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General practitioners (GPs) play a central role in healthcare, serving as the first point of contact, making appropriate referrals and coordinating care for chronic conditions such as heart failure (HF). We sought to determine healthcare use by people with HF in primary care.In this Study of Heart failure in the Australian Primary carE setting (SHAPE), we analysed records of 1.93 million adult patients who attended a total of 43 practices between 1 July 2013 and 30 June 2018. We identified and examined the data of 20,219 patients with HF to describe the frequency of visits and use of Medicare Benefits Schedule items.Patients with HF saw GPs 14.4 times per annum on average; 59.5% had a General Practice Management Plan (GPMP), 2.9% of GPMPs were reviewed annually or more frequently, and 46.8% of patients had been referred to a cardiologist. A total of 3761 had coexisting anxiety or depression, and of these 37.1% had a mental health plan.Patients with HF visit their GP frequently, with many not reaching guideline therapy nor referred to cardiologists. Low use of care planning and reviews presents an opportunity for GPs to improve care.

Aims Heart failure (HF) causes significant morbidity and mortality, but the rates and characteristics of people with HF in Australia are not well studied. SHAPE set out to describe the characteristics of HF patients seen in the real‐world setting. Methods We analysed anonymized patient data extracted from the clinical software of 43 participating GP clinics for the 5 year period from 1 July 2013 to 30 June 2018. Patients were stratified into ‘definite’ and ‘probable’ HF based on a hierarchy of selection criteria and analysed for their clinical characteristics. Symptoms and signs of HF and ejection fraction data were searched for within the free text of the medical notes. Results Of the 1.12 million adults seen regularly, 20 219 were classified as having definite or probable HF. The mean age of the population was 69.8 years, 50.6% were female, and mean body mass index was 31.2 kg/m2. Fewer than 1 in 6 had the HF diagnosis optimally recorded. Only 3.2% (650 patients) had their left ventricular ejection fraction (EF) quantified: 40.9% had an EF ≥50% and 59.1% had an EF

In this study, we examine eight social and emotional outcomes (e.g., student engagement, sense of belonging) analyzing differences for students who attend racially diverse schools. Drawing on survey responses from roughly 26,000 students, we find that racially diverse schools are associated with more positive social and emotional outcomes for all students. Strikingly, we find that these outcomes are most uniformly positive among white students, whose families have long represented the strongest opposition to systematic racial desegregation. In light of these results, this study has implications for educators, advocates, researchers, and policy makers during a time of renewed attention to school integration.

Aims At present, there is no robust information on the prevalence and incidence of heart failure (HF) in the general Australian community. The present study of primary care data sought to estimate the prevalence and incidence of HF in the community and to describe the demographic and clinical profile of Australians with HF. Methods and results We undertook a retrospective cohort study based on analysis of anonymized medical records of adult patients cared for at 43 Australian general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded and uncoded fields in electronic medical records. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals, using the ‘active’ population of people who were regular attenders at the practices. Age‐standardized estimates were also derived using the 2017 Australian population as reference. The mean age of the population with HF was 69.8 years, 50.6% were female, and mean body mass index was 31.2 kg/m2. The age‐standardized prevalence was 2.199% [95% confidence interval (CI): 2.168–2.23%], and the age‐standardized annual incidence was 0.348% (95% CI: 0.342–0.354%). These estimates accord with almost 420 000 people living with HF in Australia in 2017, and >66 000 new cases of HF occurring that year. Only 18.9% of patients with definite HF had this formally captured as a ‘diagnosis’ in their medical record. HF was more frequent among those of lower socio‐economic status. Conclusions HF is common in Australia. The majority of HF patients do not have this diagnosis optimally noted in their primary care medical records.

Background There is a paucity of information on the epidemiology of heart failure (HF) in Australia. The Study of Heart failure in the Australian Primary carE setting (SHAPE) study aims to estimate the prevalence and annual incidence of HF in the general Australian community and to describe the demographic and key clinical profile of Australians with HF. Methods We undertook a retrospective cohort study based on analysis of non-identifiable medical records of adult patients cared for at 43 general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded (diagnosis, pathology and prescription fields) and uncoded fields (clinical notes) in the medical records. The latter searches of free text looked for common synonyms relevant to HF. The population was stratified into three groups based on a hierarchy of selection criteria: (1) definite HF, (2) probable HF and (3) possible HF. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals. Results The practices provided care to 2.3 million individual patients over the five-year study period, of whom 1.93 million were adults and 1.12 million were regular patients. Of these patients 15,468 were classified as having ‘definite HF’, 4751 as having ‘probable HF’ and 33,556 as having ‘possible HF’. A further 39,247 were identified as having an aetiological condition associated with HF. A formal HF diagnosis, HF terms recorded as text in the notes and HF-specific medication were the most common methods to identify ‘definite’ HF patients. Typical signs and symptoms in combination with a diuretic prescription was the most common method to identify ‘probable HF’ patients. The majority of ‘possible’ HF patients were identified by the presence of 2 or more of the typical signs or symptoms. Dyspnoea was the commonest recorded symptom and an elevated jugular venous pressure the commonest recorded sign. Conclusions This novel approach to undertaking retrospective research of primary care data successfully analysed a combination of coded and uncoded data from the electronic medical records of patients routinely managed in the GP setting. SHAPE is the first real-world study of the epidemiology of HF in the general Australian community setting.

This paper explores changes to the educational policy-making arena through case study analysis of a Massachusetts law passed in 2012 that limits seniority-based job protections for public K-12 teachers. I use data from interviews with policy stakeholders, observations of public meetings, and policy artifacts to explore struggles over democratic engagement in what unfolded as a highly undemocratic policy development process. Using the policy cycle framework, I explore the ways that political pressure and political discourses shaped the policy development process through various contexts of political struggle. Ultimately, I argue that the case is indicative of what I am calling ‘neo-democratic’ decision-making, in which high-level interest group conflict leads to narrow forms of democratic engagement.

In recent years, a new breed of political organizations has had remarkable influence in American educational policymaking. Proponents of neoliberal reform, these groups have been labeled as Education Reform Advocacy Organizations, or ERAOs. I situate these organizations within the larger network of Intermediary Organizations (IOs). To understand the ways that ERAOs influence the policymaking process, I explore the role of Stand for Children, a national ERAO, in helping to pass neoliberal reform of teacher job security in Massachusetts. Using the Advocacy Coalition Framework (ACF), I explore common frames evident in debate about the organization’s role in the state, and I rely on data from key stakeholder interviews, observations and policy artifacts to characterize competing arguments about the organization’s political motives. I pay particularly close attention to how the organization’s political identity shaped, and was shaped by, its attempts to build an advocacy coalition in the state. Through...

Teacher learning communities are hailed by many as vehicles for reforming and elevating the professional status of teaching. While much research explores teacher community as a venue for measurable gains, our research examines the orientation of practitioner inquiry toward critical debate about effective instruction. Specifically, our study focuses on a group of middle and high school teachers who worked with a nonprofit organization to engage students in urban environmental field investigations. Teachers met regularly as a community with the common goal of teaching urban ecology in an outdoor setting. We collected interview data from members of the teacher community, and we observed teacher interaction during a meeting of the practitioner inquiry group. Interview results indicated that while the nonprofit aimed to support collaborative dialogue and self-critique, participants saw the community mainly as a venue for pursuing short-term goals, such as receiving new resources or socializing with colleagues. Observation data, however, suggested that the community was taking early steps toward building an environment oriented toward critical discussion. Juxtaposing results from our interviews and observations, we discuss the challenges communities face when they seek to develop shared beliefs and deal openly with conflict. Ultimately, we suggest that organizers of collaborative learning environments should work to actively develop structures for building the organizational trust necessary to support civil critique.

This paper situates recent changes in educational policymaking, especially the increased use of the ballot initiative, within larger historical trends related to democratic engagement in policy development. I conduct an integrative literature review that combines conceptual analyses with findings from empirical investigations into new policymaking tactics and their influence on policy development. Specifically, I explore (a) the discourses justifying policy priorities over time, and (b) the role of democratic engagement in dominant modes of policymaking. I demonstrate that various sources combine to tell a troubling story about the longstanding exclusion of the public from policymaking regarding its public schools. Further, I argue that, perhaps paradoxically, the increased use of the ballot initiative only exacerbates this trend. Ultimately, I use results from the reviewed research to ask if there is a better way to make policy, one that aspires to higher democratic ideals.

Currently there are multiple teacher education reform policies being proposed, piloted, and debated at a variety of levels and by various interest groups, stakeholders, and policy-makers. Along with an unprecedented sense of urgency about these important goals, what most U.S. reforms have in common is increased accountability. Using a discourse approach to policy analysis, which we label “the politics of policy,” this article analyzes three complicated and evolving contemporary accountability initiatives in the United States: (1) “Our Future, Our Teachers,” which is the Obama administration's proposed blueprint for the reform of teacher education programs, in particular its call for the assessment of preparation programs based on the impact of program graduates on their eventual K–12 students’ test scores; (2) the “Teacher Performance Assessment,” which is a nationally accessible instrument for assessing beginning teaching performance currently being piloted in 25 states through a partnership of ...

Since 2006, the Thomas W. Payzant School on the Move (SOM) Prize has been awarded annually to a Boston public school that has made significant progress in improving student achievement. This case study identifies the structures and strategies that best serve students in prizewinning schools and provides a profile of each of the four winning schools from 2006 to 2009. We also explore some of the opportunities and barriers the schools have faced in sustaining their success over time. A common case study methodology was employed, using school observations and interviews with school leaders, staff, and students. Findings reveal the importance of distributed leadership, data-driven instruction, and student-centered approaches to learning in achieving school success.

In the United States, there is enormous controversy about how teachers ought to be prepared and licensed. Many of the sharpest controversies stem from acute public skepticism about whether formal teacher preparation is really necessary at all given the lack of conclusive evidence that teacher preparation has a direct impact on students' achievement. With these larger issues in mind, this article presents a review of recent research that empirically examines the connection between teachers' education and either teaching practice or teacher retention (or both). The literature in six distinct genres of research is reviewed with cross-genre conclusions and implications.

In this policy analysis column, we use the analytic tools of frame analysis to explore the ideologies, implicit and explicit, in the Obama administration's educational policies. In particular, we explore the ways that the initiatives are being framed through an oversimplified view of the “problem” in education and a capitalist-based approach to fixing that problem. For a point of conjecture, we offer an alternative framing of the challenges facing current educational practice and a requisite set of responses to those challenges. However, more important is that stakeholders of the Obama administration's initiatives engage in regular and consistent analysis of political frames and reconstruction of those frames when appropriate. في عمود تحليل السياسة هذا نستخدم الأدوات التحليلية لدى الإطار التحليلي كي نستكشف العقائد أيا كانت الباطنة أو الظاهرة في سياسات إدارة أباما التعليمية وعلى وجه الخصوص نستكشف الطرق التي تشكل من خلالها المبادرات التي تنتج رأيا مبسطا للغاية عن ((المشكلة)) في التعليم والمنهاج المبني على الرأس المالي ليحل تلك المشكلة. ومن باب الافتراض نقدم إطارا بديلا للتحديات التي تواجها الممارسات التعليمية القائمة الآن ومجموعة الردود الضرورية على هذه التحديات. ولكن أهم من ذلك هو أن أصحاب الحق في تشكيل مبادرات إدارة أباما يشتغلون في تحليل منتظم ومستديم للإطارات السياسية وإعادة بناءها في أوقات مناسبة. 在本政策分析专栏中，作者利用框架性分析作为分析工具，探究奥巴马政府的教育政策所存在的隐式及显式意识形态。作者特别探究政府所框定出来的新方案，如何以过分简单化的视野去看待教育「问题」及如何以资本主义为主的观点去解决这问题。作为一个猜想，作者提出另一个框架去看待当前教育实践所面对的挑战及所需的一组回应方法。然而，更重要的是，奥巴马政府新方案的利益相关者，必须定期与持续参与分析政治框架，并在适当时重新建构这些框架。 Dans cette rubrique d'analyse politique, nous utilisons les outils de l'analyse des structures pour examiner les ideologies, implicites et explicites, des politiques educatives de l'administration d'Obama. Nous examinons en particulier la facon dont les initiatives sont en train d'etre structurees a travers une conception sur simplifiee du « probleme » de l'education et une approche basee sur le capitalisme pour resoudre ce probleme. En guise de point de conjoncture, nous presentons une structuration alternative des defis auxquels font face les pratiques pedagogiques actuelles et un ensemble de reponses qui seraient necessaires pour relever ces defis. Cependant, le plus important est que les parties prenantes des initiatives de l'administration Obama s'engagent dans une analyse reguliere et coherente des structures politiques et a la reconstruction de ces structures quand ca s'avere necessaire. В этом выпуске рубрики, посвященной образовательной политике, мы используем аналитический инструментарий анализа фреймов, чтобы исследовать явные и скрытые идеологические посылки, которыми руководствуется администрация Барака Обамы в области образования. В частности, мы исследуем фреймы, связанные с различными инициативами: упрощенное представление о том, что в образовании наличествует некая “проблема”, и типично “капиталистический” подход к решению этой проблемы. В качестве гипотезы авторы предлагают альтернативные представления о проблемах, существующих в современном образовании, и набор действий, необходимых для их решения. Однако, самое главное, чтобы ключевые фигуры в администрации Обамы производили регулярный и последовательный анализ политических фреймов и при необходимости их видоизменяли. En esta columna de analisis de politicas, se usa las herramientas analiticas del analisis enmarcado para explorar las ideologias, implicitas y explicitas, de la politica educacional de la administracion de Obama. Exploramos en particular las maneras en que se estan enmarcando las politicas por medio de una perspectiva sobresimplificada del “problema” eduacional y un acercamiento capitalista para arreglar el problema. Para iniciar la discusion, ofrecemos un marco alternativo a los retos que las practicas de hoy dia enfrentan y las respuestas necesarias a tales retos. Pero, mas importante es que los interesados en las iniciativas de la administracion de Obama participen en analisis regulares y consistentes de los marcos politicos y la reconstruccion de dichos marcos cuando necesario.

To understand how dominant messages about race and effective pedagogy impact teacherbeliefs and practice, this study employs critical race theory (CRT) in a case study analysis ofRebecca Rosenberg, a mid-career entrant into the teaching profession who was terminated fromher first job before the end of her district’s probationary period. Despite believing she wasteaching for social justice, being prepared in a program oriented toward social justice, and beinghired in a school with a comparable mission, Rebecca’s beliefs and practices affirmed uncriticalperspectives of the status quo regarding race, schooling, and social ascendance. This researchunderscores the substantial work to be done in preparing teachers to be reflective of theoverarching cultural myths and majoritarian stories that may guide their practice.