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Substantial evidence on the adverse impact of ageing on lesbian, gay, bisexual and transgender (LGBT+) populations through the lack of inclusive care services has highlighted the need for education and training of the health and social care workforce to enhance their skills, knowledge and capabilities in this area. We describe a cross-national collaboration across four European Union countries called BEING ME. This collaboration examined the current pedagogic environment within professional, vocational and community-based education to identify what is most valuable for addressing these needs. The World Café method enabled a process of structured learning and knowledge exchange between stakeholders resulting in: (a) identification of best practices in pedagogies, (b) generation of tailored co-produced educational resources, and (c) recommendations on how to improve the knowledge and capabilities of future care professionals in the area of LGBT+ affirmative practices. Combined with themes from the post-Café evaluation, our findings suggest that underpinning professional and vocational education with a person-in-environment perspective facilitates going some way to acknowledging the historical context of older LGBT+ people's lives. Addressing the unique needs of sub-populations within LGBT+ communities and setting these in the context of holistic and person-centred care may better enable the meeting of their unique diverse needs for ageing. Recommendations are made for learning and teaching strategies to support improved LGBT+ aged care.
Despite enormous strides in our field with respect to patient care, there has been surprisingly limited dialogue on how to train and educate the next generation of congenital cardiologists. This paper reviews the current status of training and evolving developments in medical education pertinent to congenital cardiology. The adoption of competency-based medical education has been lauded as a robust framework for contemporary medical education over the last two decades. However, inconsistencies in frameworks across different jurisdictions remain, and bridging gaps between competency frameworks and clinical practice has proved challenging. Entrustable professional activities have been proposed as a solution but integration of such activities into busy clinical cardiology practices will present its own challenges. Consequently, this pivot toward a more structured approach to medical education necessitates the widespread availability of appropriately trained medical educationalists; a development that will better inform curriculum development, instructional design, and assessment. Differentiation between superficial and deep learning, the vital role of rich formative feedback and coaching, should guide our trainees to become self-regulated learners, capable of critical reasoning yet retaining an awareness of uncertainty and ambiguity. Furthermore, disruptive innovations such as ‘technology enhanced learning’ may be leveraged to improve education, especially for trainees from low- and middle-income countries. Each of these initiatives will require resources, widespread advocacy and raised awareness, and publication of supporting data, and so it is especially gratifying that Cardiology in The Young has fostered a progressive approach, agreeing to publish one or two articles in each journal issue in this domain.
Flexible learning programs (FLPs) provide a place for students who have disengaged and disconnected from mainstream schools. Despite the legislative framework in Australia supporting the participation of students with disability in their local mainstream schools wherever possible, very little research focusing on whether students with disability are being excluded from, or dropping out of, mainstream schools into these FLPs has been conducted. In this paper, we report on the findings of an online cross-sectional survey of FLP leaders about their student populations, with a focus on the 10 most prevalent disabilities among Australian children. Data from the 22 participants who completed all items of the survey were analysed. The participants’ (n = 22) schools represented a total enrolment of 2,383 students in FLPs across Australia: Tasmania (n = 3), Victoria (n = 5), New South Wales (n = 5), Queensland (n = 4), Western Australia (n = 3), and South Australia (n = 2). We found that while there was an apparent overrepresentation of students with certain types of disabilities in FLPs, others were not overrepresented at all. The findings of this preliminary study are discussed, with an exploration of issues relating to why students with some disabilities may be more likely to disengage, or be excluded, from mainstream schooling while others are not, as well as recommendations for future research.
Chapter 7 deals with welfare governance concerning health, education, food security, and environmental protection in areas of limited statehood. The provision of collective goods and services with regard to welfare is possible “under anarchy” and under rather adverse conditions of civil war. The chapter covers a wide variety of actors – from IOs and foreign donors to (multinational) companies, multi-stakeholder partnerships, (I)NGOs, violent non-state actors, and “traditional” authorities. We find that most governors are able to provide effective governance services. Recent studies demonstrate that foreign aid improves local conditions, thereby contributing to increased state legitimacy. The contributions of business and VNSA to effective welfare governance is more circumscribed. Business as governors will step in as subsidiary service providers as long as nobody else is providing governance. As to VNSA, legitimacy needs lead them to provide effective welfare governance. However, the circle from effective governance to output legitimacy is likely to be disrupted by their opponents, e.g. by state actors fighting them. Effective welfare governance depends on two scope conditions: the absence of large-scale violence and at least some degree of public security, on the one hand, and a minimum infrastructure (such as roads and electricity), on the other.
Other regions are indeed following paths that diverge from the route taken by the industrialized leaders over the last two centuries. In terms of the overall effort to spending tax money on social programs, both for social insurance and for public education, while the later-developing regions have spent lower shares of GDP than do the leading rich countries today, they pay higher tax shares for social spending than did the leaders did at the same levels of real income in the past. Fifty years from now, social spending will well take more than twenty percent of GDP in Japan and many countries of Eastern Europe, and even North America. Yet elsewhere many countries, some with low social spending and some with high, appear to be making wrong choices within their social budgets. This criticism applies especially to India, Turkey, Greece, Latin America, and other nations within the global South. These countries generally have lower PISA scores, lower GDP per person, and higher inequality to show for it.
Since 1914 rich countries have shifted their social spending missions, away from anti-poverty policies and mass schooling and toward subsidies to the elderly. Over r4ecent generations, this mission shift has probably compromised both income equality and income growth. The global mission shift toward public pensions may have been due in large part to improvements in life expectancy, which allowed longer life past work and contributed to political “gray power.” The inference about gray power springs from the fact that public pension spending rose even per elderly person, and not just at the rate of population aging. Its per-person generosity rose faster than the rise in educational spending per child of school age. The rising demand for government pensions was probably linked, in addition, to a quiet global change in the role of intra-family transfers. Career and family developments may have raised public pressure for more government support of the elderly.
Human societies have always needed safety nets to catch those who end up in need. The risks have always been there. Only recently has there been a global surge in government social spending. The major historical issues raised by this long delay are introduced in this chapter. Readers are given spoiler alerts about whether it had to be government that spread the nets, and about whether large-spending countries got the mix of social spending wrong more often than did low-spending governments. The conventional arguments for and against tax-based social spending are introduced.
This paper presents a new dataset of enrolment rates and grade distribution ratios (GDR) in Brazil between 1933 and 2010, in addition to enrolment rates and GDR of Brazilian states from 1955 to 2010. To our knowledge, there are no previous estimates of enrolment rates by states for such a long period in Brazil. Enrolment rates and GDR in northern and north-eastern states were meagre and comparable to the lowest Latin American performers, and even the most advanced Brazilian states lagged behind the early leaders of the region, such as Argentina and Uruguay, until the turn of the century. Given a certain enrolment rate, Brazilian states were expected to present lower GDR compared to Latin American countries on average.
Schools have a significant role in disaster education to children. This study investigates the research works about school-based education programs in order to discover challenges and best practices. We conducted a systematic review of English language papers published in peer-review journals.
The search identified 2577 publications and 61 articles meeting selection criteria and included in the review. Reviewed studies indicated that disaster education in schools is effective but yet insufficient in many countries. Lack of equipment, financial resources, policy gaps, and teachers’ knowledge are common problems in programs. Main outcomes of this systematic review are showing methods used for health emergency preparedness of children of different ages and gender differences in school-based disaster preparedness, as well as the difference in their lifesaving skills in disasters.
This study shows that some disaster education programs reported in the papers reviewed were not high-quality enough, which may lead to insufficient preparedness of children in disasters and consequently may put their health at risk, considering the increasing number of natural hazards.
This paper examines the relationship between the coming of the railroads, the expansion of primary education, and the introduction of national school curricula. Using fine-grained data on local education outcomes in Sweden in the nineteenth century, the paper tests the idea that the development of the railroad network enabled national school inspectors to monitor remote schools more effectively. In localities to which school inspectors could travel by rail, a larger share of children attended permanent public schools and took classes in nation-building subjects such as geography and history. By contrast, the parochial interests of local and religious authorities continued to dominate in remote areas school inspectors could not reach by train. The paper argues for a causal interpretation of these findings, which are robust for the share of children in permanent schools and suggestive for the content of the curriculum. The paper therefore concludes that the railroad, the defining innovation of the First Industrial Revolution, mattered directly for the state's ability to implement public policies.
This chapter examines the crucial place education occupied in Heaney’s professional experience and literary imagination. His ruminations on teaching and learning in both poetry and prose open up personal, social, pedagogical, and political questions which grant us a richer understanding of the institutional and intellectual forces which shaped his thinking. The chapter begins by acknowledging Heaney’s beginnings as a schoolteacher in Belfast in the 1960s, and the work he undertook for the BBC Northern Ireland Schools Service with his friend David Hammond in the 1970s. His collaboration with another friend, Ted Hughes, on the celebrated Faber anthologies The Rattle Bag (1982) and The School Bag (1997), and his later recollections of this work, are central to this argument, revealing complex and generationally specific convictions about the practices of reading, writing, and teaching, from which we may yet have much to learn.
Exercising physical and occupational mobility is often understood as central to Black freedom on a national scale. Mobility as “freedom to move” is also, as Janaka Bowman Lewis argues in this chapter, central to gendered practices of Black geography. By taking up Charlotte Forten as a case study illuminated by a host of African American women’s geographical practices at mid-century, Bowman Lewis argues for a distinct narrative genre and an understanding of mobility as far more than physical movement, proposing that “mid-century Black women’s narratives of education, individual progress, marriage and family, labor, and intellectual commitments more widely … both reflected and produced national and community rebuilding projects.” Bowman Lewis considers the ways in which Black women exercised their autonomous personhood through quotidian practices, in place, as well as through physical mobility through space. For her, Forten’s participation in the Port Royal project is no more significant a practice than those she watches Sea Island women undertake, and in fact it is through her acts of observation – not necessarily through her movement – that Forten is led to a self-realization or actualization of freedom.
While population ageing is rising, the educational composition of the elderly remains rather heterogeneous. This study assesses the educational differences in future population ageing in Asia and Europe, and how future population ageing in Asia and Europe would change if the educational composition of its populations changed. A comparative population ageing measure (the Comparative Prospective Old-Age Threshold [CPOAT]) was used, which recalculates old-age thresholds after accounting for differences in life expectancy, and the likelihood of adults surviving to higher ages. Combined data from projected age- and sex-specific life-tables (from the United Nations) and projected age- and sex-specific survival ratios by different levels of education (from the Wittgenstein Centre for Demography and Global Human Capital) were used to construct projected life-tables (2015–2020, …, 2045–2050) by educational level and sex for different regions of Asia and Europe. Based on these life-tables, future comparative prospective old-age thresholds by educational level and sex were calculated. It was found that in both Asia and Europe, and among both men and women, the projected old-age thresholds are higher for higher educated people than for less-educated people. While Europe has a larger projected share of elderly in the population than Asia, Europe’s older population is better educated. In alternative future scenarios in which populations hypothetically have higher levels of education, the projected shares of elderly in the population decrease across all regions of Asia and Europe, but more so in Asia. The results highlight the effectiveness of investing in education as a policy response to the challenges associated with population ageing in Asia and Europe. Such investments are more effective in the Asian regions, where the educational infrastructure is less developed.
To examine whether the educational level moderates the relationship between baseline depressive symptoms and cognitive functioning at 5- and 10-year follow-ups in older adults, considering the association between cognitive functioning and difficulty with activities of daily living (ADL).
Using a prospective design, a path analysis was performed.
In-home, face-to-face interviews and self-administered questionnaires, within the National Social Life, Health, and Aging Project.
In total, 1,461 participants (mean age = 66.62) were followed up from Wave 1 (baseline) to Wave 2 (at 5 years) and Wave 3 (at 10 years).
Depressive symptoms were assessed at baseline. Cognitive functioning and difficulty with ADL were assessed at baseline and at 5 and 10 years.
Educational level moderates the relationship between depressive symptoms and cognitive functioning at 5 years (β = 0.07, SE = 0.03, p = 0.04, Cohen’s f2 = 0.02), being depressive symptoms related to poor cognitive functioning only at low educational levels. Cognitive functioning predicts difficulty with ADL at 5 and 10 years (β = −0.08, SE = 0.03, p = 0.008, Cohen’s f2 = 0.01; β = −0.09, SE = 0.03, p = 0.006, Cohen’s f2 = 0.02). The proposed model yielded excellent fit (CFI = 1.00, RMSEA = 0.0001, 90% CI 0.0001–0.03, SRMR = 0.004, and χ2(8) = 7.16, p = 0.52).
Cognitive reserve may act as a protective factor against the effect of depressive symptoms on cognition in older adults, which, in turn, is relevant to their functional independence.
As a response to the acute strain placed on the National Health Service during the first wave of coronavirus disease 2019 in the UK, a number of junior doctors including ENT trainees were redeployed to other clinical specialties. This presented these trainees with novel challenges and opportunities.
A qualitative study was performed to explore these experiences, undertaking semi-structured interviews with ENT trainees between 17th and 30th July. Participants were recruited through purposeful sampling. Interview transcripts underwent thematic analysis using Dedoose software.
Seven ENT trainees were interviewed, ranging from specialty trainee years four to eight (‘ST4’ to ‘ST8’) in grade. Six core themes were identified: organisation of redeployment, utilisation of skill set, emotional impact of redeployment, redeployed team dynamics, concerns about safety and impact on training.
The ENT trainees’ experiences of redeployment described highlight some important lessons and considerations for future redeployments.
Chapter 4 explores the origins of group empathy. We investigate the association of group empathy with key socio-demographic factors and the ensuing life experiences. Specifically, we find that minorities, females, the educated, and older generations display higher levels of group empathy. The life experiences that spring from these socio-demographic contexts – particularly, exposure to discrimination, the quality and quantity of contact with other groups, and perceptions of intergroup economic competition – also predict group empathy and help explain socio-demographic differences on group empathy levels. The chapter also empirically tests predictions about the link between ingroup identification and outgroup empathy among whites, blacks, and Latinos. Social Identity Theory would predict ingroup attachment to be negatively linked to outgroup empathy across all groups. However, Group Empathy Theory predicts outgroup empathy should be positively linked with ingroup identity among nonwhites. This is exactly what we find. This finding challenges one of the basic assumptions of SIT given that the underlying mechanism of ingroup–outgroup bias is different for whites than it is for minorities.
Patients with schizophrenia spectrum disorders have been increasingly recognised to form cognitive subgroups with differential levels of impairment. Using cluster analytical techniques, this study sought to identify cognitive clusters in a sample of first-episode psychosis (FEP) patients and examine clinical and developmental differences across the resultant groups.
In total, 105 FEP patients in the University of California Los Angeles Aftercare Research Program were assessed for cognition, symptoms and premorbid developmental adjustment. Hierarchical cluster analysis with Ward's method and squared Euclidean distance was conducted, confirmed by discriminant function analysis and optimised with k-means clustering. The stability of the solution was evaluated through split-sample (random, 80 and 70% samples) and alternate method (average linkage method) replication via Cohen's κ analysis. Controlling for multiple comparisons, one-way analysis of variances examined group differences in symptom severity and premorbid adjustment.
Three groups were identified: severely impaired (n = 27), moderately impaired (n = 41) and relatively intact (n = 37). There were no significant differences in symptom severity across the groups. Significant differences were observed for scholastic performance at three different developmental stages: childhood, early adolescence and late adolescence, with the relatively intact group demonstrating significantly better scholastic performance at all three stages than both the moderately impaired and severely impaired groups (who did not significantly differ from each other).
The findings add to growing evidence that cognitive clusters in FEP mirror that of later-stage schizophrenia. They also suggest that premorbid scholastic performance may not just be a risk factor for developing schizophrenia, but is also related to cognitive impairment severity and potentially to prognosis.
Post-war Sierra Leone has experienced a population explosion that has raised questions among rural farmers about the relationship between family size and poverty. Agricultural decline and the high cost of schooling are not prompting parents to articulate a desire for smaller families; rather, they highlight that the uncertainty around articulating the “right” number of children is unresolvable because the ability to send children to school is predicated on increasing agricultural outputs that decline precisely because population pressure has reduced soil fertility. Bolten and Marcantonio conclude that this renders family size the heart of a paradox, where there is no optimal number of children.