District-wide Program Research Articles

School Administrator Engagement in Teacher Induction and Mentoring: Findings from Statewide and District-Wide Programs

Research shows that school administrators’ engagement is vital in creating a structure supportive of induction and mentoring for early career teachers. This article details a mixed-method research study that examined the role and impact of school administrators’ engagement in four teacher induction programs in the United States (two statewide and two district-wide) supported by the New Teacher Center. The results identify administrator role expectations and participants’ perceptions of the programs, and they indicate how vital school administrators’ leadership and commitment are to a successful program. The article concludes with implications for theory, practice, policy, and further research.

De-Centering the Deficit Framework: Courageous Refugee Mentors in Educational Spaces

This paper, which draws on an ethnographically informed case study, examines refugee mentors working directly with refugee students and families so they can successfully overcome challenges associated with adapting to a new, urban school culture. It highlights the ways in which the mentors and students negotiate educational contexts and structures not necessarily well suited to newcomers; it also reveals how the mentors create spaces where refugee students and their families experience a sense of belonging. Through additive practices, the mentors assist refugee students in forming a legitimized identity as an alternative to the racialized American models based on normative standards. The author argues that the mentors are best situated as “additive tempered radicals” who work within school district barriers to provide incremental equitable educational opportunities for refugee students. Recommendations include utilizing the practices of the mentors as templates for district-wide programs for all newcomer students.

筑波山の眺望景観に関する制度の現状と課題

The purpose of this research is to understand the placement of scenic views of Mt. Tsukuba, along with specific preservation policies, in the plans and systems of the local governments that lie within the visual range of Mt. Tsukuba, and therefore to consider issues related to the preservation of such scenic views. It has become clear that Mt. Tsukuba is mentioned in the landscape plans and city master plans of the municipalities of an extensive part of the Kanto region. These include Saitama Prefecture, Chiba Prefecture, the city of Tokyo, and other areas. While the statements related to Mt. Tsukuba are of a diverse nature, many of them concern the placement of scenic views and also indicate specific viewpoints. However, in examining specific regulations, it becomes clear that neighboring regional governments have no district-wide policy, and individual regulations are not compliant with the larger plan - the District-wide Plan for the Formation of Scenic Views of Mt. Tsukuba. It is possible for the local governments currently designating Mt. Tsukuba as a scenic view to cooperate in establishing a district-wide program. Such a program would apply beyond a single vicinity and cross municipal areas.

Waluwin - an integrated approach towards health and wellbeing in Western NSW, Australia

Introduction : Waluwin - Health and Wellbeing in Aboriginal Language Wiradjuri The Western NSW region is one of the most vulnerable localities in Australia with a fractured service network, a strategy to transform current services into a patient centred, coherent system of care is well into its second year. The Western NSW Local Health District (LHD) is leading the way as one of three NSW Integrated Care LHD Demonstrators as part of the NSW State Government’s Integrated Care Program. A range of district-wide and locality-based integrated care initiatives are being implemented to bring together health and social providers across the continuum of care to lift health outcomes for the resident population in a large and sparsely populated area - 271,000 people in 250,000 sq km. Key drivers for change : A Western NSW health needs assessment developed in 2013 highlighted: - Significant health inequalities experienced by Western NSW’s Aboriginal population (11% of the total population) - A pressing need to redesign models of care to address projected growth in demand associated with population ageing and increasing prevalence of long term conditions, particularly given an already high hospitalisation rate for the district’s population - Opportunities to improve patient experience and value for money through addressing the current service configuration of multiple small provider entities delivering fragmented and ‘siloed’ primary, community and specialist outpatient health services. The health needs assessment received wide public interest, and resulted in health organisations in the district recognising that only through collective action could population health outcomes be lifted. The Western NSW Integrated Care Strategy : The Strategy is one of the major collaborative actions Western NSW stakeholders are undertaking to address health needs across the district. The Strategy is founded on a district-wide partnership between the LHD, the Western Primary Health Network, and and the Bila Muuji collective of Aboriginal Medical Services. The vision of the Strategy is: To transform existing services into an integrated Western NSW system of care that is tailored to the needs of our rural and remote communities, and improves access to care and health outcomes, with particular focus on closing the Aboriginal health gap. A key element of the Strategy is establishment of a ‘first wave’ of five local demonstration sites to test new models of care at a locality level. Core features of the demonstration site models of care include: - Defining priority locality target population groups - A standardised risk stratification process - A standardised enrolment process including obtaining consent to share information across providers - GP-led multi-disciplinary care teams - Shared care planning utilising an electronic shared care platform - Multi-disciplinary case conferencing. Local leadership groups and care navigators including social care co-ordination are key features of the delivery model. A second wave of demonstrator sites are currently being recruited. Highlights : Year one results of the three-year program include: - Establishment of district-wide program and project structures including locality based leadership structures and a district-wide Clinical Leadership Committee - Establishment of the HIU providing a one-stop-shop for access to health care data, analysis, advice and support for interpretation of health statistics - Establishment and implementation of five first wave local demonstrator sites over 500 patients enrolled receiving shared care planning and multi-disciplinary care - Development and implementation of a risk stratification tool - Selection and implementation of an electronic shared care planning tool - Collecting and tracking real time patient feedback to receive insight into the patient experience. Key learnings : - The time and effort required to deliver lasting change should not be underestimated - A partnership approach and constructive collaboration has been paramount for developing and implementing the Strategy - Experience with the demonstration sites has reinforced the importance of readiness and commitment to develop and progress implementation of new integrated models of care, and the intensity of resources required to support local planning and action - A key critical factor for success is establishing local multi-disciplinary clinical leadership groups committed to innovative service redesign. Conclusions : A group of 5 first wave sites has developed a successful locally led model of care which has been refined and is being implemented in a second wave of sites. The strategy beyond local demonstrator sites is leading the transformation of a whole region's health service delivery with some underpinning enablers and district wide strategies which are making good traction.

“I Do This for All of the Reasons America Doesn't Want Me To”: The Organic Pedagogies of Black Male Instructors

ABSTRACTThis article examines the teaching philosophies of Black male teachers of Black male students in manhood development classes in a district-wide program in Oakland, California. Drawing on observations and instructor interview data, we explore the teachers’ histories, teaching philosophies, and the trajectory of their racial-educational understandings. We utilize Gramsci's (1971) theory of the organic intellectual, Mills’ (1997) and Leonardo's (2013) theories of the subperson and substudent, and Dumas’ (2014) notion of Black suffering to theorize the ways that race comes into play in the teaching of African American male students. We find that racialization and re-humanization are key to instructors’ teaching, and we identify two key aspects of their teaching philosophies: (1) Humanization/Love and (2) Reciprocity.

Early Outcomes of HIV Exposed Children in the First District-wide Programme using Extended Regimens for the Prevention of Mother-to-Child Transmission of HIV, in Yaounde, Cameroon

Report on the early outcomes achieved in the prevention of mother-to-child transmission (PMTCT) programme in the Djoungolo Health District using more effective antiretroviral PMTCT regimens. Observational cohort of HIV exposed infants. early infant HIV status and 3-month mortality rate. From March 2008 to March 2010, 587 HIV-positive mother-baby pairs were enrolled and classified according to the following maternal antiretroviral regimen: Group 1: highly active antiretroviral therapy (HAART), Group 2: dual therapy, Group 3: no treatment. 484/587 (82%) underwent HIV-early infant diagnosis at a median age of 7 weeks; 4.5% (95% CI 2.65-6.34) were HIV-infected. HIV transmission rate differed by maternal prophylaxis: 1.7% for HAART, 2.7% for dual therapy and 15.7% for Group 3 (p < 0.001), but not by feeding method (2.74%)-exclusive breastfeeding vs. 5.34% formula (NS). The 3-month mortality rate stands at 1%. The 4.5% MTCT-rate of HIV-1 reported, confirms the feasibility and effectiveness of a district wide PMTCT programme using HAART in low-income settings.

Effectiveness of a district-wide programme for the prevention of mother-to-child transmission of HIV in Cambodia. Experience from six maternity units in Phnom Penh and Kandal

Background Despite the great advances in developing and implementing effective interventions to prevent HIV transmission from infected mothers to their infants, almost 2,000 infants are infected every day through MTCT in resourcepoor countries. In these settings, where prevention of mother to child transmission of HIV-1 (PMTCT) programs are in place, the uptake and effectiveness of the PMTCT comprehensive program need to be regularly monitored.

Community-based follow-up for late patients enrolled in a district-wide programme for antiretroviral therapy in Lusaka, Zambia

Timely adherence to clinical and pharmacy appointments is well correlated with favourable patient outcomes among HIV-infected individuals on antiretroviral therapy. To date, however, there is little work exploring reasons behind missed visits or evaluating programmatic strategies to recall patients. For this study we implemented community-based follow-up of late patients as part of a large-scale programme for HIV care and treatment in Lusaka, Zambia. Through a network of local home-based care organizations, we attempted home visits to recall patients using locator information provided at time of enrolment. Between May and September 2005, home-based caregivers were dispatched to trace 1,343 patients with missed appointments. Of these, 554 (41%) were untraceable because the provided address was invalid, the patient had moved or no one was at the home. Of the remaining 789, 359 (46%) were reported to have died. Only 430 (54% of those traced, 32% overall) were contacted directly and encouraged to return for care. The likelihood of patient return was higher among traced patients in crude analysis (relative risk [RR] = 2.5; 95%CI = 1.9–3.2) and in multivariable analysis controlling for baseline body mass index, sex and CD4 + count ≤ 50/µL (adjusted RR = 2.3; 95%CI = 1.7–3.2). However, the process was inefficient: one late patient returned for every 18 home visits that were made. Reasons for missed visits were provided in 271 of 430 (63%) of the patients who were successfully traced. Common reasons included feeling too sick to come to the clinic, travelling away from home and being too busy. Despite the availability of free ART in Lusaka, patients face significant barriers to attending scheduled clinical visits. Cost-effective and feasible strategies are urgently needed to improve timely patient follow-up.

English

The Glengarry adit is an underground gold mine developed between 1925 and 1934 in the New World Mining District of south-central Montana. The adit has been a historic source of metals-laden, acidic water that discharged into Fisher Creek, a major tributary to the headwaters of the Yellowstone River. The adit discharge contributed more than 30 percent of the metals load to Fisher Creek, had an average historical flow of about 363 L/min (80 gpm), Cu and Fe concentrations near 7 and 78 ppm respectively, and a pH of 2.2. The USDA- Forest Service undertook a rehabilitation and closure project to address this adit discharge in 2000, with a goal of minimizing or eliminating this discharge. Assessment included reconditioning 915 meters of underground workings and characterizing water inflows. Four principal sources of water inflows were identified. Chemical mass loading analysis allowed quantification of the impact of each of these sources to surface water quality, as well as a means of evaluating effectiveness of potential closure options. Closure alternatives considered included plugging, containing, or diverting water-flows. Engineering design work on the selected alternative was completed in 2002 and a contract awarded in 2003. Closure consisted of a combination of surface and underground grouting of water- bearing fractures and faults, selective backfilling of three segments of the underground workings, and strategic placement of five water-tight underground adit and raise plugs. A non-water tight portal plug was also constructed. Closure work was completed in 2005 and resulted in an average metals concentration reduction of 83 percent, a metal load reduction of 99.8 percent and an adit discharge flow reduction of 97 percent. The closure method used at the Glengarry Mine offers an effective approach considered to be a walk-away solution to handling sources of contamination from adit outflows. No future operational, maintenance, or treatment costs are anticipated. A long-term district-wide program to monitor water quality and aquatic health will be implemented once other reclamation construction projects in the District are complete.

An educational intervention for front-line health professionals in the assessment and management of suicidal patients (The STORM Project)

Suicide prevention is a health priority in many countries. Improved management of suicide risk may improve suicide prevention. This study aimed to assess the feasibility of health district-wide training in the assessment and management of people at risk of suicide; and to assess the impact of training on assessment and management skills. Staff in three health care settings, namely primary care, accident and emergency departments and mental health services (N = 359), were offered suicide risk management training in a district-wide programme, using a flexible 'facilitator' approach. The main outcomes were the rate of attendance at training, and changes in suicide risk assessment and management skills following training. It was possible to deliver training to 167 health professionals (47 % of those eligible) during a 6 month training period. This included 95 primary care staff (39%), 21 accident and emergency staff(42%) and 51 mental health staff (78%). Of these, 103 (69%) attended all training. A volunteer sample of 28 staff who underwent training showed improvements in skills in the assessment and management of suicide risk. Satisfaction with training was high. The expected costs of district-wide training, if it were able to produce a 2.5% reduction in the suicide rate, would be 99,747 pound sterling per suicide prevented and 3,391 pound sterling per life year gained. Training in the assessment and management of suicide risk can be delivered to approximately half the targeted staff in primary care, accident and emergency departments and mental health services. The current training package can improve skills and is well accepted. If it were to produce a modest fall in the suicide rate, such training would be cost-effective. However, a future training programme should develop a broader training package to reach those who will not attend.

Thirty Years of the Annual Survey of Deaf and Hard-of-Hearing Children &amp; Youth: A Glance Over the Decades

The 1997-98 school year marks the 30th consecutive year that the Gallaudet Research Institute (GRI, formerly Center for Assessment & Demographic Studies, Office of Demographic Studies, and Office of the Annual Census of Hearing Impaired Children) has conducted its Annual Survey of Deaf and Hard-of-Hearing Children & Youth. This survey represents the largest ongoing database of information on deaf and hard-of-hearing children in the United States. The generous contribution of time and effort provided largely by school staff and administrators across the nation has helped make it possible to collect educational, demographic, and communication data on deaf and hard-of-hearing students each year from 1968 to the present. The Annual Survey grew out of an expressed need for accurate and continuing demographic data on deaf and hard-ofhearing children in the U.S., in order to facilitate educational program planning at local, state, and national levels. Funding for the Annual Survey was initially provided bv the Bureau of Education for the Handicapped, then by the National Institute of Education. Since 1975, this survey has been financially supported by Gallaudet University through the GRI. Today, the Annual Survey provides data to a variety of individuals and organizations, permitting descriptions of health, communication, audiological, and education-related characteristics of deaf and hard-of-hearing children. These data provide valuable information for education and social program planning, legislation, and assessment that extends well beyond the Gallaudet University community. The GRI has disseminated these data nationally and internationally through numerous presentations, journal articles, and books. To preserve the statistical validity and reliability of the data, the GRI aims to include as many deaf and hard-of-hearing children as are identified. Any U.S. program or school -- public or private serving at least one deaf or hard-of-hearing child is encouraged to participate. The larger the Annual Survey database, the more accurately its summaries can the reflect characteristics of deaf and hard-ofhearing children in the U.S. population. The Annual Survey database is broad, though not deep, in that it contains a modest amount of basic information on a very large number of children. This framework lends itself to broad understanding of population characteristics, and to subsequent in-depth examination of particular attributes for select subgroups of participants. Such supplemental studies are conducted solely by GRI staff, or in collaboration with outside researchers. Over the years, this database has been the source for a number of supplemental surveys (e.g., school-to-work transition, teachers of deaf children) targeting particular characteristics and behaviors of the deaf pre-college population. The Annual Survey has also provided a sample of deaf and hard-ofhearing students for norming four editions of the Stanford Achievement Test. These activities benefit greatly from a broad and representative national database. Currently, our Annual Survey reporting units vary from large residential schools, to district-wide programs for students with special needs, to schools that may have only one or two deaf students. The most recently completed Annual Survey (1997) contained data from over 50,000 children representing more than 12,000 schools. The number of participating schools has increased consistently in each of the last 10 years. It is estimated from U.S. Child Counts that the Annual Survey (not a census) covers about 60% of identified deaf and hard-of-hearing children receiving special services across the nation. Given the large number of participating schools, and the variety of information requested, it is important to recognize that the Annual Survey respondents in many cases include clinicians and/or school administrators, as well as teachers. The survey currently known as the Annual Survey of Deaf and Hard-of-Hearing Children d Youth has undergone some changes in its 30 years. …

The Availability of Program Descriptions among Programs for Seriously Emotionally Disturbed Students

This article addresses the value of program descriptions for the field of serious emotional disturbance/behavioral disorders and presents data collected on the availability of written programs for this population of students. The development and field testing of instrumentation used to collect these and other data on the characteristics of district-wide programs for seriously emotionally disturbed children and youth are described. The availability of program descriptions was assessed in eight areas: philosophy, student needs and identification procedures, student and program goals, instructional methods and curriculum, community involvement, program design and operation, exit procedures, and evaluation. Findings indicated that relatively few comprehensive program descriptions are available to program planners and developers in the field of behavioral disorders, leading to a conclusion similar to one drawn by other writers with regard to the availability of program descriptions in the professional literature — while many high quality programs are likely to exist in the field they have not been adequately described on paper.

An Urban Nursing and Health Demonstration

T EN years ago the New York County Chapter of the American Red Cross found the New York City Department of Health and twenty-odd voluntary agencies willing to team up in a unique public health experiment. The East Harlem district on the Upper East Side, with its largely foreign-born and socially and economically handicapped residents numbering approximately 100,000, was chosen for the demonstration. Centrally housed on 116th Street, the cooperating public and private agencies were to develop through teamwork a district-wide program of services designed to care for the normal health needs of the district. Its need determined, each service was to be made a continuing function of the agency best equipped to carry on that particular work. At the end of a decade the East Harlem Health Center has the interesting experience of seeing New York City inaugurating a group of thirty district health centers to cover the entire city. The East Harlem Nursing and Health Demonstration, inaugurated in December, 1922, and reorganized five years later as the East Harlem Nursing and Health Service, was an outgrowth of the Health Center. As a teaching center for the practical field instruction of nurses and other health workers and through its published studies and reports, this undertaking, begun as a local experiment in the unified control and direction of related nursing and health activities, has attracted the interest of health workers here and abroad. This Demonstration was organized as a separate cooperative health unit pooling the various nursing services and setting up its own governing