The challenges of conducting a nurse-led intervention in a randomized controlled trial with vulnerable participants

This paper discusses the challenges encountered by researchers while conducting a randomized controlled trial (RCT) testing the efficacy of a healthy lifestyle educational and exercise intervention for people with serious mental illness. RCTs, even though considered the “gold standard” of research designs, are still prone to risks of potential bias and threats to their validity. Based on researcher reflexivity, the combination of reflection and action, during the conduct of the study, this paper outlines a number of challenges faced by the researchers. These included managing the need of participants to tell their story and be heard, reluctance of participants to remain in allocated groups, participant literacy, dual role of the nurse nurse-researcher, and reporting the benefits of nonstatistical results of a quantitative research project. Recommendations for conducting future behaviour intervention studies of this type include the incorporation of a reflexive component for the nurse nurse-researcher, highlighting the importance of taking a reflexive stance in both qualitative and quantitative research designs

Technology Integration into Differentiated Mathematics Instruction: Teacher Attitudes

Differentiated instruction (DI) is based on the idea that students differ significantly in their interests, learning styles, and readiness, and teaching strategies and decisions involving content, process, and product should vary accordingly[1]. Grimes and Stevens (2009)[2] reported a positive correlation between students’ academic success, motivation, and self-efficacy with its use. DI has also been found to result in improved test scores on district and state assessments in every subject, at every grade level. Beecher’s (2008) study supports the idea that using a DI approach and enriched learning experiences could help close the achievement gap between culturally and economically diverse groups[3]. The use of technology tools has also been shown to result in significantly improved student achievement, student engagement, peer interaction, collaboration, and communication[4] [5]. The attitudes and perceptions of 17 teachers from the Putnam County, GA school district, who attended a summer workshop: “Technology Integration into Math Engagement (TIME): A Professional Development Workshop Integrating Technology Tools in Differentiated Math Instruction for Elementary Teachers” will be shared with conference participants. Technology tools and strategies for utilizing them as aides in differentiating mathematics instruction were shared with the teachers. Teachers participated in a survey to determine perceptions about the value of the workshop activities for differentiation. Patterns/trends in the data, gleaned from the survey and from ongoing follow-up visits to teachers’ classrooms to determine any lasting effects on their attitudes and perceptions, will be shared. [1] Tomlinson, C. A. (2014). The differentiated classroom: Responding to the needs of all learners. Alexandria, VA: ASCD [2] Grimes, K., & Stevens, D. (2009). Glass, Bug, Mud: A Self-Assessment System Enables Teachers to Differentiate Elementary Mathematics Instruction, Which Boosts Both Student Learning and Students\u27 Sense of Themselves as Mathematicians. Phi Delta Kappan, 90 (9). Retrieved from http://www.questia.com/library/journal/1G1-200105549/glass-bug-mud-a-self-assessment-system-enables [3] Beecher, M., & Sweeny, S. (2008). Closing the achievement gap with curriculum enrichment and differentiation: One school\u27s story. [Electronic version]. Journal of Advanced Academics, 19(3), 502-530. [4] Fulton, K. (2012, April). The flipped classroom: Transforming education at Byron High School. THE Journal, 39(3), 18–20. [5] Kolb, L. (2011). Why and How: Teachers Using Mobile Phones in K-12. Education Leadership. February 2011

Mental health nurses' experience of challenging workplace situations : A qualitative descriptive study

Mental health nursing is acknowledged internationally as being a demanding profession; however, little is known about the range of experience and complexity of workplace challenges or their impacts on mental health nurses (MHN). This qualitative descriptive study aimed to examine and describe the range of challenging workplace situations experienced by MHN and is reported according to the Standards for Reporting Qualitative Research. An online cross-sectional survey collected demographic data and open-ended descriptions of workplace challenges experienced by n = 374 Australian MHN. Using a modified a priori framework, four categories of experience were derived through content analysis: consumer-related, colleague-related, nursing role-related, and organizational service-related challenges. Many accounts described a complex interplay of challenges. The findings extend prior knowledge on MHN experiences. Frequent workplace challenges included violence and aggression from consumers, bullying from colleagues, low staffing levels, and poor skill mix. Further extending the evidence, key challenges rarely described in prior literature were the psychological impacts of suicides and murder; the personal nature of threats from consumers; moral distress and concerns with colleagues' quality of practice; and exacerbation of practice-related issues by lack of support from colleagues and/or the organization. These have important implications for the profession and can inform targeted strategies to reduce stressors where possible, build staff well-being, support workforce retention, and improve the provision of quality care. The implementation of targeted policy and initiatives that focus on reducing key stressors and supporting practice are vital to staff retention and ensuring a high standard of practice in complex mental health workplaces

Enhanced Thermoelectric Power in Graphene: Violation of the Mott Relation By Inelastic Scattering

We report the enhancement of the thermoelectric power (TEP) in graphene with extremely low disorder. At high temperature we observe that the TEP is substantially larger than the prediction of the Mott relation, approaching to the hydrodynamic limit due to strong inelastic scattering among the charge carriers. However, closer to room temperature the inelastic carrier-optical-phonon scattering becomes more significant and limits the TEP below the hydrodynamic prediction. We support our observation by employing a Boltzmann theory incorporating disorder, electron interactions, and optical phonons.Comment: 5 pages, 4 figure

Dose Duration Effects of 17-α Ethynylestradiol in Zebrafish Toxicology

Exposure of zebrafish to the synthetic estrogen 17-α ethynylestradiol (EE2) has been shown to cause a number of detrimental effects, including but not limited to feminization of male fish, reduced reproductive capabilities, and impaired embryonic development. This paper systematically reviews the effects of five environmentally relevant concentrations of EE2 on 12 measurements that are commonly selected when studying the effects of EE2 on zebrafish. Concentrations of 0.1 ng EE2/L, 1 ng EE2/L, 3 ng EE2/L, 10 ng EE2/L, 25 ng EE2/L, and 100 ng EE2/L were reviewed for their effects on sex ratio, vitellogenin induction, gonad morphology, spawning success, survival, bodily malformation, length/weight, swim-up success, fecundity, fertilization success, hatching success, and the reversibility of aforementioned effects. A greater occurrence of effects was observed as the dose of EE2 was increased, starting at exposure levels of 1 ng EE2/L. For exposures of 3 and 10 ng EE2/L, negative effects on sex ratio, morphology, and reproductive capabilities were reversible after zebrafish were able to recover in clean water for a period of time. Data for zebrafish exposed to 100 ng EE2/L was limited, as this concentration severely decreased survival

Technology Integration into Differentiated Mathematics Instruction: Teacher Attitudes

Differentiated instruction (DI) is based on the idea that students differ significantly in their interests, learning styles, and readiness, and teaching strategies and decisions involving content, process, and product should vary accordingly[1]. Grimes and Stevens (2009)[2] reported a positive correlation between students’ academic success, motivation, and self-efficacy with its use. DI has also been found to result in improved test scores on district and state assessments in every subject, at every grade level. Beecher’s (2008) study supports the idea that using a DI approach and enriched learning experiences could help close the achievement gap between culturally and economically diverse groups[3]. The use of technology tools has also been shown to result in significantly improved student achievement, student engagement, peer interaction, collaboration, and communication[4] [5]. The attitudes and perceptions of 17 teachers from the Putnam County, GA school district, who attended a summer workshop: “Technology Integration into Math Engagement (TIME): A Professional Development Workshop Integrating Technology Tools in Differentiated Math Instruction for Elementary Teachers” will be shared with conference participants. Technology tools and strategies for utilizing them as aides in differentiating mathematics instruction were shared with the teachers. Teachers participated in a survey to determine perceptions about the value of the workshop activities for differentiation. Patterns/trends in the data, gleaned from the survey and from ongoing follow-up visits to teachers’ classrooms to determine any lasting effects on their attitudes and perceptions, will be shared. [1] Tomlinson, C. A. (2014). The differentiated classroom: Responding to the needs of all learners. Alexandria, VA: ASCD [2] Grimes, K., & Stevens, D. (2009). Glass, Bug, Mud: A Self-Assessment System Enables Teachers to Differentiate Elementary Mathematics Instruction, Which Boosts Both Student Learning and Students\u27 Sense of Themselves as Mathematicians. Phi Delta Kappan, 90 (9). Retrieved from http://www.questia.com/library/journal/1G1-200105549/glass-bug-mud-a-self-assessment-system-enables [3] Beecher, M., & Sweeny, S. (2008). Closing the achievement gap with curriculum enrichment and differentiation: One school\u27s story. [Electronic version]. Journal of Advanced Academics, 19(3), 502-530. [4] Fulton, K. (2012, April). The flipped classroom: Transforming education at Byron High School. THE Journal, 39(3), 18–20. [5] Kolb, L. (2011). Why and How: Teachers Using Mobile Phones in K-12. Education Leadership. February 2011

A 10-year review of child injury hospitalisations, health outcomes and treatment costs in Australia

Background: Childhood injury is a leading cause of hospitalisation, yet there has been no comprehensive examination of child injury and survival over time in Australia. To examine the characteristics, temporal trend and survival for children who were hospitalised as a result of injury in Australia. Method: A retrospective examination of linked hospitalisation and mortality data for injured children aged 16 years or less during 1 July 2001 to 30 June 2012. Negative binomial regression examined change in injury hospitalisation trends. Cox proportional hazard regression examined the association of risk factors on 30-day survival. Results: There were 686409 injury hospitalisations,with an age-standardised rate of 1489 per 100000 population (95%CI 1485.3 to 1492.4) in Australia. Child injury hospitalisation rates did not change over the 10-year period. For every severely injured child, there are at least 13 children hospitalised with minor or moderate injuries. The total cost of child injury hospitalisations was $A2.1billion (annually$A212million). Falls (38.4%) were the most common injury mechanism. Factors associated with a higher risk of 30-day mortality were: child was aged ≤10 years, higher injury severity, head injury, injured in a transport incident or following drowning and submersion or other threats to breathing, during self-harm and usual residence was regional/remote Australia. Conclusions: Childhood injury hospitalisation rates have not reduced in 10 years. Children’s patterns of injury change with age, and priorities for injury prevention alter according to developmental stages. The development of a national multisectorial childhood injury monitoring and prevention strategy in Australia is long overdue