The Experiences of School Counseling Directors in Relation to Job Satisfaction and Leadership

The current literature on school counselor job satisfaction does not address the experiences of school counseling directors. This is a unique set of counselors due to their role as leaders and supervisors in the building. Therefore, this study sought to better understand the experiences of school counseling directors in relation to job satisfaction and leadership. The researcher collected data through 10 interviews with participants having met the criteria of serving as a school counseling director of a middle or high school, supervising a department of at least two counselors, and working in the role for at least two years. Data analysis showcased the different expectations in the role of the school counseling director in addition to four major themes: Intentionality, Leadership Training and Knowledge, Overload of Responsibilities Assigned to Role, and Sacrifice. The subthemes for Leadership Training and Knowledge include limited counselor-specific preparation, limited recognition of leadership style, collaboration, and influence of administrators. The subthemes of Sacrifice include time to complete duties and gender-related influence on role acquisition. These themes are discussed in relation to current research as well as in regards to implications about the expectations of the school counseling director’s role, gender influence, leadership training standards and programs, and wellness. Recommendations for further research about school counseling directors, district-level supervisors, and leadership training are also given

Sustainable Grazing Management for Temporal and Spatial Variability in North Australian Rangelands–A Synthesis of the Latest Evidence and Recommendations

Rainfall variability is a major challenge to sustainable grazing management in northern Australia, with management often complicated further by large, spatially heterogeneous paddocks. This paper presents the latest grazing research and associated bio-economic modeling from northern Australia and assesses the extent to which current recommendations to manage for these issues are supported. Overall, stocking at around the safe long term carrying capacity will maintain land condition and maximize long term profitability. However, stocking rates should be varied in a risk-averse manner as pasture availability varies between years. Periodic wet season spelling is also essential to maintain pasture condition and allow recovery of overgrazed areas. Uneven grazing distributions can be partially managed through fencing, providing additional waters and in some cases patch burning, although the economics of infrastructure development are extremely context dependent. Overall, multipaddock grazing systems do not appear justified in northern Australia. Provided the key management principles outlined above are applied in an active, adaptive manner, acceptable economic and environmental outcomes will be achieved irrespective of the grazing system applied

L ennox‐ G astaut syndrome of unknown cause: Phenotypic characteristics of patients in the E pilepsy P henome/ G enome P roject

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/101778/1/epi12395.pd

Low 25-Hydroxyvitamin D Concentration Is Not Associated With Refractive Error in Middle-Aged and Older Western Australian Adults

Purpose: To investigate the association between serum 25-hydroxyvitamin D (25[OH]D) concentration and refractive error in a community-based cohort of adults aged 46 to 69 years. Methods: Residents of the City of Busselton in Western Australia born between 1946 and 1964 were invited to participate. Participants underwent cycloplegic autorefraction and completed questionnaires on education, occupational sun exposure, and physical activity. Blood samples were collected and serum frozen at −80°C. Serum 25[OH]D concentration was measured by immunoassay. Data on 25[OH]D were deseasonalized and multivariate models built to analyze the association between 25[OH]D concentration and spherical equivalent and myopia, defined as spherical equivalent <−0.50 D. Results: After exclusions, data were available for 4112 participants. Serum 25[OH]D concentration was not associated with spherical equivalent or myopia after adjustment for confounding factors (β = −0.01, 95% confidence interval [CI]: −0.03 to −0.008, P = 0.25, and odds ratio = 1.02, 95% CI: 0.99 to 1.05, P = 0.12, respectively). When participants were classified into 25[OH]D groups of lower (<50 nmol/L), medium (≥50 to <75 nmol/L), and upper (≥75 nmol/L), the upper group had slightly greater myopic refractive error than the medium group (P = 0.02) but not the lower group, after adjustment for confounders. Conclusions: There was no substantial association between 25[OH]D levels and spherical equivalent or odds of myopia in this study. The association previously noted between low serum 25[OH]D level and myopia in younger Western Australians is not evident in later adulthood. Translational Relevance: This study provides further evidence suggesting that vitamin D levels are unrelated to myopia risk in adults and thus not a suitable target for myopia intervention

Improving Discharge Times and Patient Flow

Background: Delays in discharging patients can impact hospital and emergency department (ED) throughput. The complex discharge process makes it difficult to ensure that patients are set up for successful post-hospital care regimens. The focus of this project was to improve discharge times and flow throughout the hospital to align with national standards of providing the right care, in the right place, at the right time. To improve access to beds, The Joint Commission stipulates that hospitals have processes in place to support patient flow throughout the hospital and to use data to drive improvements in patient flow. Failure to regulate flow puts patients at risk for harm and less than optimal care. It also increases clinician burden which may accelerate burnout. A lack of optimal patient flow results in ED boarding and diversions, long waits, and boarding in post-anesthesia care units. Purpose: The purpose of this project was to improve overall patient throughput within one large acute care hospital by improving discharge times. Baseline discharge times averaged over 4 hours with less than 15% of patients being discharged in less than 2 hours. Methods: A multidisciplinary patient flow team was charged with improving discharge times and removing barriers to timely discharges. The team consisted of representation from executive leadership, nursing management, pharmacy, physician staff, case management, and frontline staff. Meeting weekly, the team rapidly instituted small tests of change to address the barriers to timely discharges. The Admission Discharge Team facilitated education. Discharge accountability teams on nightshift assisted with preparing patients for discharge. Case Manager/charge nurse rounds were instituted to identify patients ready for discharge and anticipated barriers. Electronic whiteboards were utilized for interdisciplinary communication. Discharge times were reported weekly in a public area on units. Results: The program resulted in an increase in caregiver engagement in discharges and discharge times. Readmission rates decreased for heart failure patients to below national benchmark. Discharges completed in less than 2 hours improved to almost 30%. Average discharge times decreased from 4 hours to 2 hours and 30 minutes. Also, responses improved to the patient satisfaction question When I left the hospital, I had a good understanding of the things I was responsible for in managing my heath: by 25%. Conclusions: Discharge planning that is initiated on the day of admission and addressed ongoing in a uniform fashion by both nursing shifts and ancillary caregivers can alleviate delays on discharge day. An improvement in discharge times improved hospital flow. A focused approach on education throughout the patients stay improved their ability to manage their health at home and reduced readmits. Implication for Practice: The discharge protocol and procedures will continue to be implemented and evaluated for improvement needs and barriers and expanded to include skilled nursing facility transfers. The discharge process has been implemented in several inpatient units. Discharge times/barriers will be re-evaluated quarterly and the focused patient flow team will make additional adjustments to make the discharge process more efficient.https://digitalcommons.psjhealth.org/prov_rn_conf_all/1034/thumbnail.jp

Cloning and characterization of Trypanosoma congolense and T. vivax nucleoside transporters reveal the potential of P1-type carriers for the discovery of broad-spectrum nucleoside-based therapeutics against Animal African trypanosomiasis

African Animal Trypanosomiasis (AAT), caused predominantly by Trypanosoma brucei brucei, T. vivax and T. congolense, is a fatal livestock disease throughout Sub-Saharan Africa. Treatment options are very limited and threatened by resistance. Tubercidin (7-deazaadenosine) analogs have shown activity against individual parasites but viable chemotherapy must be active against all three species. Divergence in sensitivity to nucleoside antimetabolites could be caused by differences in nucleoside transporters. Having previously characterized the T. brucei nucleoside carriers, we here report the functional expression and characterization of the main adenosine transporters of T. vivax (TvxNT3) and T. congolense (TcoAT1/NT10), in a Leishmania mexicana cell line (‘SUPKO’) lacking adenosine uptake. Both carriers were similar to the T. brucei P1-type transporters and bind adenosine mostly through interactions with N3, N7 and 3′-OH. Expression of TvxNT3 and TcoAT1 sensitized SUPKO cells to various 7-substituted tubercidins and other nucleoside analogs although tubercidin itself is a poor substrate for P1-type transporters. Individual nucleoside EC50s were similar for T. b. brucei, T. congolense, T. evansi and T. equiperdum but correlated less well with T. vivax. However, multiple nucleosides including 7-halogentubercidines displayed pEC50&gt;7 for all species and, based on transporter and anti-parasite SAR analyses, we conclude that nucleoside chemotherapy for AAT is viable

Northern grazing carbon farming – integrating production and greenhouse gas outcomes 1 : Climate Clever Beef Final Report

This project targeted three large and diverse regions across northern Australia: the Queensland Gulf, the Queensland Fitzroy Basin and the Northern Territory (Victoria River District, Douglas Daly and Barkly Tableland regions). Eleven grazing businesses across three broad regions were engaged as case studies to undertake demonstrations and evaluations within their businesses. These businesses manage more than 1,281,000 ha and 97,600 cattle. The project provided an excellent opportunity to capitalize on established networks and genuine producer interest and participation built up in recent initiatives (e.g. CCRP Climate Clever Beef (Bray et al. 2014), Northern Grazing Systems project (Phelps et al. 2014), RELRP, SCaRP, SavannaPlan, CQ Beef). The project team included research and extension professionals with decades of combined experience working with northern beef producers. The knowledge and analytical tools developed during previous projects identified practices to: reduce the greenhouse gas emissions impact of beef businesses, manage climate variability, improve land condition and increase business profitability

Northern grazing carbon farming – integrating production and greenhouse gas outcomes 1 : Climate Clever Beef Final Report

This project targeted three large and diverse regions across northern Australia: the Queensland Gulf, the Queensland Fitzroy Basin and the Northern Territory (Victoria River District, Douglas Daly and Barkly Tableland regions). Eleven grazing businesses across three broad regions were engaged as case studies to undertake demonstrations and evaluations within their businesses. These businesses manage more than 1,281,000 ha and 97,600 cattle. The project provided an excellent opportunity to capitalize on established networks and genuine producer interest and participation built up in recent initiatives (e.g. CCRP Climate Clever Beef (Bray et al. 2014), Northern Grazing Systems project (Phelps et al. 2014), RELRP, SCaRP, SavannaPlan, CQ Beef). The project team included research and extension professionals with decades of combined experience working with northern beef producers. The knowledge and analytical tools developed during previous projects identified practices to: reduce the greenhouse gas emissions impact of beef businesses, manage climate variability, improve land condition and increase business profitability

INFLATE : a protocol for a randomised controlled trial comparing nasal balloon autoinflation to no nasal balloon autoinflation for otitis media with effusion in Aboriginal and Torres Strait Islander children

Background: Otitis media with effusion (OME) is common and occurs at disproportionately higher rates among Indigenous children. Left untreated, OME can negatively affect language, development, learning, and health and wellbeing throughout the life-course. Currently, OME care includes observation for 3 months followed by consideration of surgical ventilation tube insertion. The use of a non-invasive, low-cost nasal balloon autoinflation device has been found beneficial in other populations but has not been investigated among Aboriginal and Torres Strait Islander children. Methods/design: This multi-centre, open-label, randomised controlled trial will determine the effectiveness of nasal balloon autoinflation compared to no nasal balloon autoinflation, for the treatment of OME among Aboriginal and Torres Strait Islander children in Australia. Children aged 3–16 years with unilateral or bilateral OME are being recruited from Aboriginal Health Services and the community. The primary outcome is the proportion of children showing tympanometric improvement of OME at 1 month. Improvement is defined as a change from bilateral type B tympanograms to at least one type A or C1 tympanogram, or from unilateral type B tympanogram to type A or C1 tympanogram in the index ear, without deterioration (type A or C1 to type C2, C3, or B tympanogram) in the contralateral ear. A sample size of 340 children (170 in each group) at 1 month will detect an absolute difference of 15% between groups with 80% power at 5% significance. Anticipating a 15% loss to follow-up, 400 children will be randomised. The primary analysis will be by intention to treat. Secondary outcomes include tympanometric changes at 3 and 6 months, hearing at 3 months, ear health-related quality of life (OMQ-14), and cost-effectiveness. A process evaluation including perspectives of parents or carers, health care providers, and researchers on trial implementation will also be undertaken. Discussion: INFLATE will answer the important clinical question of whether nasal balloon autoinflation is an effective and acceptable treatment for Aboriginal and Torres Strait Islander children with OME. INFLATE will help fill the evidence gap for safe, low-cost, accessible OME therapies. Trial registration: Australia New Zealand Clinical Trials Registry ACTRN12617001652369. Registered on 22 December 2017. The Australia New Zealand Clinical Trials Registry is a primary registry of the WHO ICTRP network and includes all items from the WHO Trial Registration data set. Retrospective registration.</p

Effectiveness, cost-effectiveness and cost-benefit of a single annual professional intervention for the prevention of childhood dental caries in a remote rural Indigenous community

Background The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. Methods/design The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. Discussion There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015