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Between the years 1993 and 2000, the W. K. Kellogg Foundation sponsored the Comprehensive Community Health Models (CCHMs) Initiative in three Michigan counties. CCHMs was comprised of three closely related community initiatives carried out in the midst of a failed national health care reform effort and the continued penetration of managed care arrangements into many health care systems. This experimental initiative set out to test the hypothesis that traditional healthcare system animosities and exclusionary practices could be overcome by stakeholder participation in an ongoing, structured, collaborative dialogue about improving access to health services. In the process of collecting data through surveys, interviews, content analysis, and observation, we were struck by the occurrence of several overarching tensions that we perceive to exist in our data. The present article elucidates five such tensions and suggests how third parties such as communication researchers, evaluators, and practitioners can facilitate community health improvement initiatives and better their own data interpretation by acknowledging and understanding these tensions.  相似文献   
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In this article, we report the design and evaluation of a prototype for learning modules compliant to the SCORM standard. This prototype is especially developed for the subject matter of process systems engineering and features a novel process control display for the navigation between Sharable Content Objects. In a controlled field study, N=18 undergraduate students interacted with the module for a period of 40 minutes. The relations between individual differences in learner characteristics, navigation, and learning outcome were considered. Interaction with the module had a strong positive effect on learning outcome. Individual differences in learning outcome were significantly affected by individual differences in intrinsic motivation, computer experience and navigation behaviour.  相似文献   
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This was the first qualitative study of the inclusion of children with special needs into regular schools in Slovenia that focused on inter-professional collaboration and its contributions to the inclusion process. Focus groups and individual interviews were conducted with primary school teachers (N?=?36) and occupational therapists (N?=?9) to explore their personal experiences. Data were analysed using qualitative content analysis (Strauss, A., and J. Corbin. 1998. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Thousand Oaks, CA: Sage). Two categories pertaining to inter-professional collaboration emerged from the analysis. They described different barriers and strategies that either inhibited or facilitated the cooperation process. The experiences of teachers and occupational therapists differed; however, both professional groups expressed frustration with organisational and systemic factors that often prevented better exchange of knowledge and information. Due to the organisation of work and financial issues, occupational therapists had limited access to the school environment; therefore, they generally showed more eagerness to increase the level of collaboration and their presence at the school. The study also pointed out how the roles of certain professionals are not recognised, suggesting the need for more promotional work. If inclusion in Slovenia is to be fully implemented, collaboration between different professionals working with children with special needs must strengthen. This will require some significant organisational, cultural and also personal transformations.  相似文献   
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Between the years 1993 and 2000, the W. K. Kellogg Foundation sponsored the Comprehensive Community Health Models (CCHMs) Initiative in three Michigan counties. CCHMs was comprised of three closely related community initiatives carried out in the midst of a failed national health care reform effort and the continued penetration of managed care arrangements into many health care systems. This experimental initiative set out to test the hypothesis that traditional healthcare system animosities and exclusionary practices could be overcome by stakeholder participation in an ongoing, structured, collaborative dialogue about improving access to health services. In the process of collecting data through surveys, interviews, content analysis, and observation, we were struck by the occurrence of several overarching tensions that we perceive to exist in our data. The present article elucidates five such tensions and suggests how third parties such as communication researchers, evaluators, and practitioners can facilitate community health improvement initiatives and better their own data interpretation by acknowledging and understanding these tensions.  相似文献   
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