Actively Engaged Research Articles

The effect of activity type on the engagement and interaction of young children with disabilities in inclusive childcare settings

► The engagement of children with disabilities in childcare was observed across activity types. ► Level of engagement was higher during free play and routines. ► Children with disabilities were more actively engaged during routines and more passively engaged during group activities. ► Level of adult interaction was comparable across activity types but interaction with peers more frequent during free play. ► Children with ASD engaged less and interacted less with peers in free play than children with other disabilities. The engagement and adult and peer interaction of 37 young children with a range of disabilities was measured in free play, group, and meal-routine activities in inclusive childcare settings. A significant effect for activity type was found for total engagement, active engagement, and passive engagement, with the children being more engaged in free-play and meal-routine activities than group activities. Free-play and meal-routine activities provided better opportunities for active engagement than did group activities, but children were more actively engaged during meal-routine activities than during free play. Passive engagement was more commonly observed during group activities. Children interacted more with their peers during free play. When children with a diagnosis of autism spectrum disorder were compared with children with other disabilities, they were found to be significantly less engaged during free play and interacted less with their peers. The implications of these findings for inclusive practice in childcare settings are discussed.

Note Taking, Review, Memory, and Comprehension

In previous work assessing memory at various levels of representation, namely the surface form, textbase, and situation model levels, participants read texts but were otherwise not actively engaged with the texts. The current study tested the influence of active engagement with the material via note taking, along with the opportunity to review such notes, and the modality of presentation (text vs. spoken). The influence of these manipulations was assessed both immediately and 1 week later. In Experiment 1 participants read a text, whereas in Experiment 2 participants watched a video recording of the material being read as a lecture. For each experiment the opportunity to take notes was manipulated within participants, and the opportunity to review these notes before the test was manipulated between participants. Note taking improved performance at the situation model level in both experiments, although there was also some suggestion of benefit for the surface form. Thus, active engagement with material, such as note taking, appears to have the greatest benefit at the deeper levels of understanding.

Generating Action and Responding to Local Issues: Collective Efficacy in Context

Recent research suggests that communities can be collectively efficacious without dense networks and kith and kinship relations. Yet few studies examine how collective efficacy is generated and sustained in the absence of close social ties. Using in-depth interviews with local residents and key stakeholders in two collectively efficacious suburbs in Brisbane, Australia, this study explores the role of social ties and networks in shaping residents' sense of active engagement and perceptions of community capacity. Results suggest that strong social bonds among residents are not necessary for the development of social cohesion and informal social control. Instead, collective representations or symbols of ‘community’ provide residents with a sense of social cohesion, trust and a perceived willingness of others to respond to problems of crime and disorder. Yet there is limited evidence that these collectively efficacious communities comprise actively engaged residents. In both communities, participants report a strong reliance on key institutions and organisations to manage and respond to a variety of problems, from neighbourhood nuisances to crime and disorder. These findings suggest a more a nuanced understanding of collective efficacy theory is needed.

Impact of the physical environment in paediatric hospitals on health outcomes: a systematic review

Background Nesmith1 identified two roles for the physical settings in which health care is provided. One is as a tool to support productivity and effectiveness and the second is as healer: "… they are an end in themselves - aiding in the healing and wellness process through psychological and physiological effect…" (p. 671). Research to confirm this statement has been slowly accumulating over the last two decades, but primarily in the area of adult care. Although there are a plethora of articles describing the various creative and innovative approaches to physical design in paediatric hospitals, very few of these innovations have been evaluated in terms of their impact on the health outcomes of children and their families. Objectives The objective of this review was to determine from the available evidence the impact of the physical paediatric hospital environment on health outcomes of children and adolescents. Search Strategy Using a defined search and retrieval method, a wide range of indexes of periodical articles were accessed for the period 1980 to 2008 including both health and architectural databases. Unpublished studies from 1991 were sought using a variety of sources including Dissertation Abstracts, Index to Theses, conference proceedings, research and clinical trials registers and web sites of relevant professional associations. Inclusion criteria The review considered studies using either quantitative or qualitative methodologies or mixed methods that assessed the impact of physical design elements of a paediatric hospital environment including architectural, interior design, ambient features and /or features that supported patient and family centred care. The primary outcomes of interest were clinical or psychological, with other outcomes of interest being patient - family perceptions, including safety and security. Methodological quality Each study was assessed independently by two reviewers prior to inclusion in the review using standardised critical appraisal instruments developed by the Joanna Briggs Institute. As both assessors were in agreement on all studies a third reviewer was not required. Data extraction and synthesis Data was extracted independently from each of the included studies by two reviewers using standardised critical appraisal instruments developed by the Joanna Briggs Institute. Again there were no disagreements between the reviewers in relation to the data extracted from the quantitative studies. Agreement was reached on the synthesis of the findings from the two qualitative studies through discussion. Given the differences in study design, interventions and outcome measures in the quantitative studies, statistical pooling of the results was not possible and the findings are presented in a narrative form. Results Eight studies were included in the review with five elements of physical design addressed. In the sub-topic of physical building structures, single room design for paediatric intensive care units significantly reduced nosocomial infections as did the addition of negative pressure ventilation to single rooms in an isolation unit. The one study on the effect of specially designed gardens found very low usage rates but children who did visit them were actively engaged with both natural and structural features. On the same theme of active engagement a play centre designed to encourage symbolic play generated statistically significantly more total play and less unoccupied time or wandering as well as the type of play it was designed to encourage. The one study on art did not demonstrate that nature art was effective in reducing stress in hospitalised children. In regard to adolescents, the two themes that emerged in regard to physical facilities from the two qualitative studies were ways of maximising normal life and ways of supporting coping with the illness through ward design. Conclusion Given the small number of studies addressing five sub-topics, no firm conclusions can be drawn from the review. However the results suggest positive elements of physical design that could be considered for implementation to support a healing environment within paediatric hospitals or paediatric wards in general hospitals. Implications for research The review clearly illustrates the need for more research in this area assessing the health outcomes of innovations in physical design in paediatric hospitals or units. There are numerous opportunities for multidisciplinary studies and in varying cultural contexts. Implications for practice This review suggests a number of aspects of physical design that can be implemented although cost and cultural appropriateness are a consideration in several cases. These include the use of single rooms with negative pressure ventilation to control cross infection; the provision of both private and 'public' space for adolescent inpatients with 'public' spaces including spaces for interaction just with other peers; the incorporation of interactive gardens, however small, designed for families and their use encouraged by staff; and specially designed play structures to encourage symbolic play.

Impact of the physical environment in paediatric hospitals on health outcomes: a systematic review.

Nesmith identified two roles for the physical settings in which health care is provided. One is as a tool to support productivity and effectiveness and the second is as healer: "… they are an end in themselves - aiding in the healing and wellness process through psychological and physiological effect…" (p. 671). Research to confirm this statement has been slowly accumulating over the last two decades, but primarily in the area of adult care. Although there are a plethora of articles describing the various creative and innovative approaches to physical design in paediatric hospitals, very few of these innovations have been evaluated in terms of their impact on the health outcomes of children and their families. The objective of this review was to determine from the available evidence the impact of the physical paediatric hospital environment on health outcomes of children and adolescents. Using a defined search and retrieval method, a wide range of indexes of periodical articles were accessed for the period 1980 to 2008 including both health and architectural databases. Unpublished studies from 1991 were sought using a variety of sources including Dissertation Abstracts, Index to Theses, conference proceedings, research and clinical trials registers and web sites of relevant professional associations. The review considered studies using either quantitative or qualitative methodologies or mixed methods that assessed the impact of physical design elements of a paediatric hospital environment including architectural, interior design, ambient features and /or features that supported patient and family centred care. The primary outcomes of interest were clinical or psychological, with other outcomes of interest being patient - family perceptions, including safety and security. Each study was assessed independently by two reviewers prior to inclusion in the review using standardised critical appraisal instruments developed by the Joanna Briggs Institute. As both assessors were in agreement on all studies a third reviewer was not required. Data was extracted independently from each of the included studies by two reviewers using standardised critical appraisal instruments developed by the Joanna Briggs Institute. Again there were no disagreements between the reviewers in relation to the data extracted from the quantitative studies. Agreement was reached on the synthesis of the findings from the two qualitative studies through discussion. Given the differences in study design, interventions and outcome measures in the quantitative studies, statistical pooling of the results was not possible and the findings are presented in a narrative form. Eight studies were included in the review with five elements of physical design addressed. In the sub-topic of physical building structures, single room design for paediatric intensive care units significantly reduced nosocomial infections as did the addition of negative pressure ventilation to single rooms in an isolation unit. The one study on the effect of specially designed gardens found very low usage rates but children who did visit them were actively engaged with both natural and structural features. On the same theme of active engagement a play centre designed to encourage symbolic play generated statistically significantly more total play and less unoccupied time or wandering as well as the type of play it was designed to encourage. The one study on art did not demonstrate that nature art was effective in reducing stress in hospitalised children. In regard to adolescents, the two themes that emerged in regard to physical facilities from the two qualitative studies were ways of maximising normal life and ways of supporting coping with the illness through ward design. Given the small number of studies addressing five sub-topics, no firm conclusions can be drawn from the review. However the results suggest positive elements of physical design that could be considered for implementation to support a healing environment within paediatric hospitals or paediatric wards in general hospitals. The review clearly illustrates the need for more research in this area assessing the health outcomes of innovations in physical design in paediatric hospitals or units. There are numerous opportunities for multidisciplinary studies and in varying cultural contexts. This review suggests a number of aspects of physical design that can be implemented although cost and cultural appropriateness are a consideration in several cases. These include the use of single rooms with negative pressure ventilation to control cross infection; the provision of both private and 'public' space for adolescent inpatients with 'public' spaces including spaces for interaction just with other peers; the incorporation of interactive gardens, however small, designed for families and their use encouraged by staff; and specially designed play structures to encourage symbolic play.

A procedure for the measurement of infant skin conductance and its initial validation using clap induced startle

Studies examining psychophysiologic markers of infant emotional development abound. However, few studies have used skin conductance (SC), though it measure's sympathetic activity, and none have measured SC on infants sitting up and actively engaged with another person, a significant challenge given the measures sensitivity to movement artifact. In this pilot/feasibility study, we present a procedure for measuring infant SC during active engagement with another person who executes a series of startling claps to elicit an SC response. We measured SC on the plantar surface of the foot of seventeen 5-month-old infants. We found unconditioned SC responses that were related to the intensity of physical startle reactions for each clap trial. We also found anticipatory, conditioned SC responses that occurred within 5 s before each clap that occurred when the researcher raised his clasped hands. These conditioned SC responses grew linearly in intensity over trials. We conclude that SC may be a useful addition to the infant researcher's armamentarium and may indeed be used to measure physiologic reactivity in infants even when actively engaged with another person. Addition of SC measurement to research on infant emotion and emotional communication is likely to advance our understanding of the psychophysiologic foundations of infant emotional development.

I—Peter Goldie: Virtues of art and Human Well-Being

What is the point of art, and why does it matter to us human beings? The answer that I will give in this paper, following on from an earlier paper on the same subject, is that art matters because our being actively engaged with art, either in its production or in its appreciation, is part of what it is to live well. The focus in the paper will be on the dispositions—the virtues of art production and of art appreciation—that are necessary for this kind of active engagement with art. To begin with, I will argue that these dispositions really are virtues and not mere skills. Then I will show how the virtues of art, and their exercise in artistic activity, interweave with the other kinds of virtue which are exercised in ethical and contemplative activity. And finally, I will argue that artistic activity affords, in a special way, a certain kind of emotional sharing that binds us together with other human beings.

Sex and the city: Differences in disease- and disability-free life years, and active community participation of elderly men and women in 7 cities in Latin America and the Caribbean

BackgroundThe world's population is ageing, and four of the top 10 most rapidly ageing developing nations are from the region of Latin America and the Caribbean (LAC).Although an ageing population heralds likely increases in chronic disease, disability-related dependence, and economic burden, the societal contribution of the chronically ill or those with disability is not often measured.MethodsWe calculated country-specific prevalences of 'disability' (difficulty with at least one activity of daily living), 'disease' and 'co-morbidity' (presence of at least one, and at least two, of seven chronic diseases/conditions, respectively), and 'active community engagement' (using five levels of community participation, from less than weekly community contact to voluntary or paid work) in seven LAC cities. We estimated remaining life expectancy (LE) with and without disability, disease and co-morbidity, and investigated age, sex, and regional variations in disability-free LE. Finally, we modeled the association of disease, co-morbidity and disability with active community participation using an ordinal regression model, adjusted for depression.ResultsOverall, 77% of the LAC elderly had at least one chronic disease/condition, 44% had co-morbidity and 19% had a disability. The proportion of disability-free LE declined between the youngest (60–64 years) and the eldest (90 years and over) age-groups for both men (from 85% to 55%) and women (from 75% to 45%). Disease-free and co-morbidity-free LE, however, remained at approximately 30% and 62%, respectively, for men (20% and 48% for women), until 80–84 years of age, then increased. Only Bridgetown's participants had statistically significantly longer disability-free LE than the regional average (IRR = 1.08; 95%CI 1.05–1.10; p < 0.001). Only Santiago's participants had disability-free LE which was shorter than the regional average (IRR = 0.94; 95%CI 0.92–0.97; p < 0.001). There was 75% active community participation overall, with more women than men involved in active help (49% vs 32%, respectively) and more men involved in voluntary/paid work (46% vs 25%, respectively). There was either no, or borderline significance in the association between having one or more diseases/conditions and active community engagement for both sexes. These associations were limited by depression (odds ratio [OR] reduced by 15–17% for men, and by 8–11% for women), and only remained statistically significant in men. However, disability remained statistically significantly associated with less community engagement after adjusting for depression (OR = 0.58, 95%CI 0.49–0.69, p < 0.001 for women and OR = 0.50, 95%CI 0.47–0.65, p < 0.001 for men).ConclusionThere is an increasing burden of disease and disability with older age across the LAC region. As these nations cope with resulting social and economic demands, governments and civic societies must continue to develop and maintain opportunities for community participation by this increasingly frail, but actively engaged group.

Cognitive Factors, Engagement in Sport, and Suicide Risk*

The aims of this study were to identify cognitive vulnerabilities and to examine the protective role of active engagement in sport in the development of (1) suicide ideation and (2) hopelessness. In Study 1,102 male military recruits were the participants. Scores on the Automatic Thoughts Questionnaire (ATQ-30), but not on the Dysfunctional Attitude Scale (DAS-A), predicted presence of suicide ideation three months later. The results of Study 2 with 84 university students showed that scores on the ATQ-30, but not on the DAS-A were significantly associated with hopelessness. Moreover, students actively engaged in sports exhibited less hopelessness. The findings suggest that active engagement in sports is strongly associated with negative automatic thoughts, suicidal thoughts, and hopelessness.

An eco-behavioral analysis of children's engagement in urban public school preschool classrooms

Abstract The primary aim of this study was to identify particular group configurations and teacher behaviors that co-occurred with children's active engagement in public school early childhood classrooms for 4-year-olds. Children ( N = 138, 52% boys) were observed using a time sampling method in 12 classrooms in 12 urban schools serving students from predominantly lower-income, minority families. Children were involved in whole group settings for 52% of observations. The most common teacher behavior in any setting was providing direction/instruction. Logistic regression analyses indicated that, during academic activities, children were more likely to be actively engaged when involved in a peer group and when teachers were providing affirmations or were monitoring, and least likely to be actively engaged in a whole group and when teachers were providing directions. During play activities, children were more likely to be actively engaged when they were alone and least likely to be engaged in a whole group and in a child–teacher setting.

Kindergarten to 1st Grade: Classroom Characteristics and the Stability and Change of Children's Classroom Experiences

This study examines the classroom experiences of 192 children followed longitudinally from kindergarten to 1st grade. Time-sampled observations of children were conducted to compare learning formats, teaching activities, and children's engagement in activities between kindergarten and 1st grade. Classroom observations also were conducted to examine differences in classroom quality; specifically, teacher sensitivity and instructional and emotional support for learning. Results from paired t-tests show that instructional activities become more teacher-directed and structured in 1st grade, children in 1st grade are exposed to less academic instruction than children in kindergarten, but children in 1st grade are more actively engaged in activities than children in kindergarten. With respect to classroom quality, kindergarten and 1st-grade classrooms were similar in terms of teacher sensitivity and emotional support for learning. Instructional support for learning, including instructional conversations, evaluative feedback, and child responsibility, decreased from kindergarten to 1st grade. These findings point to both stability and change in children's classroom experiences across kindergarten and 1st grade and are discussed in terms of the ways in which instructional activities in the classroom and children's achievement can be enhanced in early childhood classrooms.

Gender Differences in Expectations Predictive of Volunteer Experience Among Older Chinese Professionals in Hong Kong

The purpose of this study was to examine gender differences in expectations predictive of volunteer experience. Volunteering is one pathway to remaining actively engaged in later life and active engagement is considered one of the cornerstones of successful aging. The global feminization of aging underscores the need to consider gender differences when exploring factors associated with volunteerism. There is also a growing international interest in volunteerism among older adults. A sample of 438 Chinese professionals in Hong Kong ages 45-79, including retired (36.3%) and employed (63.7%), were asked about their expectations for volunteer work. Gender was evenly distributed, with 49.8% male and 50.2% female. Forty-three percent (43%) had volunteer experience. A multivariate logistic regression model was fit to sub-samples by gender, and gender differences emerged. For males, married and the expectation to utilize own skills were associated with volunteer experience. For females, self-rated health, retired, and the expectation to meet the needs of others were associated with volunteer experience. These results suggest that gender differences in expectations may influence volunteer activity.

Interaction in cyberspace: an online focus group

This paper reports a study that explored whether active engagement and group interaction could be captured in an online environment. Focus groups have become a common means of capitalizing on group interaction to collect rich responses to questions posed. Whilst their use is well established in the repertoire of qualitative researchers, with changing technology there is the opportunity to use a computer program that facilitates online engagement and interaction to bring together a group of people to explore issues, attitudes and perceptions. Using a qualitative descriptive method and purposive sampling, 38 Australian Enrolled Nurses participated in an online focus group. WebCT, a program that facilitates online engagement and interaction, was used to enable participants to interact from any computer, from any location, at any time. The experience of conducting an online focus group was a positive one. Advantages such as cost savings and convenience for both researcher and participants were identified. This study demonstrated that participants could be actively engaged over a 2-month period and that group interaction could be achieved to collect richly detailed research data. Whilst online focus groups may not be suitable in every situation, the potential exists to capitalize on technology to bring together a group of people separated by distance in an online environment that encourages interactive discussion.

ClickersA Teaching Gimmick that Works

ClickersA Teaching Gimmick that Works

University of North Carolina at Chapel Hill School of Medicine.

University of North Carolina at Chapel Hill School of Medicine.

Transformative professional development of physicians as educators: assessment of a model.

Medical education reform has been the clarion call of U.S. medical educators and policymakers for two decades. To foster change and seed reform, Harvard Medical School created a professional development program for physicians and scientists actively engaged in educating future physicians that sought to transform both participants and their schools. This study focused on identifying the long-term effects of a professional development program on physician educators. A follow-up survey of the 1995-97 cohorts of the Harvard Macy Program for Physician Educators was conducted by sending the 99 program participants a questionnaire two years after their participation. Main outcome measures studied were individual changes as reflected in participants' self-reported shifts in teaching behaviors, academic productivity, career advancement, and sense of commitment. A total of 63 participants completed the questionnaire, for a response rate of 63.6%. Two years following participation in the program, a majority (88.8%) of respondents reported that participation had significantly affected their professional development, including long-term changes in teaching behaviors (77.8%), engagement in new educational activities from committee work (86%) to grant funding (52.4%), and renewed vitality/identification of themselves as educators. Long-term follow-up of participants enrolled in an intensive program for physician educators suggests that professional development programs that create an immersion experience designed in a high-challenge, high-support environment, emphasizing experiential and participatory activities can change behaviors in significant ways, and that these changes endure over time.

Organizational Factors in the Diffusion of an Industry Standard: Implementing an Online Documentation System for Australian Exporters

At present, governments in many countries are actively engaged in the development of electronic trading and certification standards to enable the smooth operation of export markets. Standards and their usability underpin confidence in the operations of markets and their effective functioning. In institutional markets, an important role for government agencies lies in developing the initial specifications for standards for interoperable systems. Once these specifications are accepted, governments can then facilitate the eventual diffusion of a standard to the B2B marketplace. Acceptance of an industry standard can determine demand, which defines the viability of that market. In this paper, we describe an initiative by a government agency, the Australian Quarantine and Inspection Service (AQIS), in developing EXDOC, a standard for export documentation and the role that AQIS played in its implementation and diffusion. Our case study illustrates a successfully facilitated B2G implementation. It demonstrates how a standard can be supported and promulgated for the effective functioning of markets in the transition from manual to online export documentation. Once the overarching specifications for related industries have been established and diffused by government, opportunities arise for private sector markets to develop across these industries. Government agencies can promote the effective operation of standards for electronic markets. The EXDOC implementation and its iterations provide an exemplar of active engagement in the development of electronic trading and certification standards for an institutional market. Its successful diffusion provides a model of the implementation process for other export sectors and agencies.

Active Engagement, Protective Buffering, and Overprotection: Three Ways of Giving Support by Intimate Partners of Patients with Cancer

In the present study, possible departments and effects of three different styles of giving support by healthy partners of patients with cancer were examined. Both partners' and patients' perceptions regarding these ways of providing support by healthy partners were studed. A survey was conducted among 106 patients with cancer and their intimate partners. Both healthy partners' evaluation of the patient's copying and their self effency in providing support was related to the ways in which support was provided by partners. Partners who thought the patient was copying better sith the cancer showed more active engagement and less over-protection Partners high in self-efficacy showed more active engagement, where as partners' who lacked this self-efficacy show more protective buffering. Further more, the way in which support was given was related to partners' well-being, and relationship satisfaction. Patients' with cancer reported more distress and less felings of control when their partners where move over protective. Moreover patients' evaluated the relationship with their partner more positively when thir partners where more actively engaged. In turn, patients' distress was positively related to the extend to which parters' said they show acgive engagement.

The effect of therapeutic music interventions on the behavior of hospitalized children in isolation: developing a contextual support model of music therapy.

The purpose of this study was to provide preliminary data that support or negate a contextual support model of music therapy. The contextual support model of music therapy, based on Skinner and Wellborn's (1994) motivational theory of coping, argues that therapeutic music environments possess elements of structure, autonomy support, and involvement that lead children to become more actively engaged with their environment. This study examined three basic suppositions of the theory: (a) that music interventions create supportive environments, (b) that music interventions increase children's active engagement, and (c) that relationships exist between supportive environments and engaging behavior. Ten pediatric oncology patients restricted to an isolated environment participated in the study. Participants, serving as their own controls, experienced four different environmental conditions. Each condition was videotaped to facilitate collection of environmental and behavioral data. Statistical analyses of these data revealed: (a) that the music environment possessed a significantly higher frequency of environmental support elements than other activities typically experienced by hospitalized children, (b) that therapeutic music interventions elicited significantly more engaging behaviors from hospitalized children than other hospital activities, (c) that positive behavioral effects of music interventions were not maintained in hospital experiences that followed the music session, and (d) that environmental support elements were related to some positive behaviors but these behaviors were not consistent across environments.

Disentangling the Effects of Curricular Revision and Social Grouping Within Cooperative Learning Arrangements

Two conditions were compared to study how the social grouping versus curricular revision components of cooperative learning affect participants' classroom performance. Participants were from an eighth-grade English class with 22 peers without disabilities and 2 students with moderate to severe disabilities. The first condition, a typical cooperative learning arrangement, combined the social grouping of participants and revision of course materials. The second condition presented participants with the revised curriculum but removed the social grouping component. Dependent variables included the percentage of time participants were actively engaged in class activities, weekly pre-/posttest scores on the classroom curriculum, and the frequency and duration of social interactions between students with severe disabilities and their peers. Results indicated that the active engagement of participants did not differ across conditions. A second consistent finding was that peers without disabilities showed greater improvement on posttests when they were presented with the revised curriculum minus the social grouping component. Results of a social validity assessment, however, indicated that general and special educators perceived that peers without disabilities preferred the condition with the social grouping component. Finally, results indicated that 1 of the 2 students with disabilities had higher quality social interactions in the condition that combined social grouping and the revised curriculum.