The Relationship between Nurse Manager Leadership Style and the Enculturation of Shared Governance

Shared governance, a participative model of governance, implemented by healthcare organizations for more than 30 years has been associated with empowerment, job satisfaction, and retention of registered nurses. Recent studies document a lack of participation in shared governance by registered nurses; the reason for the change is unknown. The nurse managers\u27 role in this change is unknown. The purpose of this non-experimental, cross-sectional survey design study was to test Bass\u27 theory of transformational leadership that examines the relationship between the leadership style of the manager and the enculturation of shared governance in acute care hospitals in the United States. A random sample of 111 nurse managers, who were members of the American Organization of Nurse Executives, were surveyed on leadership style using the Multi-factor Leadership Questionnaire and unit governance, using the Index of Professional Nursing Governance. Data was analyzed using Pearson\u27s Product Moment Correlation and a statistically significant positive relationship was found between transformational leadership style and shared governance. No relationship was found between other leadership styles and shared governance. There was no relationship between the achievement of a shared governance score on the participation subscale of the Index of Professional Nursing Governance and transformational leadership style. The study contributes to social change through the identification of the manager\u27s use of a transformational leadership style to foster the autonomy and empowerment of nurses to cultivate a positive the work environment using a shared governance model, which results in registered nurse retention and decreased organizational turnover costs

An investigation of the human figure drawing of kindergarten children as an indicator of personality and intelligence.

Thesis (Ed.M.)--Boston Universit

Crosslinguistic generalization and interference in trilingual aphasia: a case study

Thesis (M.S.) -- Boston University.BACKGROUND: The continual increase in the number of bi/multilingual aphasic patients has given rise to the question of efficacy of treatment across languages. One question at the forefront of current research is the extent to which language control interacts with cross-language facilitation treatment in these patients. Theories of bilingual language processing suggest that there exists bidirectional and asymmetrical relationships between the two lexicons (e.g., Revised Hierarchical Model, Kroll et al., 2010). Such a model allows for the prediction of cross-language generalization resulting in improved facilitation of translations and semantically related translations, a finding observed in treatment studies of rehabilitation of bilingual aphasia (Edmonds & Kiran, 2006; Kiran & Roberts, 2010). Recent studies examining the nature of bilingual language processing and lexical access, however, have hypothesized that cognitive-linguistic control plays a central role in selecting language representations. The neurocognitive model of language control, proposed by Green and Abutalebi (2007), states that the interplay between cortical (e.g., pre-frontal cortex, anterior cingulate cortex) and sub cortical regions (e.g., basal ganglia) sustains the intensive cognitive demand of managing two languages. This neural circuit regulates such tasks as appropriate language selection and language switching that allows for inhibition of potential cross-linguistic competitors during language production (Luk et al., 2011). Recent studies of bilingual aphasia have begun to provide evidence for impaired language/cognitive control and interference (e.g., Goral et al; 2006; Green et al., 2010). AIMS: In order to better understand the potential for cross-linguistic generalization and interference in multilingual aphasic patients, this current case study follows a trilingual woman with aphasia through two periods of rehabilitation. Several research questions are posed: (1) Does training in the weaker language (French) result in generalization to semantically related items in the target language as well as trained and untrained items in the stronger language (English); (2) Does a second period of treatment in the stronger language (English) reveal differences in treatment gains and/or in crosslinguistic generalization patterns; and (3) What is the effect of cognitive control on cross-linguistic generalization during rehabilitation of lexical access? METHODS AND PROCEDURES: The participant was a 59-year-old trilingual woman (Amharic, L1-English, L2-French, L3) who presented with a fluent aphasia secondary to left frontal tumor resection in 2008. Post-surgery CT and MRI revealed a left frontal infarct over the pre-central gyrus with extension into the basal ganglia. A detailed language use questionnaire was used to obtain information regarding the patient’s language use for each of the three languages. A single subject case study design was implemented following procedures previously developed in Edmonds & Kiran (2006) and Kiran & Roberts (2009). Following an assessment of the patient’s current language and cognitive abilities, the patient completed a 10-week treatment period in French, followed by a 10- week treatment period in English. RESULTS: Results demonstrated overall improvement on trained items in the target language across treatment periods in both languages. Within-language generalization to semantically related items and cross-linguistic generalization to translations of trained and semantically related items were not observed. In addition, error patterns revealed a considerable increase of interference of the treatment language into the non-treatment language on trained items relative to the respective treatment phase. Although the patient did show learning of new items (as evidenced by an increase in conceptual scores), as treatment progressed in one language, the patient’s ability to inhibit this language during non-treatment language probes decreased substantially. In addition, a non-linguistic flanker task targeting interference suppression demonstrated impaired non-linguistic cognitive control. Evidence from this case study suggests that facilitation may sometimes be overridden by language interference and provides support for the model of neurocognitive language control

A novel dynamic asset allocation system using Feature Saliency Hidden Markov models for smart beta investing

The financial crisis of 2008 generated interest in more transparent, rules-based strategies for portfolio construction, with Smart beta strategies emerging as a trend among institutional investors. While they perform well in the long run, these strategies often suffer from severe short-term drawdown (peak-to-trough decline) with fluctuating performance across cycles. To address cyclicality and underperformance, we build a dynamic asset allocation system using Hidden Markov Models (HMMs). We test our system across multiple combinations of smart beta strategies and the resulting portfolios show an improvement in risk-adjusted returns, especially on more return oriented portfolios (up to 50$\%$ in excess of market annually). In addition, we propose a novel smart beta allocation system based on the Feature Saliency HMM (FSHMM) algorithm that performs feature selection simultaneously with the training of the HMM, to improve regime identification. We evaluate our systematic trading system with real life assets using MSCI indices; further, the results (up to 60$\%$ in excess of market annually) show model performance improvement with respect to portfolios built using full feature HMMs

Differences in waiting times for elective admissions in NSW public hospitals: A decomposition analysis by non-clinical factors. CHERE Working Paper 2010/7

In the Australian public health system, access to elective surgery is rationed through provision of health care services, it is generally assumed that a patient?s waiting time and locations. In this paper we undertake Oaxaca-Blinder and DiNardo-Fortin-Lemieux decompostition analyses to attribute variation in waiting time to a component explained by clinical need and to differential treatment effects. The latter have an interpretation as discrimination, since treatments vary by non-clinical factors such as socioeconomic status. Using data from public patients in NSW public hospitals in 2004-2005, we find socioeconomically advantaged patients, patients in remote areas, and patients in several Area Health Services have shorter waiting times than their clinical comparable counterparts. Furthermore, the discrimination effect dominates clinical admission if their treatments are delayed. This finding has policy implications for the current operation of waiting lists and order of admission and for the design of equitable quality targets for public hospitals.Public hospitals, waiting times, discrimination, decomposition analysis

The demand for private health insurance: do waiting lists or waiting times matter? CHERE Working Paper 2010/8

Besley, Hall, and Preston (1999) estimated a model of the demand for private health insurance in Britain as a function of regional waiting lists and found that increases in the number of people waiting for more than 12 months (the long-term waiting list) increased the probability of insurance purchase. In the absence of waiting time data, the length of regional long-term waiting lists was used to capture the price-quality trade-off of public treatment. We revisit Besley et al.?s analysis using Australian data and test the use of waiting lists as a proxy for waiting time in models of insurance demand. Unlike Besley et al., we find that the long-term waiting list is not a significant determinant of the demand for insurance. However we find that long waiting times do significantly increase insurance. This suggests that the relationship between waiting times and waiting lists is not as straightforward as is commonly assumed.waiting time, waiting lists, health insurance, regional aggregation

Waiting times and the decision to buy private health insurance. CHERE Working Paper 2010/9

Over 45% of Australians buy health insurance for private treatment in hospital. This is despite having access to universal and free public hospital treatment. Anecdotal evidence suggests that one possible explanation for the high rate of insurance coverage is to avoid long waiting times for public hospital treatment. In this study, we investigate the effect of expected waiting time on individual decisions to buy private health insurance. Individuals are assumed to form an expectation of their own waiting time as a function of their demographics and health status. We estimate models of expected waiting time using administrative data on the population hospitalised for elective procedures in public hospitals in 2004-05 and use the parameter estimates to impute expected waiting times for individuals in a representative sample of the population. We model the impact of expected waiting time on the decision to purchase private health insurance. In the insurance demand model, cross-sample predictions are adjusted by the individuals? probability of hospital admission. We find that expected waiting time does not increase the probability of buying insurance but a high probability of experiencing a long wait does. Overall we find there is no significant impact of waiting time on insurance purchase. In addition, we find that the inclusion of individual waiting time variables removes the evidence for favourable selection into private insurance, as measured by self-assessed health. This result suggests that a source of the favourable selection by reported health status may be aversion to long waits among healthier people.Private health insurance, Australia

Māori Vocabulary: A Study of Some High Frequency Homonyms

The problem addressed in this thesis concerns the accuracy of Māori language vocabulary counts, e.g Boyce (2006), where Māori was found to use a very small vocabulary in comparison with e.g. English. As Boyce (2006, ii) acknowledges, this is partly explained by the degree of homonymy in Māori, which undermines the accuracy of the count. Homonymy is the phenomenon of the same string of letters (word-form) having two or more unrelated meanings (e.g. kī ‘say’, ‘be full’). Automated word-form counts of Maori language texts count the form kī as the same word, regardless of its meaning. Unless different meanings of the same word-form are counted as different words, such counts will underestimate the vocabulary of the Māori language. (Homonymy is not the only explanation for the low count; further explanations have been suggested by Bauer (2009) and Nation (2011).) The thesis explores whether there are consistent clues in the linguistic environment that signal the correct interpretation of homonyms in texts, and if so, how such clues could be used for tagging corpora so that counting would be more accurate. The Boyce corpus of modern broadcast Māori (Boyce, 2006, ii) provided the data. Case studies were made of three high-frequency homonyms in this corpus, kī ‘say’, ‘full’, mea ‘say’, ‘thing’ and tau ‘settle’, ‘year’. Lyons' (1968) criterion of distinction was applied to establish the lexemes realised by each of these word-forms on the basis of dictionary and etymological information. The tokens of each word-form were then extracted from Boyce’s (2006) corpus using the concordance program ‘WordSmith Tools’. WordSmith Tools is a computer program that helps to look at how words behave in a text. Concord which is part of WordSmith Tools enables the user to see any word or phrase in context. Phrase peripheries (the words before and after each word-form in the same phrase) were analysed and the wider syntactic environment was also examined in order to find clues which signalled the appropriate lexeme for each token. The results showed that the lexemes from all three case studies could be identified in the corpus on the basis of consistent clues that occur in its linguistic environment. If the phrasal periphery of the word-form is examined, and the grammatical information supplied by the wider linguistic environment is taken into account, it is possible to determine the appropriate lexemic tag for a word-form in a corpus in Māori