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61.
Criteria for assessing the effectiveness of a medical screening program are difficult to define; medical knowledge and screening procedures change rapidly, and self-selection at medical screens is unavoidable. This article discusses these and other basic issues in evaluation of medical screening programs with particular reference to results from the HIP breast cancer study. In addition, the article reviews various statistical models that describe the processes of disease and screening. The models are shown to be statistically indistinguishable in practice because of the small sample sizes typically available in medical screening trials. Finally the article suggests incorporating knowledge from clinical trials and from studies of robustness into statistical models designed to identify reasonable strategies for screening.  相似文献   
62.
在追求公平与质量的学前教育时代背景下,推动大型公共学前教育项目以保障弱势儿童群体的受教育权是政府的应尽责任和重要任务。当前我国公共学前教育项目正处于起步阶段,可多方借鉴有效学前教育项目的国际经验。本研究以新泽西州阿博特学前教育项目(Abbott Preschool Program)这一被公认为高效能的项目为对象,重点探讨了该项目在政策保障与政府执行、财政投入与供给模式、多层质量标准体系、高标准教师队伍以及监测系统构建等方面的核心举措,总结了该项目的中短期成效和问题反思,并结合当前我国学前教育项目的实施现状,从支持保障系统、质量提升系统、项目设计核心要素等方面提出了相应政策建议。  相似文献   
63.
Despite decades of efforts to achieve gender equality in research and innovation (R&I), all EU member states still face remarkable difficulties in driving forward the development of their innovation system while at the same time improving gender equality by using all the available research potential. In this paper we focus on the development of the share of women researchers in four national innovation systems, i.e. in Austria, Denmark, Hungary and Spain in the time period 2005-2015. The four selected cases represent countries with significant differences in their innovation capacity, gender regimes and progress of gender equality in R&I. A qualitative comparative analysis (QCA) is carried out to conduct a sector program evaluation based on statistical data and qualitative studies to understand the dynamic development of the proportion of women researchers. The study aims to provide insights into the aggregated gender equality interventions and policies implemented in the four countries studied and their contributions to the development of the proportion of women scientists at the structural level. The analysis reveals that the development of the share of women researchers during the studied period has been particularly influenced by contextual factors, namely the relative size of the business enterprise sector and the share of women among holders of tertiary education. While this is the case, it is found that gender equality interventions need to be more widespread and more effectively designed to be a strong contributing factor to an increasing representation of women in R&I.  相似文献   
64.
Women with disabilities are more vulnerable to violence, including intimate partner violence (IPV), yet the majority of emerging IPV prevention programs fail to explicitly consider the needs of participants with disabilities. Women and men living with disabilities engaged with IPV prevention programs in four countries were interviewed to explore how disability shaped their experiences of gender, violence, IPV, and whether the programs met their disability related needs. In-depth interviews were conducted with 16 women and 15 men living with disabilities in Ghana, Rwanda, Tajikistan and South Africa. The data were analysed thematically and compared across the settings. Participants described experiencing disability-related stigma, discrimination, exclusion, and for women, increased vulnerability to IPV. Barriers to full participation in programs included limited accessibility, and lack of disability-specific materials, recruitment or outreach. Enablers of inclusion included recruitment and monitoring strategies aimed at people with disabilities, partnering with a local disabled people’s organization, training staff in disability inclusion, and raising awareness of disability rights. The data encouragingly suggests that inclusion of women and men with disabilities in IPV prevention programs designed for the general population has beneficial outcomes. Inclusion can prevent violence, promote their wellbeing, support economic empowerment, and challenge disability-related stigma and discrimination.  相似文献   
65.

Background

The rates of breastfeeding worldwide are slowly improving since 1996. Europe is still trailing behind the global breastfeeding incidence and prevalence rates. Thus, breastfeeding promotion, protection, prolongation and support have become an important challenge as breastfeeding sharply decreases in the first six months of life.

Objectives

The aim of this project is to determine, assess and identify the real impact of breastfeeding support networks in Murcia (Spain).

Methods

After searching unsuccessfully for a validated questionnaire, a specific one was developed and validated for measuring the impact of formal and informal support networks through five dimensions: satisfaction, consultation, experience, problems and support. The questionnaire was provided to 500 mothers with experience in breastfeeding, who brought their children to baby paediatricians between 2 June and 27 November 2014. Upon completion of the survey and fieldwork, a detailed statistical analysis was conducted.

Results

The degree of satisfaction perceived by the users of the services of support breastfeeding networks is remarkable. In addition, mothers who clarified their doubts and discussed their problems with health professionals and/or breastfeeding support networks were more likely to breastfeed for a longer duration compared to those who did not (p = 0.005). Furthermore, mothers who sought support in breastfeeding are more likely to breastfeed for more than 6 months (p < 0.0005).

Conclusion

Based on this information, we conclude that breastfeeding support networks have a positive influence in the duration of a women’s decision to breastfeed.  相似文献   
66.
Addressing the lack of physical activity (PA) in rural adults is vital because of the role it plays in the risk for many chronic diseases. The purpose of the study was to explore the feasibility of conducting a 12-week intervention utilizing a Fitbit to increase PA behavior in inactive rural adults recruited from a primary care clinic. Semi-structured interviews were conducted with study participants (n=10) and a focus group was held with nurses (n=7) from the primary care clinic. Data were analyzed using the process of immersion/crystallization. Participants and nurses both felt the program had a positive impact on PA and that the program was needed in the community. Study participants most often reported their favorite part of the study was being able to track their activity as well as the goal setting. However, study participants reported barriers to continued participation in PA related to a lack of time and ability to be active in cold weather. Further, nursing staff reported barriers in regard to a lack of resources (staffing and money) These barriers need to be examined further and addressed in order to implement a sustainable PA program that can be maintained through a primary care clinic.  相似文献   
67.
ABSTRACT

Short-term study abroad programs are increasingly embraced by Australian schools of social work. These programs improve access to international experiences and have a demonstrable impact on academic outcomes. However, little is known about the factors that influence students who decide to participate in such programs. Using a qualitative semistructured design, eight Australian social work students were interviewed about their perspectives on the pre-application phase of a short-term study abroad program to Ireland that was advertised in early 2018. The findings reveal a number of multilevel structural, institutional, and personal enablers and barriers that impacted their decision to participate. Implications for future research, the tertiary education sector, and social work educators are identified, especially in terms of broader economic and political issues that contradict social justice and render the future of these programs precarious.

IMPLICATIONS
  • Short-term study abroad programs offer important learning opportunities for students, but there is a need to understand the dimensions that can impact the decisions of students to participate in these programs.

  • The qualitative findings indicate that various factors impact on the participation of students, especially financial and caring responsibilities.

  • Further research that is underpinned by a social justice lens is needed to address inequities in student participation.

  相似文献   
68.
The 1962–67 High/Scope Perry Preschool Program, a well-known experimental early childhood intervention study that provided quality preschool education to disadvantaged children, has been shown to have had positive impacts on early child development and on a variety of adulthood outcomes. However, most previous analyses have only examined average treatment effects across all program participants without exploring possible effect heterogeneity by children's background characteristics. We investigated this question by first using the 1964–65 Current Population Survey data in combination with the Perry data to construct a scale of child socioeconomic status based on the estimated propensity for inclusion in the Perry program, then analyzing effect heterogeneity within the Perry sample by strata of our socioeconomic scale. We found that the treatment effects of enrollment in the Perry preschool on cognitive and non-cognitive skills were much larger and more persistent among the most disadvantaged children than among others in the Perry program. Furthermore, among the most disadvantaged children, the treatment (i.e., preschool enrollment) affects later outcomes through a reinforcement mechanism of skill development (i.e., early cognitive gain leads to a non-cognitive gain, which in turn leads to later cognitive gain) and a sequential improvement of cognitive skills over time. These findings have important implications for the evaluation of policy interventions in early child development using experimental data.  相似文献   
69.
Evaluators are challenged to keep pace with the vast array of Veteran support programs operating in the United States, resulting in a situation in which many programs lack any evidence of impact. Due to this lack of evidence, there is no efficient way to suggest which programs are most effective in helping Veterans in need of support. One potential solution to this dilemma is to reconceptualize program evaluation, by moving away from evaluating programs individually to evaluating what is common across programs. The Common Components Analysis (CCA) is one such technique that aggregates findings from programs that have undergone rigorous evaluation at the level of program components (e.g., content, process, barrier reduction). Given that many Veteran programs lack outcome evidence from rigorous studies, an adaptation to CCA is needed. This report examines cross-sectional data from a pilot study using an adapted CCA across five domains of well-being (i.e., employment, education, legal/financial/housing, mental/physical health, and social/personal relationships). The purpose of this preliminary study is to determine the feasibility of eliciting program nominations and program components from Veterans via an online survey. When coupled with a longitudinal research design, this adaptation to CCA will allow for stronger causal claims about the expected impact of different program components within and across a variety of domains.  相似文献   
70.
How do the politics of agenda setting and policy adoption operate in the arena of healthcare reform in the industrializing world? Literature on the twenty‐first‐century developmental state emphasizes the role of democratic competition and civil society in causing political parties to take up new agendas, while power resources theory stresses the role of left‐wing political parties and labor unions in policy adoption. Yet, core tenets of these theories have not been considered extensively in light of dynamics in the industrializing world. This article examines the politics of policy adoption in countries that have recently aimed to provide healthcare access and financial protection to the poor and people in the informal sector in Mexico and Turkey. In line with literature on the twenty‐first‐century developmental state, we find democratic competition to play an important role in causing political parties to take up new agendas. However, examination of the cases illuminates surprising dynamics that challenge important elements of sociological theory: right‐leaning political parties played important roles in adoption, while labor unions and left‐wing parties oppose reform in the cases. Public health‐minded physicians leading change teams played important roles in agenda setting and leading the process of implementation.  相似文献   
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