Studenthood and identification: higher education as a liminal transitional space

This paper provides a conceptual discussion of studenthood as a way of understanding the ways in which student identities are related to participation and retention. Studenthood refers here to the variety of different ways in which registering for an education programme is implicated in people’s sense of who they are. The paper explores the potential of Turner's concept of liminal status for the analysis of non-traditional participation in higher educatio

Researching Retention and Non-Traditional Learners: evidence on pre-entry preparation

This paper reports on experiences of non-traditional undergraduates who have entered university following a pre-entry preparatory programme. The evidence is drawn from a collaborative European research project on Access and Retention: Experiences of Non-traditional Learners in Higher Education. The project focuses on access, retention and drop-out in higher education institutions in relation to non-traditional students (younger and adults) and the factors which promote or inhibit this (for further details see www.ranlhe.dsw.edu.pl). We present here findings for the Scottish sample to date

Associations among neighborhood socioeconomic deprivation, physical activity facilities, and physical activity in youth during the transition from childhood to adolescence

BACKGROUND: This study aims to examine the longitudinal association of neighborhood socioeconomic deprivation (SED) with physical activity in youth during the transition from elementary to middle school, and to determine if access to physical activity facilities moderates this relationship. METHODS: Data were obtained from the Transitions and Activity Changes in Kids (TRACK) study, which was a multilevel, longitudinal study designed to identify the factors that influence changes in physical activity as youth transition from elementary to middle school. The analytic sample for the current study included 660 youth with complete data in grades 5 (baseline) and 7 (follow-up). A repeated measures multilevel framework was employed to examine the relationship between SED and physical activity over time and the potential moderating role of elements of the built environment. RESULTS: Decreases in physical activity varied by the degree of neighborhood SED with youth residing in the most deprived neighborhoods experiencing the greatest declines in physical activity. Access to supportive physical activity facilities did not moderate this relationship. CONCLUSION: Future research studies are needed to better understand how neighborhood SED influences youth physical activity over time

Evidence Based Practice for Soap and Water Handwashing

https://scholarworks.moreheadstate.edu/student_scholarship_posters/1186/thumbnail.jp

The impact of health care reforms on community health nurses' attitudes

A descriptive correlational design was used to investigate community health nurses' perceptions of the impact of health care reforms and their work-related attitudes and behavioral intentions following a period of regionalization of community health services in Newfoundland and Labrador. The relationships between and among the key study variables (i.e., personal characteristics and staffing issues, perceived impact of reforms, work-related attitudes, and behavioral intentions) were also examined. The Conceptual Model of Behavioral Intentions (CMBI) was used as the framework for this study. -- The sample consisted of 170 community health nurses (i.e., 151 staff nurses and 19 managers) working with regional health and community services boards. A response rate of 52.8% was achieved. The majority of respondents were female (98.2%) and ranged in age from 25 to 57 years, (M¹ = 40.66, SD ± 7.78). Data collection occurred from October to December, 2000 using a mailed- out questionnaire (i.e., Employee Attitudes Survey). -- Study findings indicated that community health nurses were neither totally negative nor positive about the overall impact of health care reforms. Respondents were most negative about the quality of care, emotional climate of the workplace, and safety concerns, and were most positive about the importance of reforms, standards of care, and practice-related issues. Respondents were divided on whether or not they believed that employers had violated psychological contracts, were neither completely satisfied nor dissatisfied with managerial support and interdisciplinary relations since restructuring, were slightly satisfied with their jobs, were slightly committed to their organizations, and were uncertain about whether or not they would stay with current employers. Study findings also demonstrated that community health nurses in management positions were significantly more positive about practice- related issues and standards of care, less likely to perceive psychological contract violations, and more committed to their organizations than staff nurses. -- Study findings provided partial support for the major assumptions of the CMBI. All of the reform impact variables (i.e., importance of reforms, emotional climate, practice-related issues, quality of care, safety concerns, and standards of care) were significantly and positively related to the intervening attitudes (i.e., psychological contract violations, restructuring satisfaction, job satisfaction, and organizational commitment) and behavioral intentions (i.e., intent to stay). As well, all of the intervening attitudes depicted moderate to strong, positive correlations with each other and with behavioral intentions. With the exception of job level (i.e., managers vs. staff nurses), most personal characteristics and staffing issues variables did not influence the intervening attitudes. However, employment status and age were found to influence behavioral intentions. -- Contrary to the causal, linear process proposed by the CMBI, study findings failed to confirm organizational commitment as a key predictor of behavioral intentions. During regression analysis, emotional climate surfaced as the key predictor of behavioral intentions. Also, personal characteristics (i.e., age and employment status) emerged as better predictors of behavioral intentions than some intervening attitudes (i.e., restructuring satisfaction and organizational commitment). More specifically, emotional climate of the workplace, job satisfaction, psychological contract violation, age, and employment status combined to explain 53.4% of the variance in behavioral intentions. Similarly, emotional climate surfaced as the best predictor for all intermediate outcomes (i.e., intervening attitudes), with the exception of restructuring satisfaction. -- The results of this study support some of the findings from previous research and suggest that health care reforms can have both negative and positive consequences for community health nurses, and their work-related attitudes and behavioral intentions. However, due to study limitations, generalizability of the findings to other community health nurse populations is cautioned. There is a need for further investigation in order to develop a greater insight into other factors possibly influencing community health nurses' work- related attitudes and behavioral intentions

The Association Between Discrimination and Sleep is Exacerbated in Individuals with Comorbid Chronic Health Conditions

Introduction: The consequences of recurrent, stressful daily experiences for sleep health appear intensified in individuals with pre-existing health conditions. Although discrimination has been associated with sleep outcomes, the role of comorbid chronic health conditions (CCHCs), and impact of perceived discrimination, remains unclear. The present study investigated (1) the associations between daily discrimination and sleep and (2) moderating roles of CCHCs and daily life interference and hardship. Methods: The current study utilized archival data from the Midlife in the United States (MIDUS) Study II. Participants, 174 adults (51% female, Mage=57 yrs., SD=11.5 yrs.), completed 7 days of actigraphy, sleep diary, PSQI, and CCHC-reporting measures. Models examined the moderating effects of CCHCs, daily interference, and hardship on the association between discrimination and sleep. Results: Daily discriminatory experiences predicted numerous poor sleep outcomes, exacerbated for persons with higher CCHCs. Higher comorbidity (95% CI=5.40, 68.75) exacerbated the association between discrimination and TSTactigraphy, further strengthened by perceived hardship (95% CI=-3.75, -.40) and interference (95% CI=-3.65, -.30). Number of CCHCs, qualified by perceived hardship (95% CI=.00, .04) and interference (95% CI=.01, .05), predicted diary sleep quality above discrimination. The interaction between CCHCs and hardship predicted global PSQI scores (95% CI=-.91, -.12) beyond discrimination. Conclusion: Daily experiences of discrimination are associated with decreased sleep duration and quality. These associations were stronger for individuals with multiple CCHCs. Exacerbating CCHC effects were perpetuated by perceived interference and hardships, suggesting individual emotion regulation (ER) differences. Future research should attend to sleep-related consequences of differential discrimination-informed ER by persons with CCHCs.https://scholarscompass.vcu.edu/gradposters/1042/thumbnail.jp

Patient harm and institutional avoidability of out-of-hours discharge from intensive care: An analysis using mixed methods

© [2022] The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY). https://creativecommons.org/licenses/by/4.0/Objective: Out-of-hours discharge from ICU to the ward is associated with increased in-hospital mortality and ICU readmission. Little is known about why this occurs. We map the discharge process and describe the consequences of out-of-hours discharge to inform practice changes to reduce the impact of discharge at night. Design: This study was part of the REFLECT mixed methods study. We defined out-of-hours discharge as 16:00 - 07:59h. We undertook 20 in-depth case record reviews where in-hospital death after ICU discharge had been judged ‘probably avoidable’ in previous retrospective structured judgement reviews, and 20 where patients survived. We conducted semi-structured interviews with 55 patients, family members and staff with experience of ICU discharge processes. These, along with a stakeholder focus group, informed ICU discharge process mapping using the Human Factors-based Functional Analysis Resonance Method (FRAM). Setting: Three UK NHS hospitals, chosen to represent different hospital settings. Subjects: Patients discharged from ICU, their families and staff involved in their care. Interventions None. Measurements and Main Results: Out-of-hours discharge was common. Patients and staff described out-of-hours discharge as unsafe due to a reduction in staffing and skill mix at night. Patients discharged out-of-hours were commonly discharged prematurely, had inadequate handover, were physiologically unstable and did not have deterioration recognised or escalated appropriately. We identified five interdependent functions key to facilitating timely ICU discharge: multi-disciplinary team decision for discharge; patient prepared for discharge; bed meeting; bed manager allocation of beds; and ward bed made available. Conclusion: We identified significant limitations in out-of-hours care provision following overnight discharged from ICU. Transfer to the ward before 16:00 should be facilitated where possible. Our work highlights changes to help make day time discharge more likely. Where discharge after 16:00 is unavoidable, support systems should be implemented to ensure the safety of patients discharged from ICU at night.Peer reviewedFinal Published versio