologies. In contrast to strategic thinkers like Sun-Tsu, Machiavelli, Clausewitz, Moltke, and Mahan, post-World War I theorists like fuller, Liddell Hart, Douhet, and Mitchell made technology a key to their strategic concepts. Nuclear war theorists like Brodie, Kahn, and Wohlstetter made technology a centrality, while limited war theorists like Osgood and Kissinger gave it considerable, but less, stress. The reformers place more weight on tehmore » art of using military forces than on weapons, emphasizing mobility and historical lessons, rather than technology. Nuclear war theories rely too heavily on technological dimensions to expect a shift. Somewhat more attention could profitably be paid to nontechnological aspects of conventional war, but any violent pendulum swing should be avoided.« less

Innovations In Diabetes Care Around the World: Case Studies Of Care Transformation Through Accountable Care Reforms.

PubMed

Thoumi, Andrea; Udayakumar, Krishna; Drobnick, Elizabeth; Taylor, Andrea; McClellan, Mark

2015-09-01

The rising prevalence, health burden, and cost of chronic diseases such as diabetes have accelerated global interest in innovative care models that use approaches such as community-based care and information technology to improve or transform disease prevention, diagnosis, and treatment. Although evidence on the effectiveness of innovative care models is emerging, scaling up or extending these models beyond their original setting has been difficult. We developed a framework to highlight policy barriers-institutional, regulatory, and financial-to the diffusion of transformative innovations in diabetes care. The framework builds on accountable care principles that support higher-value care, or better patient-level outcomes at lower cost. We applied this framework to three case studies from the United States, Mexico, and India to describe how innovators and policy leaders have addressed barriers, with a focus on important financing barriers to provider and consumer payment. The lessons have implications for policy reform to promote innovation through new funding approaches, institutional reforms, and performance measures with the goal of addressing the growing burdens of diabetes and other chronic diseases. Project HOPE—The People-to-People Health Foundation, Inc.

Coaches as System Leaders

ERIC Educational Resources Information Center

Fullan, Michael; Knight, Jim

2011-01-01

The role of school leadership--of principals and coaches--must be played out on a systems level to get widespread and sustainable improvement. Successful, whole-system education reform relies on capacity building, teamwork, pedagogy, and systemic reform. The strategies of good coaches and the right drivers for whole-system reform go hand in hand.…

Violence against women and the Millennium Development Goals: facilitating women's access to support.

PubMed

Ellsberg, M

2006-09-01

Violence against women is a serious health and development concern, as well as a violation of women's human rights. Violence against women has a devastating effect on women's sexual and reproductive health, as well as the health of their children, and is rooted in gender inequality. Reducing violence against women is therefore a key strategy for the achievement of the Millennium Development Goals. Key lessons have emerged from more than two decades of experiences dealing with violence against women within the health sector. Interventions must go beyond training and curricula reform and utilize a system-wide approach, including changes in policies, procedures and attention to privacy and confidentiality. Providers must work together with other sectors, particularly at a community level, to strengthen local networks for support of survivors of violence. Prevention activities are critical, particularly those that seek to change cultural norms and laws that encourage violence and discriminate against women and girls.

Lessons learned from a history of perseverance and innovation in academic-practice partnerships.

PubMed

Libster, Martha Mathews

2011-01-01

Nurse leaders today are faced with a pressing concern to reevaluate established community resources and models for academic-practice partnerships that have been used in the preparation of new and advanced practice nurses. Nursing reform in education and practice is not achieved as a simple series of decisions in the present moment with future direction as its object. It is a process in which the outcome is ultimately evaluated within the context of history. Academic-practice partnerships are part of a nursing heritage that has persevered for hundreds of years. This article is a brief synopsis of examples from the historical records that evidence the lessons learned from the experiences of nurses who have formed innovative academic-practice partnerships with religious communities, medical colleges and physicians, government, hospitals, institutions of higher learning, and nursing organizations. Copyright © 2011 Elsevier Inc. All rights reserved.

California's Proposition 186: lessons from a single-payer health care reform ballot initiative campaign.

PubMed

Farey, K; Lingappa, V R

1996-01-01

Proposition 186 was an initiative on the November 1994 California ballot which proposed to establish a state single-payer health care program. Although Prop 186 was overwhelmingly defeated in the November 1994 election (73% No, 27% Yes), it accomplished many things. Model legislation was developed showing the feasibility of a specific single-payer program for California. It was placed on the ballot by an unprecedented volunteer signature-gathering effort and was the largest grassroots political campaign fund-raising effort in California history. A novel strategy for the discussion of complex issues through 1500 house parties was launched. Prop 186 was defeated by an insurance industry-led coalition with an anti-government message. Lessons for future efforts include increasing the size and duration of the grassroots organizing and educational effort, and decreasing reliance on conventional political campaign tactics and the mainstream media.

Emerging Lessons From Regional and State Innovation in Value-Based Payment Reform: Balancing Collaboration and Disruptive Innovation

PubMed Central

Conrad, Douglas A; Grembowski, David; Hernandez, Susan E; Lau, Bernard; Marcus-Smith, Miriam

2014-01-01

Policy Points: Public and private purchasersmust create a "burning bridge" of countervailing pressure that signals "no turning back" to fee-for-service in order to sustain the momentum for value-based payment. Multi-stakeholder coalitions must establish a defined set of quality, outcomes, and cost performance measures and the interoperable information systems to support data collection and reporting of value-based payment schemes. Anti-trust vigilance is necessary to find the "sweet spot" of competition and cooperation among health plans and health care providers. Provider and health plan transparency of price and quality, supported by all-payer claims data, are critical in driving value-based payment innovation and cost constraint. Context In recent decades, practitioners and policymakers have turned to value-based payment initiatives to help contain spending on health care and to improve the quality of care. The Robert Wood Johnson Foundation funded 7 grantees across the country to design and implement value-based, multistakeholder payment reform projects in 6 states and 3 regions of the United States. Methods As the external evaluator of these projects, we reviewed documents, conducted Internet searches, interviewed key stakeholders, cross-validated factual and narrative interpretation, and performed qualitative analyses to derive cross-site themes and implications for policy and practice. Findings The nature of payment reform and its momentum closely reflects the environmental context of each project. Federal legislation such as the Patient Protection and Affordable Care Act and federal and state support for the development of the patient-centered medical home and accountable care organizations encourage value-based payment innovation, as do local market conditions for payers and providers that combine a history of collaboration with independent innovation and experimentation by individual organizations. Multistakeholder coalitions offer a useful facilitating structure for galvanizing payment reform. But to achieve the objectives of reduced cost and improved quality, multistakeholder payment innovation must overcome such barriers as incompatible information systems, the technical difficulties and transaction costs of altering existing billing and payment systems, competing stakeholder priorities, insufficient scale to bear population health risk, providers’ limited experience with risk-bearing payment models, and the failure to align care delivery models with the form of payment. Conclusions From the evidence adduced in this article, multistakeholder, value-based payment reform requires a trusted, widely respected “honest broker” that can convene and maintain the ongoing commitment of health plans, providers, and purchasers. Change management is complex and challenging, and coalition governance requires flexibility and stable leadership, as market conditions and stakeholder engagement and priorities shift over time. Another significant facilitator of value-based payment reform is outside investment that enables increased investment in human resources, information infrastructure, and care management by provider organizations and their collaborators. Supportive community and social service networks that enhance population health management also are important enablers of value-based payment reform. External pressure from public and private payers is fueling a “burning bridge” between the past of fee-for-service payment models and the future of payments based on value. Robust competition in local health plan and provider markets, coupled with an appropriate mix of multistakeholder governance, pressure from organized purchasers, and regulatory oversight, has the potential to spur value-based payment innovation that combines elements of “reformed” fee-for-service with bundled payments and global payments. PMID:25199900

Historical problem areas: Lessons learned for expendable and reusable vehicle propulsion systems

NASA Technical Reports Server (NTRS)

Fester, Dale A.

1991-01-01

The following subject areas are covered: expendable launch vehicle lessons learned, upper stage/transfer vehicle lessons learned, shuttle systems - reuse, and reusable system issues and lessons learned.

Reforming the American Military Officer Personnel System: Addendum: Thoughts on Contractors

DTIC Science & Technology

2016-05-24

Testimony Reforming the American Military Officer Personnel System Addendum: Thoughts on Contractors Bernard D. Rostker CT-446/1 Document...1 Reforming the American Military Officer Personnel System Addendum: Thoughts on Contractors Testimony of Bernard D. Rostker 1 The RAND...Reform and Strengthening the All-Volunteer Force” on December 2, 2015, comment on the need to understand when contractors are being utilized and

Health system reform.

PubMed

Ortolon, Ken

2009-06-01

A vote on reforming the nation's health care system seems likely this summer as President Obama makes good on a campaign pledge. Although the Democratic leadership in Congress appears ready to push through reform legislation before the next election, TMA and AMA leaders say very little is known about what that "reform" likely will look like.

Engineering Lessons Learned and Systems Engineering Applications

NASA Technical Reports Server (NTRS)

Gill, Paul S.; Garcia, Danny; Vaughan, William W.

2005-01-01

Systems Engineering is fundamental to good engineering, which in turn depends on the integration and application of engineering lessons learned and technical standards. Thus, good Systems Engineering also depends on systems engineering lessons learned from within the aerospace industry being documented and applied. About ten percent of the engineering lessons learned documented in the NASA Lessons Learned Information System are directly related to Systems Engineering. A key issue associated with lessons learned datasets is the communication and incorporation of this information into engineering processes. Systems Engineering has been defined (EINIS-632) as "an interdisciplinary approach encompassing the entire technical effort to evolve and verify an integrated and life-cycle balanced set of system people, product, and process solutions that satisfy customer needs". Designing reliable space-based systems has always been a goal for NASA, and many painful lessons have been learned along the way. One of the continuing functions of a system engineer is to compile development and operations "lessons learned" documents and ensure their integration into future systems development activities. They can produce insights and information for risk identification identification and characterization. on a new project. Lessons learned files from previous projects are especially valuable in risk

Control of autothermal reforming reactor of diesel fuel

NASA Astrophysics Data System (ADS)

Dolanc, Gregor; Pregelj, Boštjan; Petrovčič, Janko; Pasel, Joachim; Kolb, Gunther

2016-05-01

In this paper a control system for autothermal reforming reactor for diesel fuel is presented. Autothermal reforming reactors and the pertaining purification reactors are used to convert diesel fuel into hydrogen-rich reformate gas, which is then converted into electricity by the fuel cell. The purpose of the presented control system is to control the hydrogen production rate and the temperature of the autothermal reforming reactor. The system is designed in such a way that the two control loops do not interact, which is required for stable operation of the fuel cell. The presented control system is a part of the complete control system of the diesel fuel cell auxiliary power unit (APU).

Next generation of individual account pension reforms in Latin America.

PubMed

Kritzer, Barbara E; Kay, Stephen J; Sinha, Tapen

2011-01-01

Latin America led the world in introducing individual retirement accounts intended to complement or replace defined benefit state-sponsored, pay-as-you-go systems. After Chile implemented the first system in 1981, a number of other Latin American countries incorporated privately managed individual accounts as part of their retirement income systems beginning in the 1990s. This article examines the subsequent "reform of the reform" of these pension systems, with a focus on the recent overhaul of the Chilean system and major reforms in Mexico, Peru, and Colombia. The authors analyze key elements of pension reform in the region relating to individual accounts: system coverage, fees, competition, investment, the impact of gender on benefits, financial education, voluntary savings, and payouts.

Strengthening health systems by health sector reforms.

PubMed

Senkubuge, Flavia; Modisenyane, Moeketsi; Bishaw, Tewabech

2014-01-01

The rising burden of disease and weak health systems are being compounded by the persistent economic downturn, re-emerging diseases, and violent conflicts. There is a growing recognition that the global health agenda needs to shift from an emphasis on disease-specific approaches to strengthening of health systems, including dealing with social, environmental, and economic determinants through multisectoral responses. A review and analysis of data on strengthening health sector reform and health systems was conducted. Attention was paid to the goal of health and interactions between health sector reforms and the functions of health systems. Further, we explored how these interactions contribute toward delivery of health services, equity, financial protection, and improved health. Health sector reforms cannot be developed from a single global or regional policy formula. Any reform will depend on the country's history, values and culture, and the population's expectations. Some of the emerging ingredients that need to be explored are infusion of a health systems agenda; development of a comprehensive policy package for health sector reforms; improving alignment of planning and coordination; use of reliable data; engaging 'street level' policy implementers; strengthening governance and leadership; and allowing a holistic and developmental approach to reforms. The process of reform needs a fundamental rather than merely an incremental and evolutionary change. Without radical structural and systemic changes, existing governance structures and management systems will continue to fail to address the existing health problems.

Determining Capacity within Systemic Educational Reform.

ERIC Educational Resources Information Center

Century, Jeanne Rose

The idea of "capacity" is particularly important in the reform of educational systems because the system can be both the initiator and the subject of change. In fact, the requirement for capacity is present at all levels of the system in systemic reform. In educational change, four types of capacity are generally considered: (1) human…

Activity Structures and the Unfolding of Problem-Solving Actions in High-School Chemistry Classrooms

NASA Astrophysics Data System (ADS)

Criswell, Brett A.; Rushton, Greg T.

2014-02-01

In this paper, we argue for a more systematic approach for studying the relationship between classroom practices and scientific practices—an approach that will likely better support the systemic reforms being promoted in the Next Generation Science Standards in the USA and similar efforts in other countries. One component of that approach is looking at how the nature of the activity structure may influence the relative alignment between classroom and scientific practices. To that end, we build on previously published research related to the practices utilized by five high-school chemistry teachers as they enacted problem-solving activities in which students were likely to generate proposals that were not aligned with normative scientific understandings. In that prior work, our analysis had emphasized micro-level features of the talk interactions and how they related to the way students' ideas were explored; in the current paper, the analysis zooms out to consider the macro-level nature of the enactments associated with the activity structure of each lesson examined. Our data show that there were two general patterns to the activity structure across the 14 lessons scrutinized, and that each pattern had associated with it a constellation of features that impinged on the way the problem space was navigated. A key finding is that both activity structures (the expansive and the open) had features that aligned with scientific practices espoused in the Next Generation Science Standards—and both had features that were not aligned with those practices. We discuss the nature of these two structures, evidence of the relationship of each structure to key features of how the lessons unfolded, and the implications of these findings for both future research and the training of teachers.

Moving toward equitable, systemic science education reform: The synergy among science education and school-level reforms in an urban middle school

NASA Astrophysics Data System (ADS)

Kelly, Mary Kathryn

The purpose of this study was to develop an understanding of the relationships among school-level and science education reform efforts and how, collectively, they contribute to the progress of equitable, systemic science education reform. A case study research design was employed to gather both qualitative and quantitative data between 1995 and 1999. The site of this study is a non-selective, urban middle school in a large district that participated in several reform efforts. These reforms include both efforts focused on school-level change and efforts focused on change in science teaching and learning. Its program incorporates aspects of several school-level reforms---from the underlying Paideia philosophy, to structural characteristics of middle schools, to site-based decision-making, to its status as a magnet school, to its participation as a professional development school. Further, the participation of all science teachers in the intensive, standards-based professional development offered by Ohio's systemic reform of mathematics and science created a critical mass of reform-oriented teachers who supported one another as they incorporated reform-based practices into their teaching. The interplay of the reform efforts has manifested in a high level of science achievement in comparison to the school's district. Addressing the third component of O'Day and Smith's model for systemic reform, the need for school-level change to enable implementation of curriculum frameworks and aligned policies, this study illustrates two important points. First, the high-quality teacher professional development increased teachers' capacity to change their practices by enhancing their knowledge of and skills in implementing standards-based teaching practices. Second, because of the synchrony among the school-level reforms and between the school-level and science education reforms, the context of Webster provided a supportive environment in which lasting changes in science teaching and learning were implemented. Science education reform efforts were mediated by the school's context to create an environment in which the reform practices could be implemented and sustained. Using Kahle's (1998) Equity Metric, this study demonstrates that the synergy of the policies and practices of school-level and science education reforms can contribute to the progress of equitable, systemic science education reform.

Comprehensive evaluation of power grid enterprises' credit rating under the reform of transmission and distribution price

NASA Astrophysics Data System (ADS)

Wang, Yongli; Wang, Gang; Zuo, Yi; Fan, Lisha; Wei, Jiaxiang

2017-03-01

On March 15, 2015, the central office issued the "Opinions on Further Deepening the Reform of Electric Power System" (in the 2015 No. 9). This policy marks the central government officially opened a new round of electricity reform. As a programmatic document under the new situation to comprehensively promote the reform of the power system, No. 9 document will be approved as a separate transmission and distribution of electricity prices, which is the first task of promoting the reform of the power system. Grid tariff reform is not only the transmission and distribution price of a separate approval, more of the grid company input-output relationship and many other aspects of deep-level adjustments. Under the background of the reform of the transmission and distribution price, the main factors affecting the input-output relationship, such as the main business, electricity pricing, and investment approval, financial accounting and so on, have changed significantly. The paper designed the comprehensive evaluation index system of power grid enterprises' credit rating under the reform of transmission and distribution price to reduce the impact of the reform on the company's international rating results and the ability to raise funds.

Comprehensive evaluation of power grid projects' investment benefits under the reform of transmission and distribution price

NASA Astrophysics Data System (ADS)

Wang, Yongli; Wang, Gang; Zuo, Yi; Fan, Lisha; Ling, Yunpeng

2017-03-01

On March 15, 2015, the Central Office issued the "Opinions on Further Deepening the Reform of Electric Power System" (Zhong Fa No. 9). This policy marks the central government officially opened a new round of electricity reform. As a programmatic document under the new situation to comprehensively promote the reform of the power system, No. 9 document will be approved as a separate transmission and distribution of electricity prices, which is the first task of promoting the reform of the power system. Grid tariff reform is not only the transmission and distribution price of a separate approval, more of the grid company input-output relationship and many other aspects of deep-level adjustments. Under the background of the reform of the transmission and distribution price, the main factors affecting the input-output relationship, such as the main business, electricity pricing, and investment approval, financial accounting and so on, have changed significantly. The paper designed the comprehensive evaluation index system of power grid projects' investment benefits under the reform of transmission and distribution price to improve the investment efficiency of power grid projects after the power reform in China.

A five-year assessment of the affordable care act: market forces still trump the common good in U.S. Health care.

PubMed

Geyman, John P

2015-01-01

The Affordable Care Act (ACA) was enacted in 2010 as the signature domestic achievement of the Obama presidency. It was intended to contain costs and achieve near-universal access to affordable health care of improved quality. Now, five years later, it is time to assess its track record. This article compares the goals and claims of the ACA with its actual experience in the areas of access, costs, affordability, and quality of care. Based on the evidence, one has to conclude that containment of health care costs is nowhere in sight, that more than 37 million Americans will still be uninsured when the ACA is fully implemented in 2019, that many more millions will be underinsured, and that profiteering will still dominate the culture of U.S. health care. More fundamental reform will be needed. The country still needs to confront the challenge that our for-profit health insurance industry, together with enormous bureaucratic waste and widespread investor ownership throughout our market-based system, are themselves barriers to health care reform. Here we consider the lessons we can take away from the ACA's first five years and lay out the economic, social/political, and moral arguments for replacing it with single-payer national health insurance. © The Author(s) 2015 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

Reforming options for hydrogen production from fossil fuels for PEM fuel cells

NASA Astrophysics Data System (ADS)

Ersoz, Atilla; Olgun, Hayati; Ozdogan, Sibel

PEM fuel cell systems are considered as a sustainable option for the future transport sector in the future. There is great interest in converting current hydrocarbon based transportation fuels into hydrogen rich gases acceptable by PEM fuel cells on-board of vehicles. In this paper, we compare the results of our simulation studies for 100 kW PEM fuel cell systems utilizing three different major reforming technologies, namely steam reforming (SREF), partial oxidation (POX) and autothermal reforming (ATR). Natural gas, gasoline and diesel are the selected hydrocarbon fuels. It is desired to investigate the effect of the selected fuel reforming options on the overall fuel cell system efficiency, which depends on the fuel processing, PEM fuel cell and auxiliary system efficiencies. The Aspen-HYSYS 3.1 code has been used for simulation purposes. Process parameters of fuel preparation steps have been determined considering the limitations set by the catalysts and hydrocarbons involved. Results indicate that fuel properties, fuel processing system and its operation parameters, and PEM fuel cell characteristics all affect the overall system efficiencies. Steam reforming appears as the most efficient fuel preparation option for all investigated fuels. Natural gas with steam reforming shows the highest fuel cell system efficiency. Good heat integration within the fuel cell system is absolutely necessary to achieve acceptable overall system efficiencies.

Working on reform. How workers' compensation medical care is affected by health care reform.

PubMed

Himmelstein, J; Rest, K

1996-01-01

The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies?

Policy Levers Key for Primary Health Care Organizations to Support Primary Care Practices in Meeting Medical Home Expectations: Comparing Leading States to the Australian Experience.

PubMed

Takach, Mary

2016-10-01

Several countries with highly ranked delivery systems have implemented locally-based, publicly-funded primary health care organizations (PHCOs) as vehicles to strengthen their primary care foundations. In the United States, state governments have started down a similar pathway with models that share similarities with international PHCOs. The objective of this study was to determine if these kinds of organizations were working with primary care practices to improve their ability to provide comprehensive, coordinated, and accessible patient-centered care that met quality, safety, and efficiency outcomes-all core attributes of a medical home. This qualitative study looked at 4 different PHCO models-3 from the United States and 1 from Australia-with similar objectives and scope. Primary and secondary data included semi-structured interviews with 26 PHCOs and a review of government documents. The study found that the 4 PHCO models were engaging practices to meet a number of medical home expectations, but the US PHCOs were more uniform in efforts to work with practices and focused on arranging services to meet the needs of complex patients. There was significant variation in level of effort between the Australian PHCOs. These differences can be explained through the state governments' selection of payment models and use of data frameworks to support collaboration and incentivize performance of both PHCOs and practices. These findings offer policy lessons to inform health reform efforts under way to better capitalize on the potential of PHCOs to support a high-functioning primary health foundation as an essential component to a reformed health system.

Good Health at Low Cost 25 years on: lessons for the future of health systems strengthening.

PubMed

Balabanova, Dina; Mills, Anne; Conteh, Lesong; Akkazieva, Baktygul; Banteyerga, Hailom; Dash, Umakant; Gilson, Lucy; Harmer, Andrew; Ibraimova, Ainura; Islam, Ziaul; Kidanu, Aklilu; Koehlmoos, Tracey P; Limwattananon, Supon; Muraleedharan, V R; Murzalieva, Gulgun; Palafox, Benjamin; Panichkriangkrai, Warisa; Patcharanarumol, Walaiporn; Penn-Kekana, Loveday; Powell-Jackson, Timothy; Tangcharoensathien, Viroj; McKee, Martin

2013-06-15

In 1985, the Rockefeller Foundation published Good health at low cost to discuss why some countries or regions achieve better health and social outcomes than do others at a similar level of income and to show the role of political will and socially progressive policies. 25 years on, the Good Health at Low Cost project revisited these places but looked anew at Bangladesh, Ethiopia, Kyrgyzstan, Thailand, and the Indian state of Tamil Nadu, which have all either achieved substantial improvements in health or access to services or implemented innovative health policies relative to their neighbours. A series of comparative case studies (2009-11) looked at how and why each region accomplished these changes. Attributes of success included good governance and political commitment, effective bureaucracies that preserve institutional memory and can learn from experience, and the ability to innovate and adapt to resource limitations. Furthermore, the capacity to respond to population needs and build resilience into health systems in the face of political unrest, economic crises, and natural disasters was important. Transport infrastructure, female empowerment, and education also played a part. Health systems are complex and no simple recipe exists for success. Yet in the countries and regions studied, progress has been assisted by institutional stability, with continuity of reforms despite political and economic turmoil, learning lessons from experience, seizing windows of opportunity, and ensuring sensitivity to context. These experiences show that improvements in health can still be achieved in countries with relatively few resources, though strategic investment is necessary to address new challenges such as complex chronic diseases and growing population expectations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Evaluation of health care system reform in Hubei Province, China.

PubMed

Sang, Shuping; Wang, Zhenkun; Yu, Chuanhua

2014-02-21

This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the "Result Chain" logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally.

Health Care System Reforms in Developing Countries

PubMed Central

Han, Wei

2012-01-01

This article proposes a critical but non-systematic review of recent health care system reforms in developing countries. The literature reports mixed results as to whether reforms improve the financial protection of the poor or not. We discuss the reasons for these differences by comparing three representative countries: Mexico, Vietnam, and China. First, the design of the health care system reform, as well as the summary of its evaluation, is briefly described for each country. Then, the discussion is developed along two lines: policy design and evaluation methodology. The review suggests that i) background differences, such as social development, poverty level, and population health should be considered when taking other countries as a model; ii) although demand-side reforms can be improved, more attention should be paid to supply-side reforms; and iii) the findings of empirical evaluation might be biased due to the evaluation design, the choice of outcome, data quality, and evaluation methodology, which should be borne in mind when designing health care system reforms. PMID:25170464

Case-mix payment for nursing home care: lessons from Maryland.

PubMed

Feder, J; Scanlon, W

1989-01-01

Even before Medicare adopted case-based payments for hospitals, some state Medicaid programs employed case-mix payment systems for nursing home care. Their purpose was less to promote cost containment than to improve access to nursing homes for the most costly patients. This paper evaluates one such system, adopted by the state of Maryland in 1983 as part of an overall reimbursement reform. Using data on nursing home patient characteristics, costs, and staffing, as well as interviews with officials and various providers of care, the article shows that Maryland's system was successful in shifting nursing home service away from light-care and toward heavy-care patients. Furthermore, the shift occurred without inducing readily measurable declines in quality of care and with little additional administrative cost (partly because the state built its case-mix system on preexisting patient review activities). Although states could learn from and improve upon Maryland's experience--most notably in offering incentives to improve quality of care and in targeting community care on the light-care patients that nursing homes become less willing to serve--Maryland demonstrates that case-mix payment can change nursing home behavior in desired directions without substantial negative consequences.

Signal Systems of Lesson Settings and the Task-Related Behavior of Preschool Children

ERIC Educational Resources Information Center

Kounin, Jacob S.; Gump, Paul V.

1974-01-01

Teachers were videotaped teaching lessons. Lessons were seen as signal systems to participants. These signal systems were characterized along dimensions of continuity, insulation, and intrusiveness. Task involvement was used as the criterion. Results indicate most successful to least successful lessons, based on signal systems. (Author/SE)

Engineering Lessons Learned and Systems Engineering Applications

NASA Technical Reports Server (NTRS)

Gill, Paul S.; Garcia, Danny; Vaughan, William W.

2005-01-01

Systems Engineering is fundamental to good engineering, which in turn depends on the integration and application of engineering lessons learned. Thus, good Systems Engineering also depends on systems engineering lessons learned from within the aerospace industry being documented and applied. About ten percent of the engineering lessons learned documented in the NASA Lessons Learned Information System are directly related to Systems Engineering. A key issue associated with lessons learned datasets is the communication and incorporation of this information into engineering processes. As part of the NASA Technical Standards Program activities, engineering lessons learned datasets have been identified from a number of sources. These are being searched and screened for those having a relation to Technical Standards. This paper will address some of these Systems Engineering Lessons Learned and how they are being related to Technical Standards within the NASA Technical Standards Program, including linking to the Agency's Interactive Engineering Discipline Training Courses and the life cycle for a flight vehicle development program.

An analysis of Liberia's 2007 national health policy: lessons for health systems strengthening and chronic disease care in poor, post-conflict countries

PubMed Central

2011-01-01

Background Globally, chronic diseases are responsible for an enormous burden of deaths, disability, and economic loss, yet little is known about the optimal health sector response to chronic diseases in poor, post-conflict countries. Liberia's experience in strengthening health systems and health financing overall, and addressing HIV/AIDS and mental health in particular, provides a relevant case study for international stakeholders and policymakers in other poor, post-conflict countries seeking to understand and prioritize the global response to chronic diseases. Methods We conducted a historical review of Liberia's post-conflict policies and their impact on general economic and health indicators, as well as on health systems strengthening and chronic disease care and treatment. Key sources included primary documents from Liberia's Ministry of Health and Social Welfare, published and gray literature, and personal communications from key stakeholders engaged in Liberia's Health Sector Reform. In this case study, we examine the early reconstruction of Liberia's health care system from the end of conflict in 2003 to the present time, highlight challenges and lessons learned from this initial experience, and describe future directions for health systems strengthening and chronic disease care and treatment in Liberia. Results Six key lessons emerge from this analysis: (i) the 2007 National Health Policy's 'one size fits all' approach met aggregate planning targets but resulted in significant gaps and inefficiencies throughout the system; (ii) the innovative Health Sector Pool Fund proved to be an effective financing mechanism to recruit and align health actors with the 2007 National Health Policy; (iii) a substantial rural health delivery gap remains, but it could be bridged with a robust cadre of community health workers integrated into the primary health care system; (iv) effective strategies for HIV/AIDS care in other settings should be validated in Liberia and adapted for use in other chronic diseases; (v) mental health disorders are extremely prevalent in Liberia and should remain a top chronic disease priority; and (vi) better information systems and data management are needed at all levels of the health system. Conclusions The way forward for chronic diseases in Liberia will require an increased emphasis on quality over quantity, better data management to inform rational health sector planning, corrective mechanisms to more efficiently align health infrastructure and personnel with existing needs, and innovative methods to improve long-term retention in care and bridge the rural health delivery gap. PMID:21985150

Strengthening health systems by health sector reforms

PubMed Central

Senkubuge, Flavia; Modisenyane, Moeketsi; Bishaw, Tewabech

2014-01-01

Background The rising burden of disease and weak health systems are being compounded by the persistent economic downturn, re-emerging diseases, and violent conflicts. There is a growing recognition that the global health agenda needs to shift from an emphasis on disease-specific approaches to strengthening of health systems, including dealing with social, environmental, and economic determinants through multisectoral responses. Methods A review and analysis of data on strengthening health sector reform and health systems was conducted. Attention was paid to the goal of health and interactions between health sector reforms and the functions of health systems. Further, we explored how these interactions contribute toward delivery of health services, equity, financial protection, and improved health. Findings Health sector reforms cannot be developed from a single global or regional policy formula. Any reform will depend on the country's history, values and culture, and the population's expectations. Some of the emerging ingredients that need to be explored are infusion of a health systems agenda; development of a comprehensive policy package for health sector reforms; improving alignment of planning and coordination; use of reliable data; engaging ‘street level’ policy implementers; strengthening governance and leadership; and allowing a holistic and developmental approach to reforms. Conclusions The process of reform needs a fundamental rather than merely an incremental and evolutionary change. Without radical structural and systemic changes, existing governance structures and management systems will continue to fail to address the existing health problems. PMID:24560261

A Race against Time: The Crisis in Urban Schooling. Contemporary Studies in Social and Policy Issues in Education.

ERIC Educational Resources Information Center

Cibulka, James G., Ed.; Boyd, William Lowe, Ed.

This collection of papers presents three approaches to urban educational reform. After "Introduction--Urban Education Reform: Competing Approaches" (James G. Cibulka and William Lowe Byrd), Part 1, "Systems Reforms of Urban School Systems," includes (1) "Accountability at the Improv: Brief Sketches of School Reform in Los…

Putting "The System" into a School Autonomy Reform: The Case of the Independent Public Schools Program

ERIC Educational Resources Information Center

Gobby, Brad

2016-01-01

The Australian Federal and state governments have been introducing neoliberal reforms to the governance of their education systems for a number of decades. One of the most recent programs of reform is the Western Australian Independent Public Schools (IPS) initiative. Similar to decentralizing reforms around the world, the IPS program seeks…

Evidence-based health policy: three generations of reform in Mexico.

PubMed

Frenk, Julio; Sepúlveda, Jaime; Gómez-Dantés, Octavio; Knaul, Felicia

2003-11-15

The Mexican health system has evolved through three generations of reform. The creation of the Ministry of Health and the main social security agency in 1943 marked the first generation of health reforms. In the late 1970s, a second generation of reforms was launched around the primary health-care model. Third-generation reforms favour systemic changes to reorganise the system through the horizontal integration of basic functions-stewardship, financing, and provision. The stability of leadership in the health sector is emphasised as a key element that allowed for reform during the past 60 years. Furthermore, there has been a transition in the second generation of reforms to a model that is increasingly based on evidence; this has been intensified and extended in the third generation of reforms. We also examine policy developments that will provide social protection in health for all. These developments could be of interest for countries seeking to provide their citizens with universal access to health care that incorporates equity, quality, and financial protection.

Implementing health care reform: implications for performance of public hospitals in central Ethiopia.

PubMed

Manyazewal, Tsegahun; Matlakala, Mokgadi C

2018-06-01

Understanding the way health care reforms have succeeded or failed thus far would help policy makers cater continued reform efforts in the future and provides insight into possible levels of improvement in the health care system. This work aims to assess and describe the implications of health care reform on the performance of public hospitals in central Ethiopia. A facility-based, cross-sectional study was carried out in five public hospitals with different operational characteristics that have been implementing health care reform in central Ethiopia. The reform documents were reviewed to assess the nature and targets of the reform for interpretive analysis. Adopting dimensions of health system performance as the theoretical framework, a self-administered questionnaire was developed. Consenting health care professionals who have been involved in the reform from inception to implementation filled the questionnaire. Cronbach's alpha was measured to ensure internal consistency of the instrument. Descriptive statistics, weighted median score, χ 2 , and Mann-Whitney U and Kruskal-Wallis tests were used for data analysis. s Despite implementation of the reform, the health care system in public hospitals was still fragmented as confirmed by 50% of respondents. Limited effects were reported in favour of quality (48%), access (50%), efficiency (51%), sustainability (53%), and equity (61%) of care, while poor effects were reported in patient-provider (41%) and provider-management (32%) interactions. Though there was substantial gain in infrastructure and workspace, stewardship of health care resources was less benefited. The predominant hindrances of the reform were the working environment (adjusted Odds Ratio (aOR) = 2.27, 95% confidence interval (CI): 1.15-4.47), financial resources (aOR = 3.54, 95%CI = 1.97-6.33), management (aOR = 2.27, 95% CI = 1.15-4.47), and information technology system (aOR = 3.15, 95% CI = 1.57-6.32). s The Ethiopian health care reform has laid the groundwork for health system improvement, but progress was slow and the health care delivery system was still fragile. Healthcare reform efforts in such settings are feasible, but with regular mapping of programmatic outcomes and bringing a common understanding of the reform among stakeholders.

Military Strategists are from Mars, Rule of Law Theorists are from Venus: Why Imposition of the Rule of Law Requires a Goldwater-Nichols Modeled Interagency Reform

DTIC Science & Technology

2008-04-01

demonstrates 2 Joseph J. Collins, Planning Lessons from Iraq and Afghanistan, JOINT FORCES Q., 2d Quarter 2006, at 10, 11. U.S. conventional military power...diplomatic, informational, military, and economic efforts." Id. It lists eight "trends that will affect ground force operations," to include...this definition is capable of producing a "cultural commitment’"’ by the host-nation if properly pursued from the planning stages of an intervention

The Impact of International and Domestic Factors on the Military Outcomes of National Unification: A Study of Four Historical Cases with Lessons for Korean Unification

DTIC Science & Technology

2014-06-01

between projecting an image of strength and convincing the world that it valued the city-state’s economic success and the laissez - faire sociopolitical...immediately. Poland had not existed as a country when World War I was fought, but its native leadership had a window of opportunity afterward to...reforms in the late 1980s removed from East Germany’s Communist leadership the support that they had long depended on, and the East German people took

Saudi Counter-Terrorism Strategy: Identifying and Applying Lessons Learned

DTIC Science & Technology

2013-03-01

Commission’s decision also criminalized the financing of terrorism, labeling the "partner" in crime .5 In the understanding of terrorism used in this fatwa...than retribution for murder or murderous sedition in the land it is as if he has killed all of humanity, and whoever saves a life it is as if he has...for economic reforms. The Saudi economy grew rapidly in the early 2000’s and reached rates as high as 6.4 percent growth in 2003.36 In a speech at the

Market competition in health care markets in the Netherlands: some lessons for England?

PubMed

den Exter, André P; Guy, Mary J

2014-01-01

This article seeks to establish what lessons might be available to the English health care sector following enactment of the Health and Social Care Act 2012 from the Dutch experience of introducing market competition into health care via a mandatory health insurance scheme implemented by for-profit insurance companies. The existence of the Beveridge NHS model in England, and a Bismarckian insurance system in The Netherlands perhaps suggest that a comparison of the two countries is at best limited, and reinforced by the different Enthoven-inspired competitive models each has adopted. However, we contend that there are positive and negative issues arising from introducing competition into health care-, e.g. concerns about equity and benefits of efficiencies-which go beyond national boundaries and different systems and reflect the global paradigm shift towards the use of market forces in previously non-market areas such as health. The article examines the situation in England following the HSCA 2012 and The Netherlands following the 2006 reforms before analysing two areas of common ground: the focus in both countries on competition on quality (as opposed to price) and integrated care, which is assuming ever greater significance. We suggest that our combined insights (as a health lawyer and competition lawyer respectively) coupled with a comparative approach create a novel contribution to current calls for a wider public debate about the real role of markets in health care over and above simple characterisation as a force for good or bad. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

Life Functions and Cells: Level II, Unit 7, Lesson 1; Cell Structure: Lesson 2; Tissues, Organs, Systems: Lesson 3; Growth and Nutrition: Lesson 4; Metabolism: Lesson 5. Advanced General Education Program. A High School Self-Study Program.

ERIC Educational Resources Information Center

Manpower Administration (DOL), Washington, DC. Job Corps.

This self-study program for high-school level contains lessons on: Life Functions and Cells; Cell Structure; Tissues, Organs, Systems; Growth and Nutrition; and Metabolism. Each of the lessons concludes with a Mastery Test to be completed by the student. (DB)

Developing a School Finance System for K-12 Reform in Qatar

ERIC Educational Resources Information Center

Guarino, Cassandra M.; Galama, Titus; Constant, Louay; Gonzalez, Gabriella; Tanner, Jeffery C.; Goldman, Charles A.

2009-01-01

Reform-minded leaders of Qatar, who have embarked on a sweeping reform of their nation's education system, asked RAND to evaluate the education finance system that has been adopted and to offer suggestions for improvements. The authors analyze the system's evolution and resource allocation patterns between 2004 and 2006 and develop analytic tools…

Reform in a Fragmented System: Higher Education in Bosnia-Herzegovina.

ERIC Educational Resources Information Center

Temple, Paul

2002-01-01

Analyzes issues of fragmentation and reform in Bosnia-Herzegovina's higher education system, suggesting that a better appreciation of traditional university structures, rather than just Anglo-American central management, is important in achieving effective reform. (EV)

Preservice teachers' use of lesson study in teaching nature of science

NASA Astrophysics Data System (ADS)

McDowell, Amy Virginia

The purpose of this study was to explore preservice teachers' lived experiences in a lesson study focused on teaching and learning nature of science (NOS). The body of knowledge about shifting pre- and in-service novice NOS understandings is substantial. The focus of science education research is now exploring ways to move these informed NOS understandings into classroom practice (Abd-El-Khalick & Lederman, 2000b). The research questions guiding the study were (a) how do preservice teachers' understandings of NOS shift as a result of the lesson study experience?, and (b) how does the reflective practice that occurs in lesson study influence preservice teachers' transition of NOS tenets into classroom practice? The participants in this study represented a sample of graduate preservice teachers, who were part of a middle and secondary science teaching alternative certification program in a southeastern university. In the first summer semester of this certification program, the participants were immersed in reform based science instruction; a section of which included NOS teachings (INTASC, 2002). In the following semester, participants were placed in a practicum setting; where the exploration of the preservice teachers' teaching of NOS was supported through the modified lesson study framework. Data sources included the Views on Nature of Science-Form B (VNOS-b), interviews, and lesson study portfolios. Analysis of NOS understandings was guided by instruments found in literature associated with the VNOS-b (Lederman et al., 2002) and reflection (Ward & McCotter, 2004). Results showed successful transfer of NOS into classroom practice using the modified lesson study framework, with less success in the deepening of participants' NOS understandings. Of particular significance was that results indicated a deepening of NOS pedagogical content knowledge for those participants functioning at higher levels of reflection. The study's results contributes to two knowledge bases. First it provides insight to how lesson study can be used in the United States in alterative teacher preparation programs. Second, it contributes to what is understood about how to support the transition of NOS understandings into classroom practice.

Factors Considered by Elementary Teachers When Developing and Modifying Mathematical Tasks to Support Children's Mathematical Thinking

NASA Astrophysics Data System (ADS)

Fredenberg, Michael Duane

The idea that problems and tasks play a pivotal role in a mathematics lesson has a long standing in mathematics education research. Recent calls for teaching reform appeal for training teachers to better understand how students learn mathematics and to employ students' mathematical thinking as the basis for pedagogy (CCSSM, 2010; NCTM, 2000; NRC 1999). The teaching practices of (a) developing a task for a mathematics lesson and, (b) modifying the task for students while enacting the lesson fit within the scope of supporting students' mathematical thinking. Surprisingly, an extensive search of the literature did not yield any research aimed to identify and refine the constituent parts of the aforementioned teaching practices in the manner called for by Grossman and xiii colleagues (2009). Consequently, my research addresses the two questions: (a) what factors do exemplary elementary teachers consider when developing a task for a mathematics lesson? (b) what factors do they consider when they modify a task for a student when enacting a lesson? I conducted a multiple case study involving three elementary teachers, each with extensive training in the area of Cognitively Guided Instruction (CGI), as well as several years experience teaching mathematics following the principles of CGI (Carpenter et al., 1999). I recorded video of three mathematics lessons with each participant and after each lesson I conducted a semi-structured stimulated recall interview. A subsequent follow-up clinical interview was conducted soon thereafter to further explore the teacher's thoughts (Ginsberg, 1997). In addition, my methodology included interjecting myself at select times during a lesson to ask the teacher to explain her reasoning. Qualitative analysis led to a framework that identified four categories of influencing factors and seven categories of supporting objectives for the development of a task. Subsets of these factors and objectives emerged as particularly relevant when the teachers decided to modify a task. Moreover, relationships between and among the various factors were identified. The emergent framework from this study offers insight into decompositions of the two teaching practices of interest, and, in particular, the utility of the number choices made by the teachers.

Great Teachers: The Internal and External Characteristics that Sustain Them

ERIC Educational Resources Information Center

Gennerman, Theresa

2009-01-01

For a century, school reform has been a topic of local and federal government efforts. While the reforms have evolved and changed to a small degree during this time, the deficit focus of reform has been consistent, failing schools and failing systems. Education's focus on the deficits within the system has yielded reform that has yet to succeed in…

Atuarfitsialak: Greenland's Cultural Compatible Reform

ERIC Educational Resources Information Center

Wyatt, Tasha R.

2012-01-01

In 2002, Greenlandic reform leaders launched a comprehensive, nation-wide reform to create culturally compatible education. Greenland's reform work spans the entire educational system and includes preschool through higher education. To assist their efforts, reform leaders adopted the Standards for Effective Pedagogy developed at the Center for…

School Finance Reform: Past, Present and Future. Issuegram 26.

ERIC Educational Resources Information Center

Odden, Allan

This paper examines past school finance reforms of the 1970's, current reforms in the 1980's, and future reforms in the 1990's. Fiscal inequities targeted in the reforms of the seventies resulted in major structural changes in the school finance systems of over 30 states. The reforms not only improved fiscal equity but helped increase…

Globalization, Statist Political Economy, and Unsuccessful Education Reform in South Korea, 1993-2003

ERIC Educational Resources Information Center

Kim, Ki Su

2005-01-01

This article examines the relationship between globalization and national education reforms, especially those of educational systems. Instead of exploring the much debated issues of how globalization affects national educational systems and how the nations react by what kinds of systemic education reform, however, it focuses on what such a method…

Education System Reform in China after 1978: Some Practical Implications

ERIC Educational Resources Information Center

Sun, Miantao

2010-01-01

Purpose: This paper aims to provide an overview of education system reform in China since 1978, and its practical implications. Design/methodology/approach: Data were collected from literature review and interview. An overview of education system reform and its practical implications was found through data analysis. Findings: There has been two…

Local television news coverage of President Clinton's introduction of the Health Security Act.

PubMed

Dorfman, L; Schauffler, H H; Wilkerson, J; Feinson, J

1996-04-17

To investigate how local television news reported on health system reform during the week President Clinton presented his health system reform bill. Retrospective content analysis of the 1342-page Health Security Act of 1993, the printed text of President Clinton's speech before Congress on September 22, 1993, and a sample of local television news stories on health system reform broadcast during the week of September 19 through 25, 1993. The state of California. During the week, 316 television news stories on health system reform were aired during the 166 local news broadcasts sampled. Health system reform was the second most frequently reported topic, second to stories on violent crime. News stories on health system reform averaged 1 minute 38 seconds in length, compared with 57 seconds for violent crime. Fifty-seven percent of the local news stories focused on interest group politics. Compared with the content of the Health Security Act, local news broadcasts devoted a significantly greater portion of their stories to financing, eligibility, and preventive services. Local news stories gave significantly less attention to cost-saving mechanisms, long-term care benefits, and changes in Medicare and Medicaid, and less than 2% of stories mentioned quality assurance mechanisms, malpractice reform, or new public health initiatives. Of the 316 televised news stories, 53 reported on the president's speech, covering many of the same topics emphasized in the speech (financing, organization and administration, and eligibility) and de-emphasizing many of the same topics (Medicare and Medicaid, quality assurance, and malpractice reform). Two percent of the president's speech covered partisan politics; 45% of the local news stories on the speech featured challenges from partisan politicians. Although health system reform was the focus of a large number of local television news stories during the week, in-depth explanation was scarce. In general, the news stories provided superficial coverage framed largely in terms of the risks and costs of reform to specific stakeholders.

Intended and unintended impacts of price changes for drugs and medical services: Evidence from China.

PubMed

Fu, Hongqiao; Li, Ling; Yip, Winnie

2018-06-18

In 2012, the Chinese government launched a nationwide reform of county-level public hospitals with the goal of controlling the rapid growth of healthcare expenditure. The key components of the reform were the zero markup drug policy (ZMDP), which removed the previously allowed 15% markup for drug sales at public hospitals, and associated increases in fees for medical services. By exploiting the temporal and cross-sectional variations in the policy implementation and using a unique, nationally representative hospital-level dataset in 1880 counties between 2009 and 2014, we find that the policy change led to a reduction in drug expenditures, a rise in expenditures for medical services, and no measurable changes in total health expenditures. However, we also find an increase in expenditures for diagnostic tests/medical consumables at hospitals that had a greater reliance on drug revenues before the reform, which is unintended by policymakers. Further analysis shows that these results were more likely to be driven by the supply side, suggesting that hospitals offset the reductions in drug revenues by increasing the provision of services and products with higher price-cost margins. These findings hold lessons for cost containment policies in both developed and developing countries. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Governance and health: the rise of the managerialism in public sector reform].

PubMed

Denis, Jean L; Lamothe, Lise; Langley, Ann; Stéphane, Guérard

2010-01-01

The article examines various healthcare systems reform projects in Canada and some Canadian provinces and reveals some tendencies in governance renewal. The analisis is based on the hypothesis that reform is an exercise aiming at the renewal of governance conception and practices. In renewing governance, reform leaders hope to use adequate and effective levers to attain announced reform objectives. The article shows that the conceptions and operational modalities of governance have changed over time and that they reveal tensions inherent to the transformation and legitimation process of public healthcare systems. The first section discusses the relationships between reform and change. The second section defines the conception of gouvernance used for the analisis. Based on a content analisis of the various reform reports, the third section reveals the evolution of the conception of governance in healthcare systems in Canada. In order to expose the new tendencies, ideologies and operational principles at the heart of the reform projects are analysed. Five ideologies are identified: the democratic ideology, the "population health" ideology, the business ideology, the managerial ideology and the ideology of equity and humanism. This leads to a discussion on the dominant influence of the managerial ideology in the current reform projects.

Social Reform Groups and the Legal System: Enforcement Problems. Discussion Paper No. 209-74.

ERIC Educational Resources Information Center

Handler, Joel F.

During the last two decades, there has been a great increase in the use of litigation by social reform groups. This activity has been stimulated by the hospitality of the courts to the demands of social reform groups and the availability of subsidized young, activist lawyers. The paper examines the uses of the legal system by social reform groups…

[Health reform in the USA].

PubMed

Ganduglia, Cecilia

2010-01-01

The United States of America passed early this year the bill enforcing their health reform. this reform aims at achieving universal insurance, cost containment and improving quality of care. The debate around this reform has been long and unable to arrive to an agreement between the parts. Even if the expansion in the medical coverage system does not reduce to zero the current degree of inaccessibility to the health system, these achievements could be considered a very important first step. Nonetheless, chances are that this reform will continue being as polemic as the negotiations previous to its conception.

Effectiveness of a Case-Based System in Lesson Planning

ERIC Educational Resources Information Center

Saad, A.; Chung, P. W. H.; Dawson, C. W.

2014-01-01

Lesson planning imposes a significant burden on teachers as they need to prepare different lesson plans for different classes according to various constraints. SmartLP, a case-based lesson planning system, has been implemented as a means of assisting teachers in constructing quality lesson plans more quickly. SmartLP enables teachers to retrieve…

Moving Toward Universal Health Coverage (UHC) to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience

PubMed Central

Xu, Ye; Huang, Cheng; Colón-Ramos, Uriyoán

2015-01-01

Binagwaho and colleagues’ perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries’ health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies. PMID:26673477

Rethink, Reform, Reenter: An Entrepreneurial Approach to Prison Programming.

PubMed

Keena, Linda; Simmons, Chris

2015-07-01

The purpose of this article was to present a description and first-stage evaluation of the impact of the Ice House Entrepreneurship Program on the learning experience of participating prerelease inmates at a Mississippi maximum-security prison and their perception of the transfer of skills learned in program into securing employment upon reentry. The Ice House Entrepreneurship Program is a 12-week program facilitated by volunteer university professors to inmates in a prerelease unit of a maximum-security prison in Mississippi. Participants' perspectives were examined through content analysis of inmates' answers to program Reflection and Response Assignments and interviews. The analyses were conducted according to the constant comparative method. Findings reveal the emergent of eight life-lessons and suggest that this is a promising approach to prison programming for prerelease inmates. This study discusses three approaches to better prepare inmates for a mindset change. The rethink, reform, and reenter approaches help break the traditional cycle of release, reoffend, and return. © The Author(s) 2014.

Leadership lessons in global nursing and health from the Nightingale Letter Collection at the University of Alabama at Birmingham.

PubMed

Harper, Doreen C; Davey, Kimberly S; Fordham, Pamela N

2014-03-01

This article analyzes the components of Florence Nightingale's visionary leadership for global health and nursing within the historical context of Great Britain's colonization of India. The descriptive study used the qualitative approach of narrative analysis to analyze selected letters in the Nightingale Letter Collection at the University of Alabama at Birmingham that Nightingale wrote to or about Dr. Thomas Gillham Hewlett, a physician and health officer in Bombay, India. The authors sought to increase understanding of Nightingale's visionary leadership for global nursing and health through a study of the form and content of the letters analyzed as temporally contextualized data, focusing on how the narratives are composed and what is conveyed. Several recurring themes central to Nightingale's leadership on global nursing and health emerge throughout these letters, including health and sanitation reform, collaborative partnerships, data-driven policy development, and advocacy for public health. These themes are illustrated through her letters to and testimony about Dr. Thomas Gillham Hewlett in her vivid descriptions of health education and promotion, data-driven policy documents, public health and sanitation advice, and collaboration with citizens, medicine, policy makers, and governments to improve the health and welfare of the people of India. The focus on leadership in nursing as a global construct highlights the lessons learned from University of Alabama at Birmingham's Nightingale Letter Collection that has relevance for the future of nursing and health care, particularly Nightingale's collaboration with policy leaders, her analysis of data to set policy agendas, and public health reform centered on improving the health and well-being of underserved populations.

Case studies in teaching evolution: The intersection of dilemmas in practice

NASA Astrophysics Data System (ADS)

Fisher, Rachel

Despite recent science education reform documents citing evolution as a core concept to be taught in grades K-12, research shows problems with how it is currently taught. Evolution is often avoided, teachers minimize its importance within biology, infuse misconceptions, and/or interject non-scientific ideologies into lessons. My research focused on how teachers in two geographically and culturally distinct school districts in the southwestern U.S. negotiate dilemmas during an evolution unit. One school district was rural and had a large population of Mormon students, while the other district was urban, with a large majority Mexican/Mexican-American students. Using a case study approach, I observed three biology teachers during their evolution lessons, interviewed them throughout the unit, co-planned lessons with them, and collected artifacts from this unit, including anonymous student work. I also included data from four genetics lessons for each teacher to determine if the issues that arose during the evolution unit were a result of the general practice of the teacher, or if they were unique to evolution. Findings showed teachers' backgrounds and comfort levels with evolution, in addition to their perceptions of community context, affected how they negotiated pedagogical, conceptual, political, and cultural dilemmas. This study's findings will inform in-service teachers' future practice and professional development tools to aid with their teaching---this may include methods to negotiate some of the political (e.g. state standards) or cultural (e.g. religious resistance) issues inherent to teaching evolution.

Lesson 6: Using the Checklist to Work through System Requirements

EPA Pesticide Factsheets

Lesson 6 describes how these same requirements are presented in the CROMERR System Checklist (which was introduced in Lesson 4). You may want to refer to the checklist as you step through this lesson.

[Proposals for health reform and equity in Uruguay: a redefinition of the Welfare State?].

PubMed

Mitjavila, Myriam; Fernandez, José; Moreira, Constanza

2002-01-01

This article reviews and analyzes health sector reform proposals in Uruguay and the possible effects of such reforms in terms of equity, the health sector's institutional structure, and the power relationship between the various actors in the process. The authors contend that a highly structured yet simultaneously fragmented system has conspired against any attempt to introduce major reforms into the system. Thus the only possibility for reform resides neither in the consolidation of the so-called Institutions for Collective Medical Care (IAMCs) nor in the move towards a residual model. Rather, Uruguay is witnessing the system's passive restructuring (i.e., reform by default). In this context and given the system's built-in inequities, the current trend is towards an even more regressive distribution of goods and services. The authors use qualitative and quantitative techniques to show that inequities in expenditure, access, and quality have resulted from long-term developments and adaptive movements of an IAMC system in fiscal stress and the public system's declining quality. Thus, in the absence of changes in state policy that redefine the actors' power or in the absence of system collapse, the country should expect this same regressive trend to deepen.

A Design of an Appropriate Early Childhood Education Funding System in China

ERIC Educational Resources Information Center

Xiaodong, Zeng

2008-01-01

This study analyzes the structural reform of local governments funding for early childhood education (ECE) as the general public still casts doubts about the fairness of ECE system in China. A particular case in point is the Shenzhen Municipal Government's reform on their ECE funding system. Because the reform efforts are more about restructuring…

Elementary Change: Moving toward Systemic School Reform in Rural Kentucky.

ERIC Educational Resources Information Center

Kannapel, Patricia J.; Aagaard, Lola; Coe, Pamelia; Reeves, Cynthia A.

From 1990 to 2000, a qualitative study of the implementation of the Kentucky Education Reform Act (KERA) was conducted in four small rural school districts in Kentucky. KERA reflects key components of what would later be termed "systemic reform": a unifying set of goals that all students must attain, a coherent system of instructional…

Working on reform. How workers' compensation medical care is affected by health care reform.

PubMed Central

Himmelstein, J; Rest, K

1996-01-01

The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies? Images p13-a p14-a p15-a p16-a p18-a p19-a p20-a p22-a p24-a PMID:8610187

Solar central receiver reformer system for ammonia plants

NASA Astrophysics Data System (ADS)

1980-07-01

An overview of a study to retrofit the Valley Nitrogen Producers, Inc., El Centro, California 600 ST/SD Ammonia Plant with Solar Central Receiver Technology is presented. The retrofit system consists of a solar central receiver reformer (SCRR) operating in parallel with the existing fossil fired reformer. Steam and hydrocarbon react in the catalyst filled tubes of the inner cavity receiver to form a hydrogen rich mixture which is the syngas feed for the ammonia production. The SCRR system will displace natural gas presently used in the fossil reformer combustion chamber.

[The latest reform of the Colombian healthcare-related social security system].

PubMed

Franco-Giraldo, Álvaro

2012-10-01

This essay was aimed at exploring and analysing the challenges and opportunities arising from reforming Colombian law 1438/2011 dealing with the healthcare-related social security system. Some outstanding issues from the reform introduced by Law 100/1993 were reviewed and then compared to the 2011 regulations; they were also contrasted (in market model conditions) with some public health strategies which were inoperative during the reform stage. This second reform phase was discussed in relation to the scope of the right to health, access and overall equity. Progress regarding important issues such as benefit package equalisation, primary healthcare attention, integrated healthcare service networks was recognised; however, its failure to change core aspects of the system was discussed, i.e. financial sustainability and the economic rationale imposed on the aforementioned strategies which curtailed its responsiveness to keep the model introduced by law 100/1993 intact. The crucial points necessary for major structural reform of the Colombian healthcare system based on the right to health and equity were then outlined.

Safety and Mission Assurance for In-House Design Lessons Learned from Ares I Upper Stage

NASA Technical Reports Server (NTRS)

Anderson, Joel M.

2011-01-01

This viewgraph presentation identifies lessons learned in the course of the Ares I Upper Stage design and in-house development effort. The contents include: 1) Constellation Organization; 2) Upper Stage Organization; 3) Presentation Structure; 4) Lesson-Importance of Systems Engineering/Integration; 5) Lesson-Importance of Early S&MA Involvement; 6) Lesson-Importance of Appropriate Staffing Levels; 7) Lesson-Importance S&MA Team Deployment; 8) Lesson-Understanding of S&MA In-Line Engineering versus Assurance; 9) Lesson-Importance of Close Coordination between Supportability and Reliability/Maintainability; 10) Lesson-Importance of Engineering Data Systems; 11) Lesson-Importance of Early Development of Supporting Databases; 12) Lesson-Importance of Coordination with Safety Assessment/Review Panels; 13) Lesson-Implementation of Software Reliability; 14) Lesson-Implementation of S&MA Technical Authority/Chief S&MA Officer; 15) Lesson-Importance of S&MA Evaluation of Project Risks; 16) Lesson-Implementation of Critical Items List and Government Mandatory Inspections; 17) Lesson-Implementation of Critical Items List Mandatory Inspections; 18) Lesson-Implementation of Test Article Safety Analysis; and 19) Lesson-Importance of Procurement Quality.

Reforming the road freight transportation system using systems thinking: An investigation of Coronial inquests in Australia.

PubMed

Newnam, Sharon; Goode, Natassia; Salmon, Paul; Stevenson, Mark

2017-04-01

Road freight transport is considered to be one of the most dangerous industries in Australia, accounting for over 30% of all work fatalities. Whilst system reform (i.e., change to policy and practice) is needed, it is not clear what this reform should be, or what approaches should be used to drive it. This article argues that road freight transportation reform should be underpinned by a systems thinking approach. Efforts to understand crash causation should be focused beyond the driver and identify contributing factors at other levels with the road freight system. Accordingly, we present the findings from a study that examined whether Australian Coronial investigations into road freight crashes reflect support appropriate system reform. Content analysis was used to identify the contributing factors and interrelations implicated in the road freight crashes described in publicly available Australian Coroner's inquest reports from the last 10 years (2004-2014; n=21). The results found evidence to suggest that the Coronial inquests provide some understanding of the complex system of factors influencing road freight transportation crashes in Australia. However, there was a lack of evidence to suggest an understanding of system-based reform based on the identification of reductionist-focused recommendations. It is concluded that researchers and practitioners (ie., government and industry) need to work together to develop prevention efforts focused on system reforms. Systems thinking based data collection and analysis frameworks are urgently required to help develop this understanding in road freight transportation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Beauty and the beast: Aligning national curriculum standards with state (high school) graduation requirements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Linder-Scholer, B.

1994-12-31

An overview of SCI/MATH/MN - Minnesota`s standards-based, systemic approach to the reform and improvement of the K-12 science and mathematics education delivery system - is offered as an illustration of the challenges of aligning state educational practices with the national curriculum standards, and as a model for business involvement in state educational policy issues that will enable fundamental, across-the-system reform. SCI/MATH/MN illustrates the major challenges involved in developing a statewide vision for math and science education reform, articulating frameworks aligned with the national standards, building capacity for system-oriented change at the local level, and involving business in systemic reform.

Curricular Revision and Reform: The Process, What Was Important, and Lessons Learned.

PubMed

Ilkiw, Jan E; Nelson, Richard W; Watson, Johanna L; Conley, Alan J; Raybould, Helen E; Chigerwe, Munashe; Boudreaux, Karen

Beginning in 2005, the Doctor of Veterinary Medicine program at the University of California underwent major curricular review and reform. To provide information for others that follow, we have documented our process and commented on factors that were critical to success, as well as factors we found surprising, difficult, or problematic. The review and reform were initiated by the Executive Committee, who led the process and commissioned the committees. The planning stage took 6 years and involved four faculty committees, while the implementation stage took 5 years and was led by the Curriculum Committee. We are now in year 2 of the institutionalizing stage and no longer refer to our reform as the "new curriculum." The change was driven by a desire to improve the curriculum and the learning environment of the students by aligning the delivery of information with current teaching methodologies and implementing adult learning strategies. We moved from a department- and discipline-based curriculum to a school-wide integrated block curriculum that emphasized student-centered, inquiry-based learning. A limit was placed on in-class time to allow students to apply classroom knowledge by solving problems and cases. We found the journey long and arduous, requiring tremendous commitment and effort. In the change process, we learned the importance of adequate planning, leadership, communication, and a reward structure for those doing the "heavy lifting." Specific to our curricular design, we learned the importance of the block leader role, of setting clear expectations for students, and of partnering with students on the journey.

Romanian Preservice Educators' Attitudes about Disabilities

ERIC Educational Resources Information Center

Ives, Bob; Howell, Jordan

2011-01-01

Since the 1989 revolution in Romania, the educational system has experienced tremendous reform efforts. These reform efforts continue with Romania's admission into the European Union. The area of special education has been particularly engaged in systemic reform given that students with disabilities were particularly underserved prior to the…

Gender equity and health sector reform in Colombia: mixed state-market model yields mixed results.

PubMed

Ewig, Christina; Bello, Amparo Hernández

2009-03-01

In 1993, Colombia carried out a sweeping health reform that sought to dramatically increase health insurance coverage and reduce state involvement in health provision by creating a unitary state-supervised health system in which private entities are the main insurers and health service providers. Using a quantitative comparison of household survey data and an analysis of the content of the reforms, we evaluate the effects of Colombia's health reforms on gender equity. We find that several aspects of these reforms hold promise for greater gender equity, such as the resulting increase in women's health insurance coverage. However, the reforms have not achieved gender equity due to the persistence of fees which discriminate against women and the introduction of a two-tier health system in which women heads of household and the poor are concentrated in a lower quality health system.

Policy Levers Key for Primary Health Care Organizations to Support Primary Care Practices in Meeting Medical Home Expectations: Comparing Leading States to the Australian Experience

PubMed Central

2016-01-01

Abstract Several countries with highly ranked delivery systems have implemented locally-based, publicly-funded primary health care organizations (PHCOs) as vehicles to strengthen their primary care foundations. In the United States, state governments have started down a similar pathway with models that share similarities with international PHCOs. The objective of this study was to determine if these kinds of organizations were working with primary care practices to improve their ability to provide comprehensive, coordinated, and accessible patient-centered care that met quality, safety, and efficiency outcomes—all core attributes of a medical home. This qualitative study looked at 4 different PHCO models—3 from the United States and 1 from Australia—with similar objectives and scope. Primary and secondary data included semi-structured interviews with 26 PHCOs and a review of government documents. The study found that the 4 PHCO models were engaging practices to meet a number of medical home expectations, but the US PHCOs were more uniform in efforts to work with practices and focused on arranging services to meet the needs of complex patients. There was significant variation in level of effort between the Australian PHCOs. These differences can be explained through the state governments' selection of payment models and use of data frameworks to support collaboration and incentivize performance of both PHCOs and practices. These findings offer policy lessons to inform health reform efforts under way to better capitalize on the potential of PHCOs to support a high-functioning primary health foundation as an essential component to a reformed health system. PMID:26636485

Assessment and Educational Reform: Doing More than Polishing Brass on the Titanic, a Call for Discussion.

ERIC Educational Resources Information Center

Jackman, Andrew

This exploration of evaluation strategies for systemic educational reform considers whether there is a way to design an assessment and delivery system that can accomplish the goals of the total educational process. A basic question that must be addressed in systemic reform is the role of education in the socialization processes of society. Beyond…

A miniature fuel reformer system for portable power sources

NASA Astrophysics Data System (ADS)

Dolanc, Gregor; Belavič, Darko; Hrovat, Marko; Hočevar, Stanko; Pohar, Andrej; Petrovčič, Janko; Musizza, Bojan

2014-12-01

A miniature methanol reformer system has been designed and built to technology readiness level exceeding a laboratory prototype. It is intended to feed fuel cells with electric power up to 100 W and contains a complete setup of the technological elements: catalytic reforming and PROX reactors, a combustor, evaporators, actuation and sensing elements, and a control unit. The system is engineered not only for performance and quality of the reformate, but also for its lightweight and compact design, seamless integration of elements, low internal electric consumption, and safety. In the paper, the design of the system is presented by focussing on its miniaturisation, integration, and process control.

The Effect of a Collaborative Mentoring Program on Beginning Science Teachers' Inquiry-based Teaching Practice

NASA Astrophysics Data System (ADS)

Nam, Jeonghee; Seung, Eulsun; Go, MunSuk

2013-03-01

This study investigated how a collaborative mentoring program influenced beginning science teachers' inquiry-based teaching and their reflection on practice. The one-year program consisted of five one-on-one mentoring meetings, weekly science education seminars, weekly mentoring group discussions, and self-evaluation activities. The participants were three beginning science teachers and three mentors at the middle school level (7-9th grades) in an urban area of South Korea. For each beginning teacher, five lessons were evaluated in terms of lesson design/implementation, procedural knowledge, and classroom culture by using the Reformed Teaching Observation Protocol. Five aspects of the beginning teachers' reflections were identified. This study showed that a collaborative mentoring program focusing on inquiry-based science teaching encouraged the beginning teachers to reflect on their own perceptions and teaching practice in terms of inquiry-based science teaching, which led to changes in their teaching practice. This study also highlighted the importance of collaborative interactions between the mentors and the beginning teachers during the mentoring process.

China's health care system reform: Progress and prospects.

PubMed

Li, Ling; Fu, Hongqiao

2017-07-01

This paper discusses the progress and prospects of China's complex health care reform beginning in 2009. The Chinese government's undertaking of systemic reform has achieved laudable achievements, including the expansion of social health insurance, the reform of public hospitals, and the strengthening of primary care. An innovative policy tool in China, policy experimentation under hierarchy, played an important role in facilitating these achievements. However, China still faces gaps and challenges in creating a single payer system, restructuring the public hospitals, and establishing an integrated delivery system. Recently, China issued the 13th 5-year plan for medical reform, setting forth the goals, policy priorities, and strategies for health reform in the following 5 years. Moreover, the Chinese government announced the "Healthy China 2030" blueprint in October 2016, which has the goals of providing universal health security for all citizens by 2030. By examining these policy priorities against the existing gaps and challenges, we conclude that China's health care reform is heading in the right direction. To effectively implement these policies, we recommend that China should take advantage of policy experimentation to mobilize bottom-up initiatives and encourage innovations. Copyright © 2017 John Wiley & Sons, Ltd.

Educational Reform in Spain.

ERIC Educational Resources Information Center

Marchesi, Alvaro

1992-01-01

Reviews the Spanish educational system, focusing on reforms enacted in 1990. Discusses reform movement issues, including quality, curricular control, curricular homogeneity versus diversity, and influence of European context. Describes reform movement aims (i.e., extending basic education and modifying educational levels to improve quality) and…

Health care reform and changes: the Malaysian experience.

PubMed

Merican, Mohd Ismail; bin Yon, Rohaizat

2002-01-01

Health care reform is an intentional, sustained and systematic process of structural change to one or more health subsystems to improve efficiency, effectiveness, patient choices and equity. Health care all over the world is continuously reforming with time. Health care reform has become an increasingly important agenda for policy change in both developed and developing countries including Malaysia. This paper provides an overview of the Malaysian health care system, its achievements, and issues and challenges leading to ongoing reform towards a more efficient and equitable health care system that possess a better quality of life for the population.

Solar central receiver reformer system for ammonia plants

NASA Astrophysics Data System (ADS)

1980-07-01

Details of the conceptual design, economic analysis, and development plan for a solar central receiver system for retrofitting the Valley Nitrogen Producers, Inc., El Centro, California 600 ST/SD Ammonia Plant are presented. The retrofit system consists of a solar central receiver reformer (SCRR) operating in parallel with the existing fossil fired reformer. Steam and hydrocarbon react in the catalyst filled tubes of the inner cavity receiver to form a hydrogen rich mixture which is the syngas feed for the ammonia production. The SCRR system displaces natural gas presently used in the fossil reformer combustion chamber. The solar reformer retrofit system characteristics and its interface with the existing plant are simple, incorporating state of the art components with proven technology. A northfield composed of one thousand forty second generation heliostats provides solar energy to the receiver which is positioned on top of a 90 meter high steel tower. The overall economics of this system can provide over 20% discount cash flow rate of return with proper investment and market conditions.

The Retrospection and Elicitation of China's Teacher Education Reform and Opening-Up More Than 30 Years

ERIC Educational Resources Information Center

Tian-Ping, Yang

2012-01-01

Since implementation of reform and opening-up policy, China's teacher education has got significant success on policy design, legislation process, theory research, system reform, model innovation and teaching qualification system building. Teachers' educational background level has been increased. Teachers' professional ethics and teaching…

Applying Concepts of Critical Pedagogy to Qatar's Educational Reform

ERIC Educational Resources Information Center

Romanowski, Michael H.; Amatullah, Tasneem

2016-01-01

Qatar is in the midst of a systemic education reform, Education For a New Era, steered by RAND's (a nonprofit research organization) analysis and report of Qatar's Educational system. Driven by a neoliberal agenda, the reform includes international curricula, curriculum standards, teacher licensure, and professional standards for school leaders…

The dynamics of health care reform--learning from a complex adaptive systems theoretical perspective.

PubMed

Sturmberg, Joachim P; Martin, Carmel M

2010-10-01

Health services demonstrate key features of complex adaptive systems (CAS), they are dynamic and unfold in unpredictable ways, and unfolding events are often unique. To better understand the complex adaptive nature of health systems around a core attractor we propose the metaphor of the health care vortex. We also suggest that in an ideal health care system the core attractor would be personal health attainment. Health care reforms around the world offer an opportunity to analyse health system change from a complex adaptive perspective. At large health care reforms have been pursued disregarding the complex adaptive nature of the health system. The paper details some recent reforms and outlines how to understand their strategies and outcomes, and what could be learnt for future efforts, utilising CAS principles. Current health systems show the inherent properties of a CAS driven by a core attractor of disease and cost containment. We content that more meaningful health systems reform requires the delicate task of shifting the core attractor from disease and cost containment towards health attainment.

Morality's ugly implications in Oscar Wilde's fairy tales.

PubMed

Jones, Justin T

2011-01-01

In Oscar Wilde's two volumes of fairy tales, "The Happy Prince" and Other Tales (1888) and A House of Pomegranates (1891), many central characters meet with premature death or physical disfigurement after learning a bourgeois moral lesson. In an attempt to explain this unconventional phenomenon in the fairy tale tradition, this essay examines Wilde's stories through the lens of his aesthetic ideology and demonstrates how the superficial morality of the Victorian bourgeoisie corrodes each tale's aesthetic integrity, causing the characters to either deny morality outright, assume the guise of Christian philanthropy, or die as the result of their moral reformation.

Healthcare reform: the role of coordinated critical care.

PubMed

Cerra, F B

1993-03-01

To evaluate and editorialize the evolving role of the discipline of critical care as a healthcare delivery system in the process of healthcare reform. The sources included material from the Federal Office of Management and Budget, Health Care Financing Review, President Bush's Office, Association of American Medical Colleges, and publications of the Society of Critical Care Medicine. Data were selected that the author felt was relevant to the healthcare reform process and its implications for the discipline of critical care. The data were extracted by the author to illustrate the forces behind healthcare reform, the implications for the practice of critical care, and role of critical care as a coordinated (managed) care system in the process of healthcare reform. Healthcare reform has been initiated because of a number of considerations that arise in evaluating the current healthcare delivery system: access, financing, cost, dissatisfactions with the mechanisms of delivery, and political issues. The reform process will occur with or without the involvement of critical care practitioners. Reforms may greatly alter the delivery of critical care services, education, training, and research in critical care. Critical care has evolved into a healthcare delivery system that provides services to patients who need and request them and provides these services in a coordinated (managed) care model. Critical care practitioners must become involved in the healthcare reform process, and critical care services that are effective must be preserved, as must the education, training, and research programs. Critical care as a healthcare delivery system utilizing a coordinated (managed) care model has the potential to provide services to all patients who need them and to deliver them in a manner that is cost effective and recognized as providing added value.

Engaging civil society through deliberative dialogue to create the first Mental Health Strategy for Canada: Changing Directions, Changing Lives.

PubMed

Mulvale, Gillian; Chodos, Howard; Bartram, Mary; MacKinnon, Mary Pat; Abud, Manon

2014-12-01

Citizen engagement through deliberative dialogue is increasingly being used to address 'wicked problems' in policy-making, such as the development of national mental health policy. In 2012, the Mental Health Commission of Canada (MHCC), a national organization funded by and operating at arm's length from the federal government, released the first Mental Health Strategy for Canada: Changing Directions, Changing Lives (Mental Health Commission of Canada, 2012). Despite much-needed reform, Canada, unlike most other industrialized countries, had never previously developed a national Mental Health Strategy (the Strategy). This was due to a mix of policy factors, including a federalist system of government where primary responsibility for healthcare resides with provincial and territorial governments and a highly diverse set of stakeholder groups with diverging core ideas for mental health reform that were rooted in deeply held value differences. In this case study, we review the essential role that engagement of civil society played in the creation of the Strategy, beginning with the efforts to create a national body to shine the light on the need for mental health reform in Canada, followed by the development of a framework of specific goals based on core principles to guide the development of the Strategy, and ultimately, the creation of the Strategy itself. We discuss the various approaches to civil society engagement in each step of this process and focus in particular on how deliberative approaches helped build trust and common ground amongst stakeholders around complex, and often contentious, issues. The nature and outcomes of the deliberative processes including the key tensions between different stakeholder perspectives and values are described. We close by highlighting the lessons learned in a process that culminated with a Strategy that received strong endorsement from stakeholders across Canada. Mental Health Commission of Canada (2012). Changing Directions Changing Lives, The Mental Health Strategy for Canada. Calgary, AB: MHCC. Copyright © 2014 Elsevier Ltd. All rights reserved.

A layman's guide to the U.S. health care system

PubMed Central

De Lew, Nancy; Greenberg, George; Kinchen, Kraig

1992-01-01

This article provides an overview of the U.S. health care system and recent proposals for health system reform. Prepared for a 15-nation comparative study for the Organization for Economic Cooperation and Development (OECD), the article summarizes descriptive data on the financing, utilization, access, and supply of U.S. health services; analyzes health system cost growth and trends; reviews health reforms adopted in the 1980s; and discusses proposals in the current health system reform debate. PMID:10124436

Reform of China's Technical and Vocational Education in the Transition from a Planned Economy System to a Socialist Market Economy System--A Case Study. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Yu, Zuguang; Zeng, Zida

Since the early 1990s, China's government has followed a socialist market economy system. Accordingly, the technical and vocational education (TVE) should be restructured to meet its needs. Reform of the TVE system has four aspects. First, reform of the planning system includes a move from a central plan of enrollment to planning according to…

The Gateway Paper--context and configuration of the proposed health reforms in Pakistan.

PubMed

Nishtar, Sania

2006-12-01

As an opening of a dialogue on health reforms in Pakistan, the Gateway Paper presents a viewpoint on its proposed directions making a strong case for systems reforms, which need to scope beyond the healthcare system. Positioning the reform process to strengthen Pakistan's health policy cycle, the paper articulates a roadmap for a paradigm shift to achieve health outcomes in Pakistan with major structural reorganization within the health system. The proposed reform points in the four areas namely, reforms within the health sector, overarching measures, reconfiguration of health within an inter-sectoral scope and generating evidence for reforms. Reforms within the health sector focus on developing new models of service delivery and health financing which can enable the state to leverage the private sector outreach to deliver health-related public goods on the one hand and maximize the outreach of the State's health care delivery mechanisms through mainstreaming the role of the private sector on the other, albeit with safeguards. In addition, these call for strengthening the stewardship role to regulate these arrangements. The second area of reform focuses on overarching measures; these include developing frameworks for public-private partnerships which will enable the bringing together of organizations with the mandate to offer public goods and those that could facilitate this goal through the provision of resources, technical expertise or outreach; mainstreaming health into the country's social protection strategy in order to address issues of access and affordability for the poor and introducing civil service and public service reform focused on good governance, accountability, breakdown of institutional corruption which are critical to improving health outcomes. The third area of reform involves broadening health to its inter-sectoral scope, redefinition of objectives and targets within the health sector and garnering support from across the sectors to forester inter-sectoral action particularly with reference to the social determinant of health. The fourth area of reform focuses on generation of evidence around which several priority areas for health systems and policy research have been flagged. The Gateway Paper also underscores the need to develop norms and standards and points to institution mechanisms which need to be created to support the reform process.

Understanding deficiencies of leadership in advancing health equity: a case of pit bulls, public health, and pimps.

PubMed

Clancy, Gerard P

2015-04-01

Market- and legislation-driven health reforms are being implemented across the United States. Within this time of great change for health care delivery systems and medical schools lie opportunities to address the country's long-standing health inequities by using community needs assessments, health information technologies, and new models for care and payment. In this Commentary, the author, a university regional campus leader, shares several difficult personal experiences to demonstrate that health equity work undertaken by academic institutions also requires institutional leaders to pay attention to and gain an understanding of issues that go beyond public health data. The author reflects on lessons learned and offers recommendations that may help academic health center and university leaders be more effective as they take on the complex tasks involved in improving health inequities. These include reflection on personal strengths and deficiencies, engagement with the community, recognition of the historical roots of health disparities, and the development of trusting relationships between the institution and the community.

Building regulatory and operational flexibility into accountable care organizations and 'shared savings'.

PubMed

Lieberman, Steven M; Bertko, John M

2011-01-01

The Affordable Care Act created accountable care organizations (ACOs), which will be a new part of Medicare as of January 2012, together with a "shared savings program" that will modify how these organizations will be paid to care for patients. Accountable care organizations have the potential to lower costs, improve the quality of care, facilitate delivery system reform, and promote innovation in health care. The federal government is set to create rules to regulate these organizations and has broad discretion to allow them to pursue a variety of approaches. Drawing on experience from some ACO pilot programs and the Medicare Part D prescription drug coverage program, we argue that regulations governing accountable care organizations should be flexible, encouraging of diversity and innovation and allowing for changes over time based on lessons learned. We recommend using regulations as a general framework, while relying on notices and other guidance below the regulatory level to spell out specific requirements.

Risk adjustment policy options for casemix funding: international lessons in financing reform.

PubMed

Antioch, Kathryn M; Ellis, Randall P; Gillett, Steve; Borovnicar, Daniel; Marshall, Ric P

2007-09-01

This paper explores modified hospital casemix payment formulae that would refine the diagnosis-related group (DRG) system in Victoria, Australia, which already makes adjustments for teaching, severity and demographics. We estimate alternative casemix funding methods using multiple regressions for individual hospital episodes from 2001 to 2003 on 70 high-deficit DRGs, focussing on teaching hospitals where the largest deficits have occurred. Our casemix variables are diagnosis- and procedure-based severity markers, counts of diagnoses and procedures, disease types, complexity, day outliers, emergency admission and "transfers in." The results are presented for four policy options that vary according to whether all of the dollars or only some are reallocated, whether all or some hospitals are used and whether the alternatives augment or replace existing payments. While our approach identifies variables that help explain patient cost variations, hospital-level simulations suggest that the approaches explored would only reduce teaching hospital underpayment by about 10%. The implications of various policy options are discussed.