Local Governmental Structures And Its Effects On Public Services

This study examined organizational models/structures within two municipalities within the commonwealth of Pennsylvania in order to determine if one organizational model/structure yielded better results of efficiency, effectiveness, accountability, and responsiveness of public services. For the purpose of this study, the researcher focused on a third-class city that is commission formed and a second-class township that is council-manager formed. The researcher conducted in-depth qualitative interviews with ten public professionals in order to understand the processes that take place within each municipality. The researcher sought to understand the internal processes of the organization, as well as the external processes. The internal processes included those aspects related to personnel and the operations of the organization. The external processes included those aspects related to the council-constituent relationship through interaction, engagement, and communication. It was found that while the council-manager form of government is most ideal within the literature, there were no real differences found between the two organizational models in these two cases. The city and the township were very similar in the way in which they operate, despite their given models. While the city and the township are similar in several ways, the city faces more complex issues due to its size, budget, and financially distressed status. This study showed several implications for future research, including, but not limited to: the use of a new research design that will expound upon the current findings of this study; and the need for the continuous evaluation of municipal leadership, management, and governance

Exploring the Effectiveness of a Freshman/Success Academy Program through the Perceptions of Educators in an Urban High School

The purpose of this qualitative study was to explore the perceptions of educators regarding the effectiveness of an academic success program for ninth- and 10th-grade students who are at-risk males. The term at risk has often been utilized to describe students who have low academic performance as well as social and emotional concerns observed during the transitioning process from middle to high school. The foundation of this study centered on past and current educational initiatives, achievement gaps, and pedagogical and cultural awareness for at-risk minority students as they entered high school. I used a 2-phase process that included the implementation of a questionnaire and one-on-one interviews to collect the perceptions of educators. This methodology allowed educators to provide their perspectives on the effect of a high school academic success program on the academic, social, and behavioral performance of at-risk male students for the past 2 school years. The three key indicators of “making sure that students were on the right track,” “empower students,” and “creating a positive culture” evolved linking into the themes of academic success, building a student support system, teacher effectiveness, student preparation, and building relationships. As a result, positive implications and significances were established from the perspective of the participating stakeholders of the Freshman/Success Academy

Using a Nurse Manager Prep Course to Spark Interest in Nurse Manager Succession Plan Participation

Hospitals strive to become Magnet-accredited facilities. Having Magnet status indicates an institution has high standards regarding nurse work environments and positive patient outcomes. The American Nurses Credentialing Center (ANCC) created the Magnet program criteria in 1994 (Dierkes et al., 2021). Obtaining Magnet accreditation is a coveted goal for hospitals. The target organization is currently not a Magnet-accredited hospital, nor does it have a nurse manager succession planning program. In preparation to achieve this accreditation, the target organization needed to implement a succession plan for nurse leaders. Institutions with successful succession planning programs pay careful attention when selecting participants for succession plans. Experience level, current role, willingness to work a flexible schedule, and overall good standing within the organization are criteria for acceptance into such programs (Shields et al., 2022). Once participants are selected, a curriculum supporting nurse leadership is needed. Nurse manager succession plans help decrease turnover and assist with filling vacancies. Developing a nurse manager succession plan is a proactive response for organizations. Developing and maintaining a nurse manager succession plan shows visionary executives are willing to invest in future leaders (Phillips et al., 2018). Will nurses have an increase in knowledge and awareness of the roles and responsibilities of the nurse manager after completing an education session

An Exemplar Woman Leader Of Malawi, Africa: A Narrative Account Of The Honorable Anne Mary Fletcher

The purpose of this study was to examine the life experiences, spirituality and a sense of community, and cultural values that undergird the leadership praxis of a woman leader from Malawi, Africa. By accounting for the culturally-situated understandings of leadership and leadership practices of an exemplar woman leader of Malawi, Africa, narrative inquiry methodology (Chase, 2011 &, Clandinin & Connelly, 2000) was employed to create an interpretive framework with which to analyze interviews, stories, and field notes through the lens of an endarkened transnational feminist paradigm (Dillard & Okpalaoka, 2011). An endarkened transnational paradigm includes a sacred responsibility to bring forward this leader’s story; serving the way this study was approached as well as describing the action of doing the study. Thus, interweaving narrative inquiry and endarkened transnational feminism as theoretical and methodological frameworks bring life to herstory. A theme of spirituality as necessity, interconnectedness, and devotion to service and willingness to withstand hardship affirms the sacred approach to this compelling narrative inquiry. This study captures the perspectives of Anne Mary Fletcher as she shares her life stories on African feminism, spirituality, cultural, entrepreneurial, and political leadership praxis as a woman leader in our global community. The findings contained in this study are not generalizable, but there are words of wisdom that can be replicated throughout the globe. It is applicable for all researchers interested in how African women and women in the African American diaspora engage in alternative cultural discourse to document our truths

Effects of Puberty and Parenting on Adolescent Psychosocial Maturity and Risky Behavior

This doctoral dissertation examines how pubertal onset and maternal sensitivity and responsiveness (MSR) affect psychosocial maturity (PSM) and risky behavior in late adolescence for male and female youth. Analyses were conducted on a subsample (N = 730) of Black, Hispanic, and White youth from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD SECCYD), an 18-year study of the implications of early child care experiences and youth development. Using structural equation modeling (SEM), this dissertation addresses several research questions: 1. Does MSR predict adolescent PSM and risk-taking?; 2. Does pubertal onset predict PSM and risk-taking?; 3. Does pubertal timing moderate the effects of MSR on PSM and risky behavior?; 4. Are the pathways linking MSR, puberty, PSM and risk-taking moderated by adolescent sex? For all youth, results are consistent with the notion that higher early adolescent MSR and increases across adolescence predicts higher PSM and lower sexual risk-taking, but not non-sexual risk-taking. Consistent with past literature, early pubertal onset was associated with higher non-sexual and sexual risk-taking, but not PSM. However, the present data show PSM is associated with lower sexual and non-sexual risk-taking. Results from a two-group SEM provide evidence in support of sex moderation. Specifically, higher grade 5 MSR predicted lower non-sexual risk-taking among girls, but not boys. Additionally, higher grade 5 MSR predicted lower non-sexual risk-taking among female, but not male youth. Pubertal onset was not predictive of PSM, but was predictive of non-sexual risk-taking in boys and sexual risk-taking in girls. Male youth but not female youth were differentially susceptible to MSR across pubertal onset. Specifically, males with later pubertal onset had the lowest PSM with low MSR and the highest PSM with high MSR. However, males with earlier pubertal onset were less sensitive to the effects of MSR. Taken together, these data suggest that the nuanced pathways linking pubertal onset and maternal sensitivity and responsiveness to adolescent psychosocial maturity and risky behavior are moderated by adolescent sex. Nevertheless, psychosocial maturity remains important in protecting against risky behavior across male and female youth.Doctor of Philosoph

La littérarité de l'essai selon Cioran : vers une éthique de l'écriture ou "le style comme aventure"

Cette recherche se propose comme objectif principal d'analyser les rapports entre la littérarité de l'essai et l'éthique de l'écriture dans l'œuvre de Cioran : elle couvre la période qui s'étend de La tentation d'exister (1956) à De l'inconvénient d'être né (1973) et inclut les Cahiers 1957-1972 (1997), œuvre contemporaine des deux premières, mais posthume. Tout d'abord, ce mémoire s'ouvre par une discussion sur le genre de l'essai au XXe siècle, ses caractéristiques formelles les plus importantes et la diversité des typologies qui le concerne. Un constat préliminaire permet de dégager une pratique particulière de l'essai, « l'essayisme poétique », qui s'avère opératoire dans le contexte cioranien et jette un éclairage différent sur La tentation d'exister. Au second chapitre, il est question de la relation qu'entretient Cioran avec la poésie, élément central dans sa réflexion littéraire, comme le démontre l’étude des Cahiers : l'exemple du poète Valéry cristallise l'ambivalence de l'idéal poétique et fait ressortir la quête de l'auteur pour une nouvelle manière. Enfin, le dernier chapitre est consacré au rôle du style dans le développement d'une éthique de l'écriture, par le biais de trois facteurs constitutifs majeurs : l'écriture fragmentaire, le travail du style et la représentation de soi. Ceux-ci doivent libérer l'auteur du didactisme discursif associé généralement aux œuvres de pensée et atténuer la thématisation négative de l'existence. Aussi, l'originalité et la pertinence de ce projet découlent de son hypothèse directrice : le travail du style, comme valeur positive, permet à Cioran d'alléger les rigueurs du sens logique, du poids des idées, pour se concentrer sur la perfection formelle, instituant un régime de valeur sur lequel repose son éthique. La publication De l'inconvénient d'être né marque ainsi l'aboutissement de ce régime, axé surtout sur le détachement et la retenue, à partir duquel il est possible d'affirmer que la poétique de Cioran représente non seulement une façon d'écrire mais une manière d'exister.\ud ______________________________________________________________________________ \ud MOTS-CLÉS DE L’AUTEUR : Cioran, littérarité, essai, style, poésie, éthique, écriture

An investigation to see what has become of the English O students of Indiana State Teachers College

Not Available.Nila Pettiford ManuelNot ListedNot ListedMaster of ArtsDepartment Not ListedCunningham Memorial library, Terre Haute, Indiana State University.isua-thesis-1942-manuel.pdfMastersTitle from document title page. Document formatted into pages: contains 43p. : ill. Includes appendix and bibliography

Understanding the patient journey to diagnosis of lung cancer

OBJECTIVE: This research describes the clinical pathway and characteristics of two cohorts of patients. The first cohort consists of patients with a confirmed diagnosis of lung cancer while the second consists of patients with a solitary pulmonary nodule (SPN) and no evidence of lung cancer. Linked data from an electronic medical record and the Louisiana Tumor Registry were used in this investigation. MATERIALS AND METHODS: REACHnet is one of 9 clinical research networks (CRNs) in PCORnet®, the National Patient-Centered Clinical Research Network and includes electronic health records for over 8 million patients from multiple partner health systems. Data from Ochsner Health System and Tulane Medical Center were linked to Louisiana Tumor Registry (LTR), a statewide population-based cancer registry, for analysis of patient\u27s clinical pathways between July 2013 and 2017. Patient characteristics and health services utilization rates by cancer stage were reported as frequency distributions. The Kaplan-Meier product limit method was used to estimate the time from index date to diagnosis by stage in lung cancer cohort. RESULTS: A total of 30,559 potentially eligible patients were identified and 2929 (9.58%) had primary lung cancer. Of these, 1496 (51.1%) were documented in LTR and their clinical pathway to diagnosis was further studied. Time to diagnosis varied significantly by cancer stage. A total of 24,140 patients with an SPN were identified in REACHnet and 15,978 (66.6%) had documented follow up care for 1 year. 1612 (10%) had no evidence of any work up for their SPN. The remaining 14,366 had some evidence of follow up, primarily office visits and additional chest imaging. CONCLUSION: In both cohorts multiple biopsies were evident in the clinical pathway. Despite clinical workup, 70% of patients in the lung cancer cohort had stage III or IV disease. In the SPN cohort, only 66% were identified as receiving a diagnostic work-up

Anatomic segmentectomy for stage I non–small-cell lung cancer: Comparison of video-assisted thoracic surgery versus open approach

ObjectivesAnatomic segmentectomy is increasingly being considered as a means of achieving an R0 resection for peripheral, small, stage I non–small-cell lung cancer. In the current study, we compare the results of video-assisted thoracic surgery (n = 104) versus open (n = 121) segmentectomy in the treatment of stage I non–small-cell lung cancer.MethodsA total of 225 consecutive anatomic segmentectomies were performed for stage IA (n = 138) or IB (n = 87) non–small-cell lung cancer from 2002 to 2007. Primary outcome variables included hospital course, complications, mortality, recurrence, and survival. Statistical comparisons were performed utilizing the t test and Fisher exact test. The probability of overall and recurrence-free survival was estimated with the Kaplan-Meier method, with significance being estimated by the log-rank test.ResultsMean age (69.9 years) and gender distribution were similar between the video-assisted thoracic surgery and open groups. Average tumor size was 2.3 cm (2.1 cm video-assisted thoracic surgery; 2.4 cm open). Mean follow-up was 16.2 (video-assisted thoracic surgery) and 28.2 (open) months. There were 2 perioperative deaths (2/225; 0.9%), both in the open group. Video-assisted thoracic surgery segmentectomy was associated with decreased length of stay (5 vs 7 days, P < .001) and pulmonary complications (15.4% vs 29.8%, P = .012) compared with open segmentectomy. Overall mortality, complications, local and systemic recurrence, and survival were similar between video-assisted thoracic surgery and open segmentectomy groups.ConclusionsVideo-assisted thoracic surgery segmentectomy can be performed with acceptable morbidity, mortality, recurrence, and survival. The video-assisted thoracic surgery approach affords a shorter length of stay and fewer postoperative pulmonary complications compared with open techniques. The potential benefits and limitations of segmentectomy will need to be further evaluated by prospective, randomized trials

Succinic semialdehyde dehydrogenase deficiency: Lessons from mice and men

Succinic semialdehyde dehydrogenase (SSADH) deficiency, a disorder of GABA degradation with subsequent elevations in brain GABA and GHB, is a neurometabolic disorder with intellectual disability, epilepsy, hypotonia, ataxia, sleep disorders, and psychiatric disturbances. Neuroimaging reveals increased T2-weighted MRI signal usually affecting the globus pallidus, cerebellar dentate nucleus, and subthalamic nucleus, and often cerebral and cerebellar atrophy. EEG abnormalities are usually generalized spike-wave, consistent with a predilection for generalized epilepsy. The murine phenotype is characterized by failure-to-thrive, progressive ataxia, and a transition from generalized absence to tonic-clonic to ultimately fatal convulsive status epilepticus. Binding and electrophysiological studies demonstrate use-dependent downregulation of GABA(A) and (B) receptors in the mutant mouse. Translational human studies similarly reveal downregulation of GABAergic activity in patients, utilizing flumazenil-PET and transcranial magnetic stimulation for GABA(A) and (B) activity, respectively. Sleep studies reveal decreased stage REM with prolonged REM latencies and diminished percentage of stage REM. An ad libitum ketogenic diet was reported as effective in the mouse model, with unclear applicability to the human condition. Acute application of SGS–742, a GABA(B) antagonist, leads to improvement in epileptiform activity on electrocorticography. Promising mouse data using compounds available for clinical use, including taurine and SGS–742, form the framework for human trials