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Telemedicine has been touted as a solution to the problems of access to health care experienced by rural and other isolated populations. Few studies exist, however, that explain the differential use of telemedicine by patients. Patient utilization of this technology is likely to be predicted by both those factors that affect the adoption of new ideas, on the one hand, and those factors that affect the utilization of health care, on the other. These include (1) propensity factors such as education and ethnicity; (2) enabling factors such as income and health insurance, and (3) need characteristics such as the severity of the illness as well as factors that impact (4) accessibility. Data were collected from samples of patients who had experienced telemedicine in one of two rural locations in Texas. A second sample of patients who had not experienced telemedicine was drawn from these same locations for comparative purposes. Models were developed to differentiate among patients who would elect to use telemedicine for each of six hypothetical medical conditions versus the alternatives of consulting their local physician without the presence of telemedicine or travel to see a specialist. Separate models were developed for those patients who had previous experience with telemedicine and for those without such previous experience. Prior experience was associated with a greater willingness to use telemedicine for all but the most serious of medical conditions. Predisposition factors had the greatest impact on the more serious conditions (e.g., problem pregnancy and cancer), and enabling conditions as well as access factors were more likely to affect the less serious conditions (e.g., cough and rash).

Proponents of telemedicine believe this technology will resolve many of the problems associated with the lack of access to specialty care by isolated populations. However, in order for telemedicine to be successful, health care professionals and patients must be willing to use it. Few studies exist that identify those characteristics that differentiate adopters from non-adopters of this technology. Furthermore, little is known about the kinds of health care professionals and patients who are willing to make continued use of telemedicine after initial adoption. Prior studies of the adoption of medical technology have identified personal characteristics such as age and gender among patients and age, gender, years since graduation from medical school, and medical specialty among providers as predictors of the adoption of medical technolgy. Using data collected from the first 483 teleconsultations performed by a West Texas medical system, we developed prediction models of the continued use of telemedicine using the personal characteristics of patients, primary care professionals, and medical specialists as predictors. We included the number of primary care professionals and specialists involved in prior teleconsultations in these prediction models. Patient characteristics contributed little to the prediction of continued use of telemedicine; however, characteristics of the health care professionals such as age, gender, and years since graduation as well as the number of health care personnel involved in previous consultations were significant predictors of the continued use of telemedicine.

This chapter discusses how attachment theory, a theory that provides insight into the processes through which psychological and emotional bonds are developed in relationships, can be useful for understanding mentoring relationships. We develop a conceptual model emphasizing how attachment-related constructs and their relationships with mentors’ and protégés’ behaviors and emotions influence each phase of a mentoring relationship. Recognizing reciprocity in the mentoring process, the model also explains how the interpersonal dynamics of the mentor–protégé relationship influence the benefits gained by both partners. Propositions for future research on mentoring relationships are provided. We contend that examining mentoring through the lens of attachment theory can increase our understanding of the underlying factors or mechanisms that determine individuals’ involvement in mentoring relationships and differentiate successful from unsuccessful mentoring relationships. The research and practical implications are discussed.

This chapter examines the potential and barriers for evidence-based practices in Californian schools. In a large and complex school system, the state plays an important role in legitimating the use of certain types of evidence, but evidence-based practices are heavily determined by the resources, actors, and prevailing cultures in a local district environment. Until recently, high-stakes accountability policies mandated improvements in student test performance and intrusive interventions for failure. In recent years, the state has shifted to a different accountability approach that emphasizes local control and the use of multiple measures of school performance to pursue continuous improvement around locally developed goals and interventions. Amid this context, two stories arise about evidence-based practices in California. In one story, a set of major and highly touted districts have led the way in demonstrating evidence-informed continuous improvement district-wide. In these districts, the new state accountability approach, enabling leadership, long-term commitments to collective learning, networked opportunities to learn, and access to elite external expertise have contributed to fairly extensive practices of disciplined team problem-solving involving rich data. In a second story, schools and districts that face resource scarcity, high turnover, and conflict and in which past high-stakes accountability left a deep imprint on prevailing norms and routines, leaders and teachers have had difficulty establishing a conducive context for collective learning. However, given ingrained practices and limited absorptive capacity, it is not entirely clear how to enable productive evidence-based practices in such contexts.

A growing number of African countries are starting to produce science, technology and innovation (STI) indicators. The purpose of this paper is to provide some lessons learnt in the production and use of STI indicators in Malawi and South Africa. It is compares the two countries’ efforts to conduct Research and Development (R&D) surveys and examines whether and how STI indicators are used in policymaking processes.

The study approach is qualitative. The research methodology encompasses a thorough review of both policy and academic literature as well as some interviews.

The study demonstrates that South Africa has a relatively developed institutional arrangement for undertaking R&D and innovation surveys and developing related STI indicators. There is evidence that efforts are being made to use STI indicators to inform policymaking in the country. On the other hand, Malawi conducted its first R&D survey under the African Science, Technology and Innovation Indicators Initiative (ASTII) and has not established an institutional mechanism dedicated to producing STI indicators. There is no evidence that indicators are used in, or to inform, policymaking in the country.

Because of significant differences in STI policymaking histories, capacities and cultures of the two countries, it is not really useful to compare the STI production and use. Rather it is important to draw lessons from the efforts of the two countries.

The results suggest that the production of STI indicators should be embedded in policy processes. To be useful and effective, STI indicators production needs to be explicitly linked to policy formulation, evaluation and monitoring activities without necessarily undermining the independence of producing STI indicators.

Creating stand-alone programmes or agencies for R&D and innovation surveys without clear articulation with policymaking needs erodes opportunities of having evidence-based STI policy regimes.

Although in 2005 only South Africa and Tunisia had national programmes dedicated to the generation of R&D statistics, by the end of 2010 at least 19 African countries had experimented with conducting R&D surveys under the auspices of the ASTII of the New Partnership for Africa’s Development. These countries accumulated different experiences and consequently build different kinds of institutional capacities. Through the Malawi and South Africa case studies, some important lessons for STI indicators production and use and STI policymaking can be drawn for developing countries in general and African countries in particular.