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Today's focus on high-stakes standardized tests has had a massive impact on education throughout America, and standardized test preparation is one of the ugly, open secrets of education. Ever since 2001 when President Bush signed into law No Child Left Behind (NCLB), a bipartisan reauthorization of Johnson's landmark Elementary and Secondary Education Act of 1965, students have been bombarded with standardized tests from the earliest grades. Politicians believe these measures are the only way to remedy the perceived weaknesses in the education system because "stringent accountability mandates… [provide] vital levers of change, inclusiveness, and transparency of results" (Education Week, 2011, para. 15). Yet as time progresses, the quantity and importance of the exams increase to such proportions that, by the time students are in high school, their performance dictates whether they will graduate or attend college. While proponents of such exams say that they only test the skills that students ought to be learning anyway, the reality tends to be that teachers start to focus only on the specific questions the test will cover, and thereby lose the ability to provide full, comprehensive education. "Teaching to the test" is the much-maligned experience of most high schools. In order to combat the pressure students feel to perform and teachers feel to shortchange the learning experience, a "Build Your Own Adventure" manual designed around research-based principles demonstrated to improve student learning gains will allow students to focus on the key areas needed to improve test performance, demystify the test itself, and thus help students obtain score improvement. In so doing, students will not only perform better on standardized assessments, but ultimately be able to attend more elite colleges.

Unplanned hospital admissions (UHA) in older adult populations are a recurring problem in older adults with cancer. Older adults comprise approximately 60% of cancer diagnoses and receive the majority of cancer treatment. However, little is known about why older adults under treatment for cancer experience a high number of unplanned hospital admissions. A review of the literature provided few study findings and a gap in the current knowledge was identified regarding the factors associated with unplanned hospital admissions in older adults under treatment for cancer. A conceptual framework based on the literature and this researcher's clinical experienced guided this study. The purpose of this study was to explore the factors related to unplanned hospital admissions and determine if one or more factors are predictive of unplanned hospital admissions of older adults with cancer. A convenience sample of 129 dyads of older adults with cancer and their family caregivers were approached and enrolled in the adult oncology outpatient infusion centers and inpatient units within a community cancer center in central Florida. Patient demographic and clinical data were obtained through a retrospective medical record review. Family caregiver demographic and side effect knowledge data was collected prospectively during interviews with family caregivers using a newly developed tool, Nurse Assessment of Family Caregiver Knowledge and Action Tool (NAFCKAT). The NAFCKAT contains 11 items to determine baseline knowledge about side effects and plan for managing side effects. A fever subsection consists of 4 knowledge and 2 action questions and a dehydration subsection consists of 2 knowledge and 2 action questions. Preliminary research was conducted to determine reliability and validity of the NAFCKAT. Excellent inter-reliability was found for the tool and preliminary support for validity was determined for the fever subscale. Descriptive statistics and logistic regression analyses were used to evaluate data collected from patient medical records and NAFCKAT scores. Study findings revealed that unplanned hospital admissions were more likely to occur when older adults had the presence of impaired function prior to treatment initiation and/or experienced side effects of infection /fever and vomiting/diarrhea during treatment. The presence of impaired function and family caregiver support (knowledge and availability) did not moderate the relationship between side effects and unplanned hospital admissions. Findings suggest that the presence of impaired function and side effects of infection and fever, and vomiting and diarrhea, predict unplanned hospital admissions in older adults during the active cancer treatment phase. Nurses should advocate for and conduct targeted assessments to identify the presence of functional impairments prior to cancer treatment initiation. In addition, nurses should actively monitor for the presence of cancer treatment-related side effects during the treatment phase of the cancer trajectory. Information gained from these assessments will assist nurses to provide practical and tailored strategies to support older adults and their family caregivers during cancer treatment and reduce the risk for unplanned hospital admissions.

In July 2022, the University of California (UC) permanently eliminated the standardized tests requirement for its freshman admissions in order to alleviate the severed socioeconomic gap and college access barriers that were heightened by the COVID-19 pandemic. This critical policy analysis research explored the immediate effects of UC’s policy reform on higher education equity. All 14 participants were underrepresented minority (URM) students who applied to at least one UC campus for fall 2022’s freshman admissions and were enrolled in four-year universities at the time of this study. From demographic surveys, focus groups, and in-depth interviews, I applied critical race theory (CRT) tenets and internalized oppression theory to explore, interpret, and provide counter-narratives of URM students’ college planning and application experiences after the policy reform. From analyzing these students’ perceptions of the elimination of the standardized tests requirement and UC’s admissions equity, I identified the following four findings: 1. Insidiousness of Higher Education Racism: The Role of Standardized Testing in Admissions 2. Enduring Internalized Oppression: The Lingering Effects of the Legitimization of Standardized test requirement 3. Intersectionality of Race, Income, First-Generation College Students’ Status, and Pandemic Impacts 4. Increased Trust in the Higher Education Admissions System After application and identification, I critically discussed the research findings and provided implications for future policies, practices, and research directions for higher education admissions equity based on the four findings. In conclusion and alignment with the CRT tenet of interest convergence, UC’s policy has increased opportunities for all students and has benefited both White and underrepresented minority URM students in terms of their acceptance into highly selective, four-year universities.

Thesis advisor: M. Utku Ünver / Thesis advisor: Tayfun Sönmez / This thesis is a collection of three essays in market design concerning designs of matching markets with aggregate constraints, affirmative action schemes, and investigating boundaries of simultaneous efficiency-stability relaxation for one-to-one matching mechanisms.In Chapter 1, I establish and propose a possible solution for a college housing crisis, a severe ongoing problem taking place in many countries. Every year many colleges provide housing for admitted students. However, there is no college admissions process that considers applicants’ housing needs, which often results in college housing shortages. In this chapter, I formally introduce housing quotas to the college admissions problem and solve it for centralized admissions with common dormitories. The proposed setting is inspired by college admissions where applicants apply directly to college departments, and colleges are endowed with common residence halls. Such setting has many real-life applications: hospital/residents matching in Japan (Kamada and Kojima, 2011, 2012, 2015), college admissions with scholarships in Hungary (Biró, 2012), etc. A simple example shows that there may not be a stable allocation for the proposed setting. Therefore, I construct two mechanisms that always produce some weakened versions of a stable matching: a Take-House-from-Applicant-stable and incentive compatible cumulative offer mechanism that respects improvements, and a Not-Compromised-Request-from-One-Agent-stable (stronger version of stability) cutoff minimising mechanism. Finally, I propose an integer programming solution for detecting a blocking-undominated Not-Compromised-Request-from-One-Agent-stable matching. Building on these results, I argue that presented procedures could serve as a helpful tool for solving the college housing crisis. In Chapter 2, I propose a number of solutions to resource allocation problems in an affirmative action agenda. Quotas are introduced as a way to promote members of minority groups. In addition, reserves may overlap: any candidate can belong to many minority groups, or, in other words, have more than one trait. Moreover, once selected, each candidate fills one reserve position for each of her traits, rather than just one position for one of her traits. This makes the entire decision process more transparent for applicants and allows them to potentially utilize all their traits. I extend the approach of Sönmez and Yenmez (2019) who proposed a paired-admissions choice correspondence that works under no more than two traits. In turn, I allow for any number of traits focusing on extracting the best possible agents, such that the chosen set is non-wasteful, the most diverse, and eliminates collective justified envy. Two new, lower- and upper-dominant choice rules and a class of sum-minimizing choice correspondences are introduced and characterized. In Chapter 3, I implement optimization techniques for detecting the efficient trade off between ex-post Pareto efficiency (for one side of a two-sided matching market) and ex-ante stability for small one-to-one matching markets. Neat example (Roth, 1982) proves that there is no matching mechanism that achieves both efficiency (for one side of the one-to-one matching market) and stability. As representative mechanisms I choose deferred-acceptance for stability, and top trading cycles for Pareto efficiency (both of them are strategy-proof for one side of the market). I compare performances of a randomized matching mechanism that simultaneously relaxes efficiency and stability, and a convex combination of two representative mechanisms. Results show that the constructed mechanism significantly improves efficiency and stability in comparison to mentioned convex combination of the benchmark mechanisms. / Thesis (PhD) — Boston College, 2023. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Economics.

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This three-year study is an ethnography of communication of a private high school in Japan. The purpose of this study is to investigate how teachers at this private high school understand their environment in the context of changes in Japanese education and even larger changes in Japanese society. These changes include a decreasing population in Japan, shifting university admission policies, and changes to teacher licensing regulations. Methods of data collection include participant observations, interviews, artifact collection, and focus groups. Although the focus is on teachers, students and informants outside of the school are included in order to provide a fuller picture of the context in which the study is conducted. These data are viewed through the lens of Communities of Practice developed by Etienne Wenger and also through the Ethnography of Communication framework. The intended audience for this study includes people interested in cross-cultural studies, Japanese studies, educators teaching in or studying secondary education outside of Japan, teacher trainers, and western educators working in Japan as well as Japanese educators. The findings suggest that changes in student population numbers, university entrance requirements, and licensing procedures have all placed new demands upon teachers. Japan’s decreasing population places greater requirements upon teachers in private high schools to help with student recruitment, and one way to do this is by supporting efforts to brand the school name. In addition, shifting admission policies have placed an emphasis on the connection between high schools and their associated universities. Schools actively work to protect this relationship by introducing new elements to the curriculum in an attempt to better prepare students for the university experience. Finally, changes to teacher licensing regulations have introduced teacher training to private high schools as well as new members to the central community of practice in the school, the gakunen, or the group of teachers and students assigned to a year grade. The response to these new members has varied both among the newcomers and the teachers who were licensed before the changes were introduced. Further data collection and analysis reveal how other societal trends shape the local practices of teachers, and how the teachers in the gakunen community of practice work at times together, and at times to resolve conflicts with each other, students, and parents as they confront demands being placed on educators in Japan in the 21st century. / Teaching & Learning

Yes / Repeated hospital admissions are prevalent in older people. The role of medication in repeated hospital admissions has not been widely studied. The hypothesis that medication-related risk factors for initial hospital admissions were also associated with repeated hospital admissions was generated. To examine the association between medication-related risk factors and repeated hospital admissions in older people living with frailty. A retrospective case-control study was carried out with 200 patients aged ≥75 years with unplanned medical admissions into a large teaching hospital in England between January and December 2015. Demographic, clinical, and medication-related data were obtained from review of discharge summaries. Statistical comparisons were made between patients with 3 or more hospital admissions during the study period (cases) and those with 2 or fewer admissions (controls). Regressions were performed to establish independent predictors of repeated hospital admissions. Participants had a mean age of 83.8 years (SD 5.68) and 65.5% were female. There were 561 admission episodes across the sample, with the main reasons for admissions recorded as respiratory problems (25%) and falls (17%). Univariate logistic regression revealed five medication-related risks to be associated with repeated hospital admissions: Hyper-polypharmacy (defined as taking ≥10 medications) (OR 2.50, p < 0.005); prescription of potentially inappropriate medications (PIMs) (OR 1.89; p < 0.05); prescription of a diuretic (OR 1.87; p < 0.05); number of high risk medication (OR 1.29; p < 0.05) and the number of 'when required' medication (OR 1.20; p < 0.05). However, the effects of these risk factors became insignificant when comorbid disease was adjusted for in a multivariable model. Medication-related risk factors may play an important role in future repeated admission risk prediction models. The modifiable nature of medication-related risks factors highlights a real opportunity to improve health outcomes.

Yes / New healthcare models are being explored to enhance care coordination, efficiency, and outcomes. Evidence is scarce regarding the impact of vertical integration of primary and secondary care on emergency department (ED) attendances, unplanned hospital admissions, and readmissions. Aim To examine the impact of vertical integration of an NHS provider hospital and 10 general practices on unplanned hospital care Design and setting A retrospective database study using synthetic controls of an NHS hospital in Wolverhampton integrated with 10 general practices, providing primary medical services for 67 402 registered patients. Method For each vertical integration GP practice, a synthetic counterpart was constructed. The difference in rate of ED attendances, unplanned hospital admissions, and unplanned hospital readmissions was compared, and pooled across vertical integration practices versus synthetic control practices pre-intervention versus post-intervention. Results Across the 10 practices, pooled rates of ED attendances did not change significantly after vertical integration. However, there were statistically significant reductions in the rates of unplanned hospital admissions (−0.11, 95% CI = −0.18 to −0.045, P = 0.0012) and unplanned hospital readmissions (−0.021, 95% CI = −0.037 to −0.0049, P = 0.012), per 100 patients per month. These effect sizes represent 888 avoided unplanned hospital admissions and 168 readmissions for a population of 67 402 patients per annum. Utilising NHS reference costs, the estimated savings from the reductions in unplanned care are ∼£1.7 million. Conclusion Vertical integration was associated with a reduction in the rate of unplanned hospital admissions and readmissions in this study. Further work is required to understand the mechanisms involved in this complex intervention, to assess the generalisability of these findings, and to determine the impact on patient satisfaction, health outcomes, and GP workload.

Differential predictive validity in assessing academic performance in institutions of higher education has been assessed for a number of years. Historically, this body of research focused on gender and ethnicity. This study extends that research to geographic region (e.g., rural and non-rural populations). Specifically, this study predicted relationships between preadmission variables of incoming grade point average (GPA) and medical college admissions test (MCAT) and output variables of medical school GPA and comprehensive osteopathic medical licensing exam (COMLEX). Results indicate incoming GPA and MCAT are good variables to use to predict academic performance in medical school and score on the licensing board exam. Further, rural populations presented similar scores on preadmission variables and, thus, are not at a disadvantage in the admission process. A second goal of this study was to explore differential prediction of medical school GPA and COMLEX Level 1 score for the MCAT for rural and non-rural populations. Results provide some evidence of differential prediction of COMLEX score for the physical and biological sciences MCAT sub-tests such that rural populations' performance on the COMLEX Level 1 exam was underpredicted. Hence, when rural and non-rural populations present the same physical sciences and biological sciences MCAT sub-test score, the rural sub-group is predicted to obtain a lower COMLEX score and non-rural sub-group is predicted to obtain a higher COMLEX score. Further, when the two sub-groups present different MCAT scores for the physical and biological sciences sub-test, they are likely to obtain similar scores on the COMLEX. Implications and recommendations for future research are discussed. / Master of Science