Impact of a Person-Centered Care Model on Nursing Job Satisfaction

Executive Summary Long-term care (LTC) facilities have historically created an institutionalized environment for their residents which have been shown to decrease quality of life and decrease nursing job satisfaction within those facilities (Koren, 2010). This paper outlines a single implementation study of a person-centered care model in a long-term care facility. The goal of this implementation was to not only change the practice from a medical model to a person-centered care model but to positively impact nursing job satisfaction. This implementation took place at a long-term care facility in The State of Oregon. This study included an educational intervention, as well as practice change at the bedside and used pre and post job satisfaction surveys to measure nursing job satisfaction. The person-centered model of care was chosen because it was not only the model of care the nurses desired to implement but also gave nursing staff the foundation, knowledge and tools to move practice away from the traditional medical model of care thus improving resident quality of life and personal job satisfaction (Jones, 2011). The Population-Intervention-Comparison-Outcome model (PICO) used for this project was as follow: Population: Nursing staff in a long-term care setting, Intervention: Implementation of person-centered care model, Comparison: Current medical model of practice, Outcome: Improved job satisfaction among nursing staff. The sample size for this project was 17 nursing staff members both pre and post implementation. This study consisted of two phases over a 6-month time period. The results of this study showed a positive improvement in nursing job satisfaction over a six-month time period

Photocatalysis on Titanium Dioxide Surfaces

The adsorption, photo- and thermal- chemistry of adsorbates, and the photoactivation of TiO2(110) single crystalline surfaces are the central topics investigated and presented in this thesis. The hole-induced photodesorption of chemisorbed O2 from a defective TiO2(110) surface was studied to monitor the kinetics of electron-hole pair formation, recombination and hole-trapping. Two distinct O2 desorption processes are found which are characteristic of low and high photon fluxes. At a critical photon flux, the slow O2 desorption process converts to a fast process as a result of the saturation of hole trapping sites in the TiO2 crystal. Both the slow and fast O2 desorption processes are governed by the flux of UV radiation, Fhv1/2, indicating that the steady state concentration of photogenerated holes can be described by second-order electron-hole pair recombination kinetics. A hole scavenger is used to probe the role of added hole trap centers on the photodesorption rate.The photodesorption for O2 from TiO2(110) was found to exhibit fractal kinetic behavior where the photodesorption process is described by a rate coefficient that varies throughout the measurement. A model is proposed in which the electrons associated with O-vacancy defects on the surface percolate from vacancy site to vacancy site via the filled orbitals at these sites to neutralize photo-produced holes. This electron percolation, causing e-h recombination, reduces the efficiency of charge transfer between a photoproduced hole and an O2-(a) species localized at a vacancy defect site, causing the rate of O2 photodesorption to follow a fractal rate law. We postulate that the fractal electron conduction path across the surface is one-dimensional.The adsorption and thermal desorption of CO2 on TiO2(110) was investigated as a probe of the concentration of oxygen vacancy defects. For the stoichiometric and fully oxidized surface, a single thermal desorption feature (Ed = 48.5 kJ/mol) is measured and is attributed to CO2 bound to regular 5-fold coordinated Ti4+ atoms. For the partially reduced TiO2(110) surface, CO2 binds not only to regular sites, but also to oxygen vacancy sites (Ed = 54.0 kJ/mol), created by thermal annealing. The variation in the characteristic CO2 desorption kinetics was measured as a function of the surface reduction temperature and the systematic production of increasing levels of surface defects is observed in the temperature range of 600K- 1100K.The effect of impurity doping on the photoactivity of TiO2 rutile single crystals was subjected to a combined surface science and bulk analysis study. Two approaches were taken: First, the incorporation of nitrogen ions, N-, into TiO2 single crystals was achieved by sputtering with N2+/Ar+ mixtures and subsequent annealing to 900 K under ultra high vacuum conditions; Secondly, a chemical doping method where TiO2(110) single crystals were exposed to gaseous NH3 at 870 K was used. The nitrogen implantation method employed in the first study resulted in an unexpected blueshift of the photoexcitation threshold energy for the doped material compared to undoped TiO2. For crystals doped using the second chemical doping method, a decrease in the required photoactivation energy was observed when compared to undoped TiO2 crystals.Finally, the thermal- and photo- chemistry of the mustard gas simulant molecule, 2-chloroethyl ethyl sulfide (2-CEES), was investigated on both TiO2(110) single crystals and TiO2 powdered materials. 2-CEES decomposition occurs through the incorporation of lattice oxygen from the TiO2 material into the oxidized products.A review of aspects of photochemistry on TiO2 surfaces forms the concluding chapter of the thesis

The Values Influencing Assistant Principals\u27 Decisions to Utilize School Resource Officers

School administrators use control and maintenance to create a safe learning environment for students in the United States public schools. However, when school resource officers (SROs) within U.S. schools are assigned authority over disciplinary procedures certain students become negatively impacted. Substantial research has been conducted regarding the impact and roles of SROs, but very few studies explored the opinions of assistant principals (APs), the individuals typically responsible for the enforcement of school discipline. In this study, a qualitative interpretative design was used to explore what values and beliefs guide APs in their decisions to involve SROs in school disciplinary procedures. Hodgkinson\u27s hierarchy of values served as the theoretical framework. Interviews were conducted with 11 APs, representing 7 high schools amongst 3 school districts in a southeastern state of the United States. Interview responses were coded and analyzed and identified 3 key categories of values used by APs in deciding whether to involve SROs: ethical, organizational, and personal, with ethical values serving as the most frequent determinant for using SROs. The primary ethical values described were faith and spirituality. Based on the analysis of the roles and values of APs, the findings suggest that SROs are not creating safe environments as intended. Instead, the over dependence on SROs negatively impacts students (particularly black and brown students). Findings further suggest that school systems could better meet the long-term needs of students through alternatives to SROs, such as an increased use of professional school counsellors

Effects of Concrete, Virtual, and Multimodal Tangram Manipulatives on Second Grade Elementary Students� Mathematics Achievement and Development of Spatial Sense: A Convergent Parallel Mixed Methods Study

This convergent parallel mixed methods study sought to determine what effects, if any, the use of multimodal tangrams have on second grade students' mathematical achievement and the development of spatial sense, as compared to concrete and virtual manipulatives. This research examined differences in math achievement and spatial development when using the three different types of manipulatives: concrete, virtual, and multimodal. While the quantitative findings showed no significant difference in achievement and spatial sense, the qualitative data suggested that students who had experiences with virtual and multimodal tangram manipulatives were more likely to experiment with the shapes on the screen. They saw the objects as being less permanent. Students in the physical tangram group were less likely to move pieces once they were set in place. Students in the virtual and multimodal groups also showed more persistence when solving difficult puzzles. However, this study found that experiences with tangram manipulatives, regardless of type, provided opportunities for students to develop geometric knowledge including composition and decomposition of shapes, shape congruence, and an understanding of transformations.Education (PhD

A New, Better BET: Rescuing and Revising Basic Emotion Theory

Basic Emotion Theory, or BET, has dominated the affective sciences for decades (Ekman, 1972, 1992, 1999; Ekman and Davidson, 1994; Griffiths, 2013; Scarantino and Griffiths, 2011). It has been highly influential, driving a number of empirical lines of research (e.g., in the context of facial expression detection, neuroimaging studies and evolutionary psychology). Nevertheless, BET has been criticized by philosophers, leading to calls for it to be jettisoned entirely (Colombetti, 2014; Hufendiek, 2016). This paper defuses those criticisms. In addition, it shows that we have good reason to retain BET. Finally, it reviews and puts to rest worries that BET’s commitment to affect programs renders it outmoded. We propose that, with minor adjustments, BET can avoid such criticisms when conceived under a radically enactive account of emotions. Thus, rather than leaving BET behind, we show how its basic ideas can be revised, refashioned and preserved. Hence, we conclude, our new BET is still a good bet

Genome-Wide Association Studies of Endometrial Cancer: Latest Developments and Future Directions.

Endometrial cancer, the most commonly diagnosed cancer of the female reproductive tract in developed countries, has a heritable component. To date, 16 genetic risk regions have been robustly discovered by genome-wide association studies (GWAS) of endometrial cancer. Post-GWAS analyses including expression quantitative trait loci analysis and laboratory-based functional studies have been successful in identifying genes and pathways involved in endometrial carcinogenesis. Mendelian randomization analysis studies have confirmed factors causal for endometrial cancer risk, including increased body mass index and early onset of menarche. In this review, we summarize findings from GWAS and post-GWAS analyses of endometrial cancer. We discuss clinical implications of these findings, current knowledge gaps, and future directions for the study of endometrial cancer genetics.TAO’M is supported by a National Health and Medical Research Council (NHMRC) Early Career Fellowship (APP1111246), PFK is supported by an Australian Government Research Training Program PhD Scholarship and QIMR Berghofer Postgraduate Top-Up Scholarship, ABS is supported by an NHMRC Senior Research Fellowship (APP1061779)

Assessing the Role of Selenium in Endometrial Cancer Risk: A Mendelian Randomization Study.

Endometrial cancer is the most commonly diagnosed gynecological cancer in developed countries. Based on evidence from observational studies which suggest selenium inhibits the development of several cancers (including lung and prostate cancer), selenium supplementation has been touted as a potential cancer preventative agent. However, randomized controlled trials have not reported benefit for selenium supplementation in reducing cancer risk. For endometrial cancer, limited observational studies have been conducted assessing whether selenium intake, or blood selenium levels, associated with reduced risk, and no randomized controlled trials have been conducted. We performed a two-sample Mendelian randomization analysis to examine the relationship between selenium levels (using a composite measure of blood and toenail selenium) and endometrial cancer risk, using summary statistics for four genetic variants associated with selenium levels at genome-wide significance levels (P < 5 × 10-8), from a study of 12,906 endometrial cancer cases and 108,979 controls, all of European ancestry. Inverse variance weighted (IVW) analysis indicated no evidence of a causal role for selenium levels in endometrial cancer development (OR per unit increase in selenium levels Z-score = 0.99, 95% CI = 0.87-1.14). Similar results were observed for sensitivity analyses robust to the presence of unknown pleiotropy (OR per unit increase in selenium levels Z-score = 0.98, 95% CI 0.89-1.08 for weighted median; OR per unit increase in selenium levels Z-score = 0.90, 95% CI = 0.53-1.50 for MR-Egger). In conclusion, these results do not support the use of selenium supplementation to prevent endometrial cancer.This work was supported by a National Health and Medical Research Council (NHMRC) Project Grant (APP1109286). PFK is supported by an Australian Government Research Training Program PhD Scholarship and QIMR Berghofer Postgraduate Top-Up Scholarship, TAO’M is supported by an NHMRC Early Career Fellowship (APP1111246), ABS is supported by an NHMRC Senior Research Fellowship (APP1061779)