This study explores history teachers’ conditions for planning teaching based on progression. It focuses on transition processes: what information is passed on as pupils move from one stage or school form to the next, and how do the receiving teachers deal with the extent and character of that information in their own planning. Previous research on transitions has mainly focused on the transition from pre-school to schooling, indicating that social stability promotes positive educational effects. By contrast, our study covers a broader spectrum of stage transitions and focuses specifically on history teaching, thereby highlighting that teachers who receive new pupils also need information on the curriculum contents they have encountered, and what knowledge they have developed. The study is based on semi-structured interviews with seven teachers from grade four to upper secondary school. The interviews centre on the teachers’ perceptions of the information they receive from the previous stage, their descriptions of how transition practices are organised, their use of information for planning, and their understanding of what progress in history teaching means. These concerns are reflected in the theoretical point of departure, emphasizing the conditions for predictability and the creation of information continuity in complex social systems. To this end, we have used Niklas Luhmann’s concepts of person, role and program, to disentangle the different ways in which information continuity can be achieved within school organization.  The results of the study show that the teachers do encounter programs for passing on information about social aspects and learning difficulties. Information about curriculum content, however, is not mandatory and transition practices here are both varied and less rich in information. This is consonant with the pressure exerted by school legislation to document aspects pertaining to individuals and their rights, and the lack of binding demands on the organization of teaching and subject matter. One consequence of this is that transition practices cannot be relied upon to ensure information continuity. Nor is the curriculum in itself sufficiently specific and time-ordered to serve as program in this sense. It gives teachers little guidance for selection, thus creating information insecurity throughout the educational chain. A second result of the study concerns how receiving the teachers’ conceptions and practices are shaped by the way they deal with this information insecurity. They either set out to find the information they need, or they limit their planning to what they can control, and do not consider what their new pupils have studied at the previous stage. A third result is that only two of the teachers interviewed understood progression in history as progression in the subject matter from grade one to upper secondary school. The teachers tended to think about progression in terms pupil/student achievement and their assessment of these achievements.

Background: Focal segmental glomerulosclerosis (FSGS) is a component of childhood nephrotic syndrome occurring in 10%-20% of all cases. Over time, 25%-50% of children with FSGS develop kidney failure disease. We followed a cohort of children with FSGS in order to delineate the risk profile of progression to kidney failure (KF). Methods: We evaluated patient data collected from 1977 to 2002 at a regional mid-Atlantic nephrology center in the United States. KF was defined primarily for those patients whose serum creatinine (SCr) value doubled compared with the SCr value from a previous visit. Patients who received dialysis or a kidney transplant were also defined as having KF. We analyzed patient data for those who had at least two visits with SCr values recorded. Various baseline characteristics of patients who had developed KF and those with no kidney failure (NKF) were compared. Hazard ratios and correlation were used to further investigate potential risk factors of the kidney failure. We also compared the inverse SCr trend for KF and NKF patients using weighted linear regression. Results: Thirty-four of 43 FSGS patients had adequate follow-up data. About 60% of the patients developed KF over the study period. The average age of the KF patients at diagnosis of FSGS was 9 years, and that of NKF patients 12 years (P=0.05). FSGS patients with KF had a significantly higher mean diastolic blood pressure (DBP) at baseline, compared to those with NKF (P<0.0001). Other baseline characteristics including race, body mass index (BMI), systolic blood pressure, total cholesterol, urinary protein/creatinine ratio and calculated glomerular filtration rate (cGFR) were not significantly different. Baseline DBP was a significant risk factor in progression to KF (HR: 1.03; 95%CI: 1.01-1.06). Inverse SCr values were significantly decreased over time in KF patients (P=0.01). Conclusions: The data of this study indicate that children diagnosed with FSGS who are younger than 10 years and have elevated baseline DBP are more likely to develop kidney failure. The non-significant hazard ratios for other baseline characteristics including gender, race, and BMI are not instrumental risk factors. These results may help understand what may affect progression towards kidney failure in children with FSGS.

Evidence supports bedside report as a mechanism to improve communication, patient safety, quality of report, and nurse and patient satisfaction when implemented in a closed unit. The purpose of this project was to examine the impact of implementing a bedside report process to transition patients from the emergency department to a medical-surgical unit. Specifically, the goal was to analyze the impact of a bedside- reporting process on patient progression and on nurse and patient satisfaction. Lewin's change model provided the theoretical framework for this quasi-experimental study. Patient progression data consisted of 706 patient transitions from the emergency department to the medical-surgical unit. Pre and post implementation survey responses from 87 patients and 61 nurses comprised the patient and nurse satisfaction data. The data were evaluated through multiple t test analyses. Patient progression times improved significantly post implementation of the bedside report process (p < .05). Nursing satisfaction, quality of report, and safety information were gathered using the Transfer Report Communication Survey. There was statistically significant improvement in survey scores for perceived openness and ease of communication, nurses' perception of the accuracy of information exchanged, and the ability to understand the reported patient information after bedside report was implemented (p < .05). Assessment of patient satisfaction via the Hospital Consumer Assessment of Healthcare Providers and Systems survey noted no improvement in patient satisfaction during the project timeframe (p < .05). These findings may promote positive social change by improving patient care transitions and improving safety in acute care patient transfers.

Although licensed registered nurses (RNs) comprise a significant percentage of the U.S. health care workforce, there is a lack of qualified nurses to meet patient needs. This shortage is expected to intensify as practicing nurses leave the profession. The problem that prompted this study was that an attrition-reduction program implemented in the nursing program at a U.S. midwestern community college did not show a reduction in the average attrition rate. The academic integration construct of Tinto's theory of student departure was used to examine archival academic performance records of 145 students enrolled in the local program from 2010 to 2012. The central research question focused on the correlations between academic progression requirements to student attrition rates in 1st-semester associate degree in nursing (ADN) courses. The correlation was computed using the point-biserial calculation. Findings from the data analysis indicated a statistically significant correlation between 2nd-semester licensed practical nurse (LPN) courses and success in 1st-semester ADN courses, but at a higher benchmark than the current requirement. There was no statistically significant correlation between the standardized exit examination and success in 1st-semester ADN courses. The resulting project was a white paper policy recommendation for the institutional and community stakeholders. The project was evaluated with an outcomes-based evaluation method to measure the effectiveness of the revised progression requirements by measuring attrition rates in the 1st cohort of nursing students who were held to the revised progression requirements. The project contributes to positive social change by providing recommendations to decrease student attrition rates, which, in turn, may help to reduce the global nursing shortage.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21681号 / 医博第4487号 / 新制||医||1036(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 松田 文彦, 教授 清水 章, 教授 濵﨑 洋子 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

The dissertation presents a connected vehicle based traffic signal control model (CVTSCM) for signalized arterials. The model addresses different levels of traffic congestion starting with the initial deployment of connected vehicle technologies focusing on two modules created in CVTSCM. For near/under-saturated intersections, an arterial-level traffic progression optimization model (ALTPOM) is being proposed. ALTPOM improves traffic progression by optimizing offsets for an entire signalized arterial simultaneously. To optimize these offsets, splits of coordinated intersections are first adjusted to balance predicted upcoming demands of all approaches at individual intersections. An open source traffic simulator was selected to implement and evaluate the performance of ALTPOM. The case studies’ field signal timing plans were coordinated and optimized using TRANSYT-7F as the benchmark. ALTPOM was implemented with connected vehicles penetration rates at 25% and 50%, ALTPOM significantly outperforms TRANSYT-7F with at least 26.0% reduction of control delay (sec/vehicle) and a 4.4% increase of throughput for both directions of major and minor streets. This technique differs from traditional traffic coordination which prioritizes major street traffic, and thereby generally results in degrading performance on minor streets. ALTPOM also provides smooth traffic progression for the coordinated direction with little impact on the opposite direction. The performance of ALTPOM improves as the penetration rate of connected vehicles increases. For saturated/oversaturated conditions, two queue length management based Active Traffic Management (ATM) strategies are proposed, analytically investigated, and experimentally validated. The first strategy distributes as much green time as possible for approaches with higher saturation discharge rate in order to reduce delay. For the second approach, green times are allocated to balance queue lengths of major and minor streets preventing queue spillback or gridlock. Both strategies were formulated initially using uniform arrival and departure, and then validated using field vehicle trajectory data. After validation of the modules, the effectiveness of CVTSCM is proven. Then, conclusions and recommendations for future researches are presented at the end.

No description available.

The purpose of this study has been to contribute knowledge about textbooks in mathematics in the field of geometry. More precisely, our ambition has been to find out if the textbooks offer progression between grades 1-3. To study progression in textbooks, we have used van Hiele’s theory, which is a model for how students learn geometry in five hierarchical levels. The method we chose for our study was a combination of a quantitative and a qualitative content analysis. To meet the aim of the study, we analysed two different textbook series. Six textbooks were analysed in total. The textbooks were selected because of their popularity in Swedish schools, one of the textbook series was printed, Favorit Matematik and the other series was digital, Matematik (NE). The results of our analysis showed that both textbook series contained two dimensional and three-dimensional geometric objects and the tasks in these textbooks could be classified according to van Hiele levels 1-3. The results of our study showed that both textbook series offered progression in degree of difficulty based on van Hiele’s levels of thinking. We found differences between these two-textbook series with the number of tasks and in the degree of difficulty. We also found similarities in the fact that both textbook series in grade 2 had tasks that consisted three-dimensional geometrical objects. Our results also showed that Favorit Matematik had a higher degree of difficulty compared to Matematik (NE) which makes it doubtful when it comes to an equivalent education in Swedish schools, as according to school law, equality and equal conditions for all students is central in each school form. The conclusion that was then made is that Favorit Matematik is more suitable for students with higher learning abilities whilst Matematik (NE) is more suited for students who need tasks with a lower degree of difficulty as well as less tasks. The results of this study can provide increased knowledge about how van Hiele theory is used in the textbooks in primary schools.

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Yes / Importance: Myopia is a leading cause of untreatable visual impairment and is increasing in prevalence worldwide. Interventions for slowing childhood myopia progression have shown success in randomized clinical trials; hence, there is a need to identify which children would benefit most from treatment intervention. Objectives: To examine whether genetic information alone can identify children at risk of myopia development and whether including a child’s genetic predisposition to educational attainment is associated with improved genetic prediction of the risk of myopia. Design, Setting, and Participants: Meta-analysis of 3 genome-wide association studies (GWAS) including a total of 711 984 individuals. These were a published GWAS for educational attainment and 2 GWAS for refractive error in the UK Biobank, which is a multisite cohort study that recruited participants between January 2006 and October 2010. A polygenic risk score was applied in a population-based validation sample examined between September 1998 and September 2000 (Avon Longitudinal Study of Parents and Children [ALSPAC] mothers). Data analysis was performed from February 2018 to May 2019. Main Outcomes and Measures: The primary outcome was the area under the receiver operating characteristic curve (AUROC) in analyses for predicting myopia, using noncycloplegic autorefraction measurements for myopia severity levels of less than or equal to −0.75 diopter (D) (any), less than or equal to -3.00 D (moderate), or less than or equal to −5.00 D (high). The predictor variable was a polygenic risk score (PRS) derived from genome-wide association study data for refractive error (n = 95 619), age of onset of spectacle wear (n = 287 448), and educational attainment (n = 328 917). Results: A total of 383 067 adults aged 40 to 69 years from the UK Biobank were included in the new GWAS analyses. The PRS was evaluated in 1516 adults aged 24 to 51 years from the ALSPAC mothers cohort. The PRS had an AUROC of 0.67 (95% CI, 0.65-0.70) for myopia, 0.75 (95% CI, 0.70-0.79) for moderate myopia, and 0.73 (95% CI, 0.66-0.80) for high myopia. Inclusion in the PRS of information associated with genetic predisposition to educational attainment marginally improved the AUROC for myopia (AUROC, 0.674 vs 0.668; P = .02), but not those for moderate and high myopia. Individuals with a PRS in the top 10% were at 6.1-fold higher risk (95% CI, 3.4–10.9) of high myopia. Conclusions and Relevance: A personalized medicine approach may be feasible for detecting very young children at risk of myopia. However, accuracy must improve further to merit uptake in clinical practice; currently, cycloplegic autorefraction remains a better indicator of myopia risk (AUROC, 0.87). / PhD studentship grant from the College of Optometrists (Drs Guggenheim and Williams; supporting Mr Mojarrad) entitled Genetic prediction of individuals at-risk for myopia development) and National Institute for Health Research (NIHR) Senior Research Fellowship award SRF-2015-08-005 (Dr Williams). The UK Medical Research Council and Wellcome grant 102215/2/13/2 and the University of Bristol provide core support for the Avon Longitudinal Study of Parents and Children (ALSPAC). A comprehensive list of grants funding is available on the ALSPAC website (http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). This research was conducted using the UK Biobank Resource (application 17351). The UK Biobank was established by the Wellcome Trust, the UK Medical Research Council, the Department for Health (London, England), the Scottish government (Edinburgh, Scotland), and the Northwest Regional Development Agency (Warrington, England). It also received funding from the Welsh Assembly Government (Cardiff, Wales), the British Heart Foundation, and Diabetes UK.