Developing methods for systematic reviewing in health services delivery and organization: an example from a review of access to health care for people with learning disabilities. Part 1. Identifying the literature

OBJECTIVES: Our objectives were to identify literature on: (i) theory, evidence and gaps in knowledge relating to the help-seeking behaviour of people with learning disabilities and their carers; (ii) barriers experienced by people with learning disabilities in securing access to the full range of health services; (iii) interventions which improve access to health services by people with learning disabilities. DATA SOURCES: twenty-eight bibliographic databases, research registers, organizational websites or library catalogues; reference lists from identified studies; contact with experts; current awareness and contents alerting services in the area of learning disabilities. REVIEW METHODS: Inclusion criteria were English language literature from 1980 onwards, relating to people with learning disabilities of any age and all study designs. The main criteria for assessment was relevance to the Guilliford et al. model of access to health care (Gulliford et al. Access to health care. Report of a Scoping Exercise for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO). London: NCCSDO, 2001), which was modified to the special needs of people with learning disabilities. Inclusion criteria focused on relevance to the model with initial criteria revised in light of literature identified and comments from a consultation exercise with people with learning disabilities, family and paid carers and experts in the field. Data abstraction was completed independently and selected studies were evaluated for scientific rigour and the results synthesized. RESULTS: In total, 2221 items were identified as potentially relevant and 82 studies fully evaluated. CONCLUSIONS: The process of identifying relevant literature was characterized by a process of clarifying the concept under investigation and sensitive search techniques which led to an initial over-identification of non-relevant records from database searches. Thesaurus terms were of limited value, forcing a reliance on using free-text terms and alternative methods of identifying literature to supplement and improve the recall of the database searches. A key enabler in identifying relevant literature was the depth and breadth of knowledge built up by the reviewers whilst engaged in this process.     

Barriers to higher education for Asian/Pacific-American females

As a group, Asian/Pacific Americans (APA) have more credits in high-level science and mathematics than other ethnic groups, but many APAs do not follow this model minority stereotype. This paper focuses on Asian/Pacific-American females who are socialized into traditional roles and are not academically prepared for higher education. Data were collected from questionnaires and life-history narratives completed by 46 part Hawaiian, Filipino, and Samoan-American public high school girls, and from their school records.     

Mergers and Linkages in British Higher Education

In its pursuit of the cost-effective expansion of higher education (HE), the British Conservative government has strongly encouraged competition and has opened the HE sector to the influence of market forces. This policy has certainly helped to drive down unit costs but it also has an inherent destructive potential which requires to be mitigated by a whole spectrum of collaborative structures. To study the interplay between competition and co-operation in British higher education, it is useful to focus on the relationships between higher education institutions (HEIs) as manifested in mergers (both actual, proposed and ‘failed’) and the various forms of inter-institutional linkage which are leading to a re-alignment of HEIs in the post-binary era. A number of forms of linkage, stopping short of merger, are defined and illustrated: for example, affiliation, validation, accreditation, franchising and access arrangements, and the important function of consortia is underlined. However, because they exist within a matrix which is basically competitive, such forms of co-operation are subject to stress and disruption. The British higher education system manifests an unusual degree of flexibility which has enabled it to adapt organically to new policies and challenges. It is more permeable than that of most other European countries, but this permeability is gradually being endangered by increasing UK reliance on formal legislation in HE. Experience abroad, notably in Australia, indicates that wholesale dissolution of boundaries, combined with fierce forms of competition, can in the end lead to serious deterioration in educational standards. A balance between competition and co-operation must be sought, but can never be ‘established’ once and for all because external circumstances require it to be constantly re-adjusted. The research on which this paper is based was carried out with funds from the Economic and Social Research Council and from the Faculty of Education Research Committee of the University of Ulster.     

The Refinement of an “Ideas Map” as a Means of Assessment and of Enhancing Children’s Understanding of Texts

Ideas maps, or concept maps as they are more usually known, have been accepted by a number of teachers as a useful way of helping establish or clarify children’s knowledge about a particular topic. Here Alan Pritchard presents the results of a useful study which explored the use of ideas maps as a means of evaluating children’s abilities to engage with and understand text.     

Tell me a story!

If there were no other reason for sharing literature with children, enjoyment would be reason enough, for enjoyment leads to interest and interest leads to self-motivated reading. Enjoyable experiences with literature build positive attitudes toward books—a prerequisite for reading success.Rosalind E. Engel is Associate Professor of Child Development and a Children's Literature Instructor at Iowa State University in Ames.