Institutions In England Research Articles

The resilience of democratic institutions in Britain, Australia and the United States under conditions of total war

To what extent are democratic institutions resilient when nation states mobilise for war? Normative and empirical political theorists have long argued that wars strengthen the executive and threaten constitutional politics. In modern democracies, national assemblies are supposed to hold the executive to account by demanding explanations for events and policies; and by scrutinising, reviewing and, if necessary, revising legislative proposals intended to be binding on the host society or policies that have been implemented already. This article examines the extent to which the British and Australian parliaments and the United States Congress held their wartime executives to account during World War II. The research finds that under conditions approaching those of total war, these democratic institutions not only continued to exist, but also proved to be resilient in representing public concerns and holding their executives to account, however imperfectly and notwithstanding delegating huge powers. In consequence, executives—more so British and Australian ministers than President Roosevelt—were required to be placatory as institutional and political tensions within national assemblies and between assemblies and executives continued, and assemblies often asserted themselves. In short, even under the most onerous wartime conditions, democratic politics mattered and democratic institutions were resilient.

Improving assessment practices - is there a place for online marking?

The starting point of this educational inquiry is my concern that marking is time consuming when trying to provide high quality, useful feedback to assist student learning. This poster gives a flavour of the process of creating ‘living theory' in an action research project into online marking, illustrating the energising nature of the 'action-reflection cycles'; cycles which encompass six elements: ‘observe - reflect - act - evaluate - modify - move in new directions' (McNiff & Whitehead, 2006, p.41 & 49). It may be of interest to those concerned with assessment practices in higher education regardless of whether they are currently considering online marking. Initially the purpose was to increase my knowledge of the affordances offered by GradeMark software. However, my gaze turned to the wider purpose of assessment - this was prompted by the literature, interviews with two learning technologists and one academic working at different higher education institutions in England, and concurrent marking commitments. The research question evolved from ‘How can GradeMark be used to mark assessments?' to the broader issue of ‘How can assessment practices be improved and might an online tool, such as GradeMark, assist this aim?' In interviews my sense of inquiry was ‘how can participants' practices help mine?' Emergent categories included the affordances of and barriers to using online marking, together with participants' views on resistance to online marking and what is needed for its successful implementation. The relative positions of stakeholders are illustrated in a model where academics are found to be less aligned with online marking than administrators, technologists, students and institutions. It is proposed that, grounded in their own contexts, academics should determine the pedagogical case for or against online marking and direct their practice accordingly. Without such self-determination others may discover convincing reasons to impose change, leaving academics poorly placed to muster convincing arguments for or against. Thus the pedagogical design of programmes is found to be important and suggestions for a participatory approach to develop feedback practices within a work team, prior to considering whether online marking is supportive of this, are made. The significant influence being the pedagogical design of assessment processes within a particular programme, rather than whether a specific electronic tool facilitates specific functions - though this becomes important having decided to use such a tool. Where online marking is indicated this is likely to require considerable institutional support in terms of leadership, training and technology.

Teaching as a Masters profession in England: the need for continued debate

In this paper we suggest that teacher educators in higher education institutions (HEIs) in England are not fully convinced that teaching should be a Masters profession. The original engagement with...

Review: Architecture and Academe: College Buildings in New England before 1860, by Bryant F. Tolles Jr.

Bryant F. Tolles Jr. . Architecture and Academe: Buildings in New England before 1860 . Hanover, N.H., and London: University Press of New England, 2011, xxi + 217 pp., 28 color and 213 b/w illus. $50, ISBN 9781584658917 Bryant F. Tolles Jr., professor emeritus of history and art history at the University of Delaware, offers us the first book-length study of the college and university architecture of pre–Civil War New England. Tolles is the author and editor of several books from the same publisher, including Summer Cottages in the White Mountains (2000), Resort Hotels of the Adirondacks (2003) and, more recently, Summer by the Seaside: The Architecture of New England Coastal Resort Hotels (2008). The current volume has its origins in Tolles's PhD dissertation of more than forty years ago, College Architecture in Northern New England Before 1860: A Social and Cultural History (Boston University, 1970). Clearly, the subject matter of Architecture & Academe has been on Tolles's mind for a long time, and it shows in the thoughtful account he has produced. Tolles explains in his preface that he will focus primarily on the architecture and related history of individual buildings, their origins, their functions, and their interrelationships with other buildings in their respective campus environments (xvii). Covered in this way are the principle buildings of sixteen New England institutions—Harvard, Yale, Brown, Dartmouth, Williams, Bowdoin, University …

Health IT & Pediatric Obesity Management

Source: McDonald J, Goldman RE, O’Brien A, et al. Health information technology to guide pediatric obesity management. Clin Pediatr (Phila). 2011; 50(6): 543– 549; doi: 10.1177/0009922810395131Researchers from several New England institutions sought to ascertain pediatricians’ current approach to obesity screening and management, familiarity with and use of expert recommendations (the Expert Report1) and use of health information technology (HIT) in obesity screening and management, and suggestions for potential HIT innovations. They conducted in-depth telephone interviews, using open-ended questions, with primary care pediatricians from two multisite group practices with ethnically diverse patients in the Boston area.The 32 participating pediatricians averaged 24 years post-medical school graduation. Their estimates for the percentage of their patients over 2 years old with a body mass index (BMI) of at least 95th percentile were: between 5% and 20% reported by 46%; between 20% and 30% reported by 44%; and over 30% reported by 9% of respondents. Nearly all respondents were unfamiliar with the specific content of the Expert Report; while most included elements of the recommendations in their approaches to obese patients, few participants reported routinely ordering recommended tests, and some stated tests were not useful and/or possibly harmful (if a test returns as normal the family might not appreciate a need to make a behavioral change). Most cited the use of growth charts to start discussions with families, followed by an individualized approach to counseling and management, but few felt confident in their management of childhood obesity.The two group practices surveyed use an electronic health record system from a single vendor (EPIC) for documentation, prescribing, and order entry. Participants reported using growth charts and trend information for viewing serial weights. One practice had an obesity order set that helped with documentation and continuity, but thought it was too complex (“multiple clicks”) and not clinically useful.When asked about helpful HIT interventions, most proposed alerts and links to algorithms incorporating expert recommendations. However, there were many concerns that overuse of alerts would result in provider distraction and alert fatigue. Other suggestions included: tailored education materials; links to community resources for physical activity; patient-specific panels of laboratory screening tests; an obesity dashboard to keep track of patients; and information on specialty referrals.The authors conclude that an electronic alert to clinicians for patients with elevated BMI may have strong acceptance among pediatricians if it incorporates other functions in high demand, including links to educational materials, local resources, and other tools related to physical activity and nutrition.Dr Kim has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.Childhood obesity is a priority in the American Academy of Pediatrics’ Agenda for Children2 and is also important in comparative effectiveness research because of its “high prevalence…, associated co-morbidities and the need for testing of available prevention and treatment strategies.”3 Successful management of childhood obesity, on individual and population levels, will require aligning personal and public health efforts.At the patient care level such alignments include: a) translation of research findings into usable diagnostic, therapeutic, and preventive methods and tools; and b) incorporation of these into common and widespread practice that produces measurable results. The former requires assimilation of published evidence into explicit and actionable recommendations and guidelines,4 while the latter requires effective design of structures and processes of care to guide, reinforce, and integrate patient management to implement best practices.HIT can provide functionalities (guided data collection, automated calculation, alerts and reminders, linked education for patients and clinicians, registries, audits, and performance feedback) to support best practice in direct patient care. However, its design, implementation, and deployment must align with clinical and cognitive workflows of providers (and patients).These researchers determined at least one alignment of practitioners’ reported use of HIT with published recommendations: the use of electronic growth charts to calculate serial BMI. However, they also found variances in practitioners’ knowledge and implementation of the Expert Report recommendations, including their laboratory testing practices.HIT has great potential to enhance early diagnosis and effective treatment of pediatric obesity and assess physicians’ adherence to expert recommendations. Iterative exploration of how clinicians and patients interact with information tools and systems of care can leverage the power of HIT to address the complex and chronic problems of childhood obesity.Readers should not confuse recommendations based on expert consensus (referenced below1) with evidence-based clinical practice guidelines. All too often expert consensus has been refuted when evidence became available. We desperately need evidence to guide our management and prevention of childhood obesity, but in the meantime we look to experts for advice.

Abstract B15: An assessment of eligibility and enrollment into cancer clinical trials among a disadvantaged urban population

Abstract Background: Enrollment rates into cancer clinical trials among the adult population remains at approximately 2–11% with the vast majority being white men and women from high socioeconomic status and educational backgrounds. In order to address the unequal burden of cancer among underserved populations, it is imperative to enroll representative populations into cancer clinical trials, yet little is known about reasons why minority accrual is so low. We aim to examine the eligibility and enrollment criteria for disadvantaged populations in cancer clinical trials as a first step to increase minority accrual. Methods: Boston Medical Center, a recently designated Minority Based Community Clinical Oncology Program by the National Cancer Institute, is the largest Safety Net medical institution in New England serving Boston's most vulnerable cancer patients. Using the hospital cancer registry to identify incident cases in the calendar year 2010 (n=1300), we conducted a retrospective review of the electronic medical record (EMR) to identify rates of screening for available cancer clinical trials. Each patient considered potentially eligible for a cancer clinical trial has documentation in their EMR from a clinical trials nurse. This screening note documents potential eligibility for enrollment, reasons for ineligibility or non-enrollment. Socio-demographic information was obtained from the cancer registry. Descriptive statistics were used to report our main outcomes: screening rate, eligibility and enrollment rate (of those screened) and reasons for not enrolling. Results: Among 1300 newly diagnosed cancer patients served in calendar year 2010, mean age 61; 49% female; 48% White, 30% Black, 11% Hispanic, 4% Asian. One hundred clinical trials were available for accrual during the time period. Overall, we found documentation that 686 screenings for specific cancer trials were performed across 547 unique patients, resulting in a screening rate of 42% of newly diagnosed cancer patients. Among all 686 screenings, we found that patients were deemed ineligible for a specific clinical trial 92% of the time (n=630). The most commonly noted reasons for ineligibility were administrative issues (such as pending IRB approval and timing of screening) versus patient co-morbidities or disease stage. Of the patients who were deemed eligible (n=56) for clinical trials, 55% (n=31) were enrolled, of which 51% were white, 45% black and 4% Hispanic. Conclusions: Most patients screened for a cancer clinical trial were not eligible. Earlier evaluation may address the administrative issues. Co-morbidities continue to be a major source of ineligibility for minority patients. When eligible, a racially representative sample was enrolled, suggesting the need to identify trials that are specific to our patient population in order to increase minority accrual. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B15.

A follow‐up evaluation of the impact of the Chief Nursing Officer’s review of mental health nursing in Mental Health Trusts and Universities in England: comparisons of two e‐surveys

This article is a report of a study that aimed to establish a national picture of the implementation of Review recommendations over time in both Mental Health Trusts and Higher Education Institutions (Universities) in England. The 2006 Review of Mental Health Nursing in England by the Chief Nursing Officer made 17 key recommendations for Mental Health Trusts and Universities to improve mental health nursing. This article outlines key findings from a national survey of National Health Service Trusts and Universities in England with regard to prioritization and progress on implementation of these recommendations. An e-survey was carried out in 2008-2009 based on the Chief Nursing Officer review recommendations and guidance. Participants included all Trusts which delivered mental health services (n = 68) and Universities which delivered pre-registration mental health nursing education (n = 50) in England. There appears to be some evidence that the Chief Nursing Officer review of Mental Health Nursing in England continues to be implemented in both Mental Health Trusts and Universities. There is variety in levels of implementation, but Mental Health Trusts and Universities broadly agree on priority areas. The Chief Nursing Officer review has been influential in focusing the care and education of mental health nurses and services in England. There appears to be a range of barriers and facilitators which aid the implementation of healthcare policy. More attention is required from researchers to enhance and evaluate the impact of policy implementation on the quality of care provided.

Costs and efficiency of higher education institutions in England: a DEA analysis

As student numbers in higher education in the UK have expanded during recent years, it has become increasingly important to understand its cost structure. This study applies Data Envelopment Analysis (DEA) to higher education institutions in England to assess their cost structure, efficiency and productivity. The paper complements an earlier study that used parametric methods to analyse the same panel data. Interestingly, DEA provides estimates of subject-specific unit costs that are in the same ballpark as those provided by the parametric methods. The paper then extends the previous analysis and finds that further student number increases of the order of 20–27% are feasible through exploiting operating and scale efficiency gains and also adjusting student mix. Finally the paper uses a Malmquist index approach to assess productivity change in the UK higher education. The results reveal that for a majority of institutions productivity has actually decreased during the study period.

Confidence and Perceived Competence of Preservice Teachers to Implement Biodiversity Education in Primary Schools—Four comparative case studies from Europe

This multinational research study was carried out between 2004 and 2006 in four teacher education institutions in Cyprus, England, Switzerland, and Germany. With the help of a written questionnaire, the confidence and perceived competence of preservice primary teachers (N = 690) to deliver biodiversity education in school were investigated. Data were triangulated with findings from a previous stage of the overall research project. Study participants' confidence to carry out certain outdoor activities in school increased with the number of similar experiences they had during their own secondary school education, and the more personal classroom experiences they had during their teacher education. A sound knowledge of local wild organisms strongly added to their confidence. However, preservice teachers' perceived competence, and thus motivation to implement biodiversity education later on in school, was related even more strongly to the extent of preparation they had received during their teacher education. The results indicate that teacher education programmes that focus exclusively on filling (biodiversity) knowledge gaps might fail to raise confidence and competence in their students to carry out biodiversity education in school. Programmes that have a higher possibility of attaining effectiveness in biodiversity education seek to strike a balance between background knowledge development, pedagogical content knowledge, and opportunities during teaching practice that leads to experiential gains in enacting meaningful activity sequences and engaging students in holistic educational innovations. Within such programmes, it would be fruitful to further explore the relationship between confidence, perceived competence, and actual teaching performance.

Student perceptions of support in practice

This paper reports on a funded research project exploring perceptions and experiences of pre-registration nursing students of support in practice in one Higher Education Institution in England. The study used a mixed method approach with samples of new students (within the first six months) and finishing students (within the last three months). Students reported that the most important areas they needed support with were clinical skills, placement situations, documentation and personal issues. The mentor qualities that were valued were personal attributes, being facilitative and being knowledgeable; newly qualified mentors and experienced students were seen as being the most supportive. Students saw their own responsibilities as learning and gaining skills, being professional and caring for patients. The finishing students also felt that accountability and teaching were part of their role. Reported challenges encompassed personal issues, including work-life balance and finances, dealing with elements such as patient death and uncertainties in new situations. The best aspects of practice emerged as being involved in patient care, feeling part of a team and experiencing positive support from mentors. The findings explicated the multi-faceted nature of student support in practice that need to be taken into account when putting support frameworks in place.

Promise or Compromise? Education for Young People in Secure Institutions in England

In the light of recent legislative changes, this article offers an exposition of key issues relating to the positioning of education for young people under 18 years in secure institutions in England. It argues that interpretations of education have become overly narrow in criminal justice policy and practice and that, while the new legislation offers potential for improvement, further consideration needs to be given to the impact of existing penal and reform agendas which currently limit the conceptual reach and delivery of education in secure institutions.

Apostolic Minds and the Spinning House: Jane Ellen Harrison and Virginia Woolf's Discourse of Alterity

Jane Ellen Harrison (1850–1928) and Virginia Woolf (1882–1941) are two of the most iconic figures in British feminist history whose enduring influence have helped create and sustain a multitude of feminist discourses. Interestingly, both produced their landmark feminist studies in Cambridge when it was, arguably, the most aggressively anti-feminist institution in Britain at that time. Evidence of the kind of institutionalized disciplinary control Cambridge historically exercised on women can be found in the three Committals books (1823–1894) of the Spinning House (1631–1894) in the University archives. So called because the inmates were given wool to spin, the Spinning House was a penitentiary for young girls who were judged to be compromising the morals of the undergraduates. The Spinning House had its basis in the legal authority of the University which declared ‘That the University by virtue of their Charter sanctioned by Act of Parliament, have an undoubted right to cause the Public Street to be inspected, and loose and disorderly women to be taken up and sent to the Spinning House or the house of correction’. Against the background of the culture encapsulated by the Spinning House, women academics, in the late nineteenth and early twentieth century, were making tremendous efforts to bring about intellectual equality. And though the two—the spinner and the woman student—occupied mutually exclusive spaces, they were nevertheless held on the margins of the power structure that produced both. This paper examines the socio-historical context and the puritan intellectual politics of Cambridge against which feminist theories of Harrison and Woolf were produced to identify some of the methods with which they negotiated masculine orthodoxy and structured their feminist discourse of alterity.

Use of peer teaching to enhance student and patient education

This article describes an evaluation of a peer-teaching project undertaken by second-year nursing students at a higher education institution in England. The initiative has enhanced the students' understanding of peer education. The importance of the nurse's role in patient education is emphasised. It is hoped that the experience of peer teaching will prepare nursing students for their future roles as nurse educators for patients, students and other staff.

Regulating 'Mobility' and Masculinity through Institutions in Colonial Victoria, 1870s-1890s

David Rollison shows us that ‘mobility’ and ‘settlement’ operated in a dynamic and dialectical relationship in the past. Mobility, he argues, was a force for social change. Social institutions in early modern England, such as families, the Law, and the Church, were not immobile in the face of new populations. Travellers, sojourners, internal migrants and strangers moved through ‘settled’ spaces and featured in everyday life. ‘Thus movement,’ Rollison shows, ‘was literally the necessary condition of the abiding, settled, “structure”’ (Rollison 1999: 10).

Editorial

Editorial

What Factors Encourage High Levels of Student Participation in a Self-Access Centre?

The motivation to write about Self-Access Centres (SACs) comes from experiencing a marked difference in the frequency and depth of student participation at two separate centres; one in a university in Japan and one in a private language school in England. In this context ‘frequency’ means how often the students use the centre and ‘depth’ means in what ways and to what extent the equipment and resources are used. At the SAC in Japan, the facilities are continually exploited by a large number of students with many of them visiting three or four times a week, on an optional basis, for usually over an hour each time. The activities in which the students are engaged include listening to music while annotating lyrics, practising pronunciation in speaking booths, reading English language novels and graded-readers, and communicating in the target-language with other students and learning advisors. In contrast, the SAC at the institution in England is only frequented by a very small number of students and the activities are generally limited to the issuance and return of books and the use of computers for online social networking, which is usually conducted in the native languages of the students.

Is There an Information Literacy Skills Gap to Be Bridged? An Examination of Faculty Perceptions and Activities Relating to Information Literacy in the United States and England

Surveys of faculty were conducted at two higher education institutions in England and the United States to ascertain their perceptions of information literacy. Faculty were also asked about the extent to which they incorporated information literacy skills into their courses. Similarities were found across the two institutions both in the importance that faculty attached to information skills and what they actually did to incorporate the skills within curricula. The results reflect an information literacy skills gap between what faculty (and librarians) want for their students and the practical reality. Librarians and faculty should work collaboratively together to bridge this gap.

Oxygenator change-out times: the value of a written protocol and simulation exercises

A survey by our department revealed that most of the institutions in New England and New York have written protocols for low-volume, high-risk, emergency events but few of these centers formally practice these protocols through simulation. We hypothesized that hands-on experience with medical emergency protocols will significantly improve clinician performance. Two groups (n = 24 each) of third semester perfusion students with comparable clinical skills were enrolled in this study. The first group was surprised with an emergent oxygenator change-out drill during a simulation exercise, with no prior warning and without the benefit of a written protocol. The second group was asked to develop a written protocol before they were challenged with the change-out drill. Subsequently, both groups were given a week to practice a protocol for emergent change-out before re-testing. The times for all change-out drills were recorded and the groups were compared with a Student's t-test. A p-value < 0.05 was considered significant. The group without a written protocol (NP) had the longer time (559.7 +/- 84.9 sec) while the group with the written protocol (P) performed better (461.8 +/- 57.5 sec, p < 0.05). However, both groups achieved significantly better performance following repeated practice (NP = 167.8 +/- 34.8; P = 170.9+/-32.5 sec, p < 0 .05). While written protocols for emergent events will improve patient care, simulation and practice of emergency protocols is the most significant way to protect our patients. Based on this, we advocate for all perfusion groups to simulate emergency events and practice their crisis protocols.

Sustainable higher education buildings in a changing climate

Higher education institutions in England occupy approximately 25 million m2 of gross space. Considerable sums of money are now being spent on refurbishing parts of the estate, much of which was built since the 1940s to thermal standards far lower than those expected today. The choice of whether to refurbish or demolish and rebuild requires a critical analysis of a range of environmental, social and economic issues. To this end the Association of University Directors of Estates developed a toolkit to identify crucial issues that need to be taken into account in order to make this choice clear. However, while the toolkit represents a considerable step forward, it does not include the projected impact of climate change and its uncertainty. Analysis of an existing naturally ventilated higher education building built in 1974 suggests that projected changes in the UK climate will have a significant impact on the likelihood of building overheating. Consequently, when assessing likely refurbishment options it is essential that the impacts of climate uncertainty now and in the future are considered.

The Patterns of Change in Higher Education Institutions: The context of the changing quality assurance mechanisms in England, Japan, and New York State

The purpose of the study is to identify the patterns of change in higher education institutions. It examines the contexts of the changing quality assurance mechanisms used by the different types of higher education institutions in England, Japan, and New York State between 2001 and 2007. The paper argues that there were no clear patterns of institutional change in terms of speed, intensity, extensiveness, momentum, trajectory, and consequence between centralized and decentralized institutions and public and private institutions. The study suggests three points for explanation why institutional types do not shape certain patterns of institutional change. The first point is that institutional change heavily relies on agents’ interactions. The second point is that the ideas of centralized or decentralized and private or public per se are becoming ambiguous in the market or market-like systems. The third point is that the relationship between the central authorities and the institutions is far more significant than the types of institutions in the formation of particular patterns of institutional change.