Living within reform : a phenomenological study of the lived experiences of teacher leaders in high schools

This is a phenomenological study of the experiences of three teacher leaders in the context of high school reform. It examines the essence of teacher leadership and how these teacher leaders made sense of their experiences. At the outset is a portrayal of my position and connection to the phenomenon of teacher leadership. This study reviews literature within three distinct areas. First, the nature of school reform is examined, including the rationale for reform, the challenges associated with reform, how to achieve sustainable reform, and a review of six drivers for effective reforms. Then, an investigation of distributed leadership follows which includes a discussion of the processes and forms of distributed leadership and a description of the facilitators and tensions for distributed leadership. The third area of the review is focused on teacher leadership including the roles and characteristics of teacher leaders, their connection to staff development, issues of effectiveness, and tensions for teacher leaders. Following this review, the research design and methodology is presented. Transcendental phenomenology including the concepts of phenomenological reduction and imaginative variation are explored in detail. Protocol writing was utilized to select participants for this study. From collected writings by formal teacher leaders, participants suited for phenomenological research were selected. Three teacher leaders participated in in-depth, semi-structured interviews. The interviews were transcribed by the researcher. Participants shared their experiences as teacher leaders. Additional questions were asked to elicit more details about their experiences and to find out how participants made sense of their experiences. In the experiences of the participants, five themes emerged: Grappling with teacher leadership identity, facing the uncertainties of sustaining the reform initiative, negotiating the tensions between management and leadership, experiencing challenges of leading, and feeling the empowerment of success. Participants made sense of their experiences in these four ways: learning, communicating, doing, and reflecting. Several forces that impact the experience of teacher leadership and facilitate the formation of teacher leadership identity emerged. Through the process of making sense of their experiences, teacher leaders came to understand theory, which they termed “getting it”, and then enacted their learning. The ways in which teacher leaders made sense of their experiences were influenced in part by their leadership persona and in part by the culture and context within which they lived. Among the implications for theory from this study is that more needs to be learned about the leadership identity of teacher leaders leading reforms. Implications for practice include the provision of time for teacher leaders to reflect on and discuss their experiences, as well as the provision of professional development focused on change praxis and leadership praxis for teacher leaders and instructional leadership for in-school administrators. Among the implications for research are the need to investigate teacher leaders’ association with administration, both in their aspirations and in how they are perceived towards administration, the cognitive changes that occur for teacher leaders, whether a context of instructional leadership eases tensions in teacher leadership, and whether formal teacher leader roles are an effective way for school divisions to plan for leadership succession. In addition, the phenomenological research method is reflected upon

Does participation in cardiac rehabilitation affect health outcomes and health care utilization and costs?

Exercise based cardiac rehabilitation (CR) programs have been shown to be efficacious in the reduction of recurrent cardiovascular events and increased physical and psychological function. However, in North America only about 10-40% of eligible CVD patients are referred to CR. One reason for poor CR referral may be a lack of information on the costs and health care utilization associated with CR. Thus, the purpose of this project was to explore differences in health care utilization and costs among patients who attended and did not attend cardiac rehabilitation

Staying Ahead of the Digital Technological Curve Using Survey Methods

In the early twentieth century, surveys were an innovative and neoteric methodology. Collected in-person or by mail, researchers could ascertain the thoughts and opinions of a small sample, which could then be applied to the general population. Almost one hundred years later, the use of surveys has become pervasive in society due to digital technological advancement. However, while the digital evolution has not only altered the possibilities of how, when, and where surveys may be administered, the threats to this methodology has also evolved. While issues related to previously known errors (i.e. sampling error, non-response error, etc.) remain and have also evolved, new threats regarding confidentiality and privacy, design issues, and others, have emerged in response to this digital advancement. Novice and experienced researchers alike should be cognizant of the impact digital technologies have had on survey data collection to ensure high quality research findings. This paper explores the threats to survey methodology due to digital technological changes and discusses how novice researchers and students can mitigate these challenges. Au début du vingtième siècle, les sondages constituaient une méthodologie novatrice et moderne. Les chercheurs pouvaient, à partir d’un petit échantillon, cerner des idées et opinions recueillies en personne ou par courrier, pour ensuite les appliquer à la population générale. Près de 100 ans plus tard, grâce aux avancées de la technologie numérique, les sondages sont omniprésents dans la société. Or, l’évolution numérique a non seulement modifié les paramètres spatiotemporels et les techniques d’administration des sondages, mais aussi les risques liés à cette méthodologie. Alors que les problèmes liés aux erreurs déjà connues (erreurs d’échantillonnage, erreurs de non-réponse, etc.) demeurent et évoluent tout autant, de nouvelles menaces associées à la confidentialité et à la protection des renseignements personnels, aux questions de conception et à d’autres enjeux ont surgi en réaction à cette évolution technologique. Afin d’optimiser la qualité des résultats de recherche, les chercheuses débutantes et chevronnées devraient être au fait des retombées possibles des technologies numériques sur la collecte de données par sondage. Cet article porte sur les menaces à la méthodologie des sondages en raison des changements liés aux technologies numériques, et traite de stratégies permettant aux étudiantes et aux chercheuses débutantes d’éviter ces écueils

Pulmonary Dysfunction in Patients with Femoral Shaft Fracture Treated with Intramedullary Nailing

Background: This study was undertaken to determine whether alveolar dead space increases during intramedullary nailing of femoral shaft fractures and whether alveolar dead space predicts postoperative pulmonary dysfunction in patients undergoing intramedullary nailing of a femoral shaft fracture. Methods: All patients with a femoral shaft fracture were prospectively enrolled in the study unless there was evidence of acute myocardial infarction, shock, or heart failure. Arterial blood gases were measured at three consecutive time-periods after induction of general anesthesia: before intramedullary nailing and ten and thirty minutes after intramedullary nailing. The end-tidal carbon-dioxide level, minute ventilation, positive end‐expiratory pressure, and percent of inspired and expired inhalation agent were recorded simultaneously with the blood-gas measurement. Postoperatively, all subjects were monitored for evidence of pulmonary dysfunction, defined as the need for mechanical ventilation or supplemental oxygen (at a fraction of inspired oxygen of >40%) in the presence of clinical signs of a respiratory rate of >20 breaths/min or the use of accessory muscles of respiration. Results: Seventy‐four patients with a total of eighty femoral shaft fractures completed the study. Fifty fractures (62.5%) underwent nailing after reaming, and thirty fractures (37.5%) underwent nailing with minimal or no reaming. The mean alveolar dead-space measurements before canal opening and at ten and thirty minutes after canal opening were 14.5%, 15.8%, and 15.2% in the total series of seventy‐four patients (general linear model, p = 0.2) and 20.5%, 22.7%, and 24.2% in the twenty patients with postoperative pulmonary dysfunction (general linear model, p = 0.05). Of the twenty‐one patients with an alveolar dead-space measurement of >20% thirty minutes after nailing, sixteen had postoperative pulmonary dysfunction. According to univariate and multivariate analysis, the alveolar dead-space measurement was strongly associated with postoperative pulmonary dysfunction. Conclusions: According to our data, intramedullary nailing of femoral shaft fractures did not significantly increase alveolar dead space, and the amount of alveolar dead space can predict which patients will have pulmonary dysfunction postoperatively

The Perceived Value and Utilization of Occupational Therapy Models in the United States

This study investigated United States (U.S.) occupational therapy (OT) practitioners’ perceived value and utilization of OT models in practice. In addition, this research explored correlations that might impact practitioner value and choice of models as related to entry-level OT educational program, practice setting, and frequency of model utilization. The study utilized a cross-sectional research design. A convenience sample of 219 OT practitioners completed an 18-question online survey capturing participant demographics, perceived value, and utilization of models. Practitioners indicated they used models (79.45%, n = 174) in practice with 77.63% (n = 170) reporting they somewhat or strongly agreed that models were valuable to their practice. The greater the practitioner’s perceived value of models, the more often the person used models in practice (rs = .575,

Women with coronary artery disease report worse health-related quality of life outcomes compared to men

BACKGROUND: Although there have been substantial medical advances that improve the outcomes following cardiac ischemic events, gender differences in the treatment and course of recovery for patients with coronary artery disease (CAD) continue to exist. There is a general paucity of data comparing the health related quality of life (HRQOL) in men and women undergoing treatment for CAD. The purpose of this study was to compare HRQOL outcomes of men and women in Alberta, at one-year following initial catheterization, after adjustment for known demographic, co-morbid, and disease severity predictors of outcome. METHOD: The HRQOL outcome data were collected by means of a self-reported questionnaire mailed to patients on or near the one-year anniversary of their initial cardiac catheterization. Using the Seattle Angina Questionnaire (SAQ), 5 dimensions of HRQOL were measured: exertional capacity, anginal stability, anginal frequency, quality of life and treatment satisfaction. Data from the APPROACH registry were used to risk-adjust the SAQ scale scores. Two analytical strategies were used including general least squares linear modeling, and proportional odds modeling sometimes referred to as the "ordinal logistic modeling". RESULTS: 3392 (78.1%) patients responded to the follow-up survey. The adjusted proportional odds ratios for men relative to women (PORs > 1 = better) indicated that men reported significantly better HRQOL on all 5 SAQ dimensions as compared to women. (PORs: Exertional Capacity 3.38 (2.75–4.15), Anginal Stability 1.23 (1.03–1.47), Anginal Frequency 1.70 (1.43–2.01), Treatment Satisfaction 1.27 (1.07–1.50), and QOL 1.74 (1.48–2.04). CONCLUSIONS: Women with CAD consistently reported worse HRQOL at one year follow-up compared to men. These findings underline the fact that conclusions based on research performed on men with CAD may not be valid for women and that more gender-related research is needed. Future studies are needed to further examine gender differences in psychosocial adjustment following treatment for CAD, as adjustment for traditional clinical variables fails to explain sex differences in health related quality of life outcomes

Time-Resolved Spectroscopy of the 3 Brightest and Hardest Short Gamma-Ray Bursts Observed with the FGST Gamma-Ray Burst Monitor

From July 2008 to October 2009, the Gamma-ray Burst Monitor (GBM) on board the Fermi Gamma-ray Space Telescope (FGST) has detected 320 Gamma-Ray Bursts (GRBs). About 20% of these events are classified as short based on their T90 duration below 2 s. We present here for the first time time-resolved spectroscopy at timescales as short as 2 ms for the three brightest short GRBs observed with GBM. The time-integrated spectra of the events deviate from the Band function, indicating the existence of an additional spectral component, which can be fit by a power-law with index ~-1.5. The time-integrated Epeak values exceed 2 MeV for two of the bursts, and are well above the values observed in the brightest long GRBs. Their Epeak values and their low-energy power-law indices ({\alpha}) confirm that short GRBs are harder than long ones. We find that short GRBs are very similar to long ones, but with light curves contracted in time and with harder spectra stretched towards higher energies. In our time-resolved spectroscopy analysis, we find that the Epeak values range from a few tens of keV up to more than 6 MeV. In general, the hardness evolutions during the bursts follows their flux/intensity variations, similar to long bursts. However, we do not always see the Epeak leading the light-curve rises, and we confirm the zero/short average light-curve spectral lag below 1 MeV, already established for short GRBs. We also find that the time-resolved low-energy power-law indices of the Band function mostly violate the limits imposed by the synchrotron models for both slow and fast electron cooling and may require additional emission processes to explain the data. Finally, we interpreted these observations in the context of the current existing models and emission mechanisms for the prompt emission of GRBs.Comment: 14 pages, 10 figures, 9 tables, Accepted for publication in the Astrophysical Journal September, 23 2010 (Submitted May, 16 2010) Corrections: 1 reference updated, figure 10 captio

An administrative data merging solution for dealing with missing data in a clinical registry: adaptation from ICD-9 to ICD-10

<p>Abstract</p> <p>Background</p> <p>We have previously described a method for dealing with missing data in a prospective cardiac registry initiative. The method involves merging registry data to corresponding ICD-9-CM administrative data to fill in missing data 'holes'. Here, we describe the process of translating our data merging solution to ICD-10, and then validating its performance.</p> <p>Methods</p> <p>A multi-step translation process was undertaken to produce an ICD-10 algorithm, and merging was then implemented to produce complete datasets for 1995–2001 based on the ICD-9-CM coding algorithm, and for 2002–2005 based on the ICD-10 algorithm. We used cardiac registry data for patients undergoing cardiac catheterization in fiscal years 1995–2005. The corresponding administrative data records were coded in ICD-9-CM for 1995–2001 and in ICD-10 for 2002–2005. The resulting datasets were then evaluated for their ability to predict death at one year.</p> <p>Results</p> <p>The prevalence of the individual clinical risk factors increased gradually across years. There was, however, no evidence of either an abrupt drop or rise in prevalence of any of the risk factors. The performance of the new data merging model was comparable to that of our previously reported methodology: c-statistic = 0.788 (95% CI 0.775, 0.802) for the ICD-10 model versus c-statistic = 0.784 (95% CI 0.780, 0.790) for the ICD-9-CM model. The two models also exhibited similar goodness-of-fit.</p> <p>Conclusion</p> <p>The ICD-10 implementation of our data merging method performs as well as the previously-validated ICD-9-CM method. Such methodological research is an essential prerequisite for research with administrative data now that most health systems are transitioning to ICD-10.</p

Health-Related Quality of Life in Premature Acute Coronary Syndrome: Does Patient Sex or Gender Really Matter?

Background-Limited data exist as to the relative contribution of sex and gender on health-related quality of life (HRQL) among patients with acute coronary syndrome (ACS). This study aims to evaluate the effect of sex and gender-related variables on long-term HRQL among young adults with ACS. Methods and Results-GENESIS-PRAXY (GENdEr and Sex determInantS of cardiovascular disease: from bench to beyond-Premature Acute Coronary SYndrome) is a multicenter, prospective cohort study (January 2009 to August 2013) of adults aged 18 to 55 years, hospitalized with ACS. HRQL was measured at baseline, 1, 6, and 12 months using the Short Form-12 and Seattle Angina Questionnaire (SAQ) among 1213 patients. Median age was 49 years. Women reported worse HRQL than men over time post-ACS, both in terms of physical and mental functioning. Gender-related factors were more likely to be predictors of HRQL than sex. Femininity score, social support, and housework responsibility were the most common gender-related predictors of HRQL at 12 months. We observed an interaction between female sex and social support (beta=0.44 [95% confidence interval, 0.01, 0.88]; P=0.047) for the physical limitation subscale of the SAQ. Conclusions-Young women with ACS report significantly poorer HRQL than young men. Gender appears to be more important than sex in predicting long-term HRQL post-ACS. Specific gender-related factors, such as social support, may be amenable to interventions and could improve the HRQL of patients with premature ACS.CIHRHeart and Stroke Foundation of QuebecHeart and Stroke Foundation of Nova ScotiaHeart and Stroke Foundation of AlbertaHeart and Stroke Foundation of OntarioHeart and Stroke Foundation of YukonHeart and Stroke Foundation of British Columbia, CanadaJames McGill Chair at McGill Universit

Temporal Deconvolution study of Long and Short Gamma-Ray Burst Light curves

The light curves of Gamma-Ray Bursts (GRBs) are believed to result from internal shocks reflecting the activity of the GRB central engine. Their temporal deconvolution can reveal potential differences in the properties of the central engines in the two populations of GRBs which are believed to originate from the deaths of massive stars (long) and from mergers of compact objects (short). We present here the results of the temporal analysis of 42 GRBs detected with the Gamma-ray Burst Monitor onboard the Fermi Gamma-ray Space Telescope. We deconvolved the profiles into pulses, which we fit with lognormal functions. The distributions of the pulse shape parameters and intervals between neighboring pulses are distinct for both burst types and also fit with lognormal functions. We have studied the evolution of these parameters in different energy bands and found that they differ between long and short bursts. We discuss the implications of the differences in the temporal properties of long and short bursts within the framework of the internal shock model for GRB prompt emission.Comment: 38 pages, 11 figure