The development of an intervention to improve the safety of community care nurses while driving and a qualitative investigation of its preliminary effects

This paper details the development of, and perceived role and effectiveness of an innovative intervention designed to ultimately improve the safety of a group of community care (CC) nurses while driving. Recruiting participants from an Australian CC nursing car fleet, qualitative responses from a series of open-ended questions were obtained from drivers (n = 36), supervisors (n = 22), and managers (n = 6). The findings supported the effectiveness of the intervention in reducing self-reported speeding and promoting greater insight into one’s behaviour on the road. This research has important practical implications in that it highlights the value of developing an intervention based on a sound theoretical framework and which is aligned with the needs and beliefs of personnel within a particular organisation

Strengthening Primary Care: Recent Reforms and Achievements in Australia, England, and the Netherlands

Outlines efforts to enhance primary care quality and access, including postgraduate training for family physicians, general practitioner accreditation, greater use of nurse practitioners, and after-hours care; their outcomes; and insights for U.S. reform

Teacher Absenteeism and the Perceived Reasons for its Effect on Student Achievement in Three Barbadian Secondary Schools.

Abstract This thesis investigated the reasons for teacher absences, and how it has impacted on student achievement in the core subjects at three suburban secondary schools in Barbados using a cross-sectional survey research design which included teachers and students. The study focuses on four research questions: Which reasons do teachers give that contribute most to their being absent from work at three Barbadian Secondary Schools? Are there significant differences in the reasons for absenteeism based on specific teacher characteristics? What are students’ perceptions of teachers’ absenteeism at three Barbadian Secondary Schools? Do teacher absences impact upon student achievement in the core subjects at three Barbadian Secondary Schools? Does the relationship between teacher absenteeism and student achievement differ between teachers with diverse characteristics at three Barbadian Secondary Schools? Data were collected on self-reported paper and pencil questionnaires, teacher absence data and student test scores. There were forty-five closed and one open-ended question on the teacher questionnaire, and twenty-five closed and one open-ended question on the student questionnaire. Open responses by teachers revealed that absences were mainly due to personal circumstantial factors. Students however, believed that their teachers were absent because they did not want to work. Correlation analysis determined that a moderate negative, linear relationship exists between teacher absence and student averages in English, Integrated Science and Spanish at Schools A and C. A moderate, negative relationship also existed between teacher absences and student averages in Social Studies at School A, but a strong positive relationship at School C. A weak negative relationship was discovered for Math at School C, with a moderate relationship at School A. All correlations were statistically significant. These negative statistically significant relationships support previous research by (Brown and Arnell 2012; Bruno, 2002; Obeng-Denteh, Yeboah, Sam, & Monkah, 2011; Scott, Vaughn, Wolfe, & Wyant, 2007; Speas, 2010) and other researchers who also discovered similar relationships. Multivariate regression analysis ascertained that total teacher absence in the core subjects of Integrated Science, Math, Social Studies and Spanish negatively impacted student averages. These findings suggest that the more absent days taken by the teacher in the core subjects, the lower their students’ averages will be. Conversely, teacher absences had a significant positive effect on student averages for English. This finding was not expected and indicates that there are other variables besides teacher absence which contribute to low student achievement

Demographic Differences, Self-esteem and Sexual Assertiveness among Black Women

There is a high HIV prevalence rate for Black women in Virginia; however, few scholars have examined how sexual assertiveness and self-esteem against HIV vary within this group. Black women who have low levels of self-esteem may increase their risk for HIV. The purpose of this quantitative cross-sectional study was to determine if four aspects of sexual assertiveness (sexual initiation, sexual refusal, HIV/AIDS/STD communication, and contraception/STD prevention) differed across demographic categories and were associated with self-esteem in a diversified group of Black women living in Virginia. A cross-sectional survey was conducted with a community-based sample of 117 adult Black women. The social cognitive theory was the framework that guided this study. ANOVAs were used to determine differences in means of the four sexual assertiveness subscales across the demographic categories (age, sexual orientation, income, education, and relationship status. HIV, AIDS, and sexual transmitted disease communication assertiveness mean scores were significantly higher among higher income Black women (padj=.016) and Black women with a college versus a high school degree (padj=.047). Moreover, Pearson bivariate correlation results showed self-esteem was significantly positively associated with all but one measure (sexual initiation) of sexual assertiveness. Health educators can use the findings of this study to create education initiatives that focus on building self-esteem and sexual assertiveness behaviors among Black women as an HIV/AIDS prevention method

The Black Ceiling: The Underrepresentation of African American Females in the CES Professorate

This qualitative phenomenological study highlighted the lived experiences of six African American female professors in the counseling education and supervision professorate. The professors were faculty within universities across the United States in the mid-Atlantic, southern, and midwestern regions. This study obtained data from semi-structured interviews as well as photovoice submissions from the interview participants in order to identify experiences which facilitated their persistence in the professorate and overcoming internal and external barriers. The research problem was the underrepresentation of African American females within the counseling education and supervision professorate, which further facilitates minority students’ attrition and underrepresentation. A thematic analysis of the source data revealed five themes and three subthemes. The themes were mentors facilitated persistence, belief in concepts of calling and gifts, encouragers and positive family support, external barriers (referred to as the Black ceiling), and persistence. The subthemes were encountered racial discrimination, feelings of loneliness and invisibility, and realities of intersectionality and minority status. The study revealed that in the face of adverse external barriers, persistence in the counseling education and supervision professorate was facilitated by the positive influence of mentors, callings, and encouragers despite discrimination, loneliness and invisibility, and intersectionality and minority status

Studies of Mercury Dynamics in Birds

1. A review is presented of the use of seabirds as biomonitors of heavy metals and factors influencing mercury dynamics in birds. 2. The effect of atmospheric deposition on mercury levels found in the plumage of seabirds was assessed and found to be negligible. No difference was found between feathers exposed for ten months to the atmosphere and feathers sealed over the same period. 3. Significant differences were found between the tip, middle and bottom portion of the feather but this was concluded to be due to natural depletion of the body pool of mercury as the feathers grew and not due to the effect of exogenous contamination. 4. The effect of age and sex upon mercury concentrations in feathers of red-billed gulls was investigated. Feather concentrations were not influenced by age nor sex in adults nor chicks. Dietary specialisation was assumed to be an important determinant of mercury levels in this species. 5. The effect of growth development on tissue distribution and excretion in kittiwake chicks was examined. No age-related changes in the retention of mercury by any of the tissues analysed were found nor were any differences in mercury excretion apparent. There was a positive correlation between the total amount of mercury going into the plumage and age which was suggested to reflect an increase in the amount of mercury circulating in the blood of older birds. 6. No difference in the mercury distribution between the liver, kidney and pectoral muscle was found which differed markedly from results of other studies. It was suggested that this may be an indication that the levels in chicks were approaching a toxic threshold. 7. Mercury accumulation and excretion were investigated in laboratory-reared black-headed gull chicks in relation to mercury intake. There was an increase in the proportion of mercury deposited in the kidney as the dose increased. The proportional accumulation of mercury in the carcass was also dose-dependent. The amount of mercury administered had no effect on the total excretion rate. 8. Mercury accumulated differentially in the internal tissues, concentrations in the kidney were greater than in the liver which in turn exceeded concentrations found in the pectoral muscle. All feather types contained much higher mercury concentrations than internal tissues and there was a consistent difference between different feather types in relation to mercury content. There was a pronounced reduction in the concentration of mercury in the primary feathers as the growth sequence progressed. 9. An average of 71% of the dose administered was excreted over the fledging period. Of this, 22% of the dose was excreted into the feathers. Sixty five percent of the total body burden of mercury was present in the plumage after the completed moult. Of administered mercury, 49% was contained in the plumage. 10. The retention and excretion of mercury after a single dose of methyl mercury was investigated in male and female quail. The role of eggs in mercury excretion was also assessed. The birds accumulated mercury rapidly in their internal tissues and lost it relatively slowly. Mercury accumulated differentially in the internal tissues. Kidney concentrations exceeded liver concentrations which exceeded pectoral muscle concentrations. 11. For up to eight weeks after mercury administration there was a difference between the mercury levels in the internal tissues of male and female birds, with less mercury in the female tissues. Twelve weeks after administration differences in the mercury levels of the kidney and pectoral muscle were still found. 12. There was no difference in mercury levels of the male and female plumage, although total mercury excretion did differ between the sexes with females losing up to 80% of their mercury intake in the first four weeks after mercury administration compared to 40% lost by male birds. Male birds lost over 80% of the mercury intake via the faeces compared to only 44% lost this way by the females. Initial mercury concentration in the eggs was over 3.5 pg/g. Over 40% of the females' intake was lost by this route supporting the use of bird eggs to sample for environmental contamination. 13. The effect of sex and species on mercury retention was examined in two species of seabird (shags and kittiwakes) after a single dose of methyl mercury. The excretion of mercury into the eggs and chicks was also assessed. Mercury accumulated differentially in the internal tissues. In both species there was no difference between the concentration of mercury found in the liver and kidney although levels in both these tissues were greater than levels found in the pectoral muscle. 14. Mercury concentrations in both species of seabird were similar. There were differences in the total amount of mercury in the tissues analysed, shag tissues having up to four times the amount of mercury in their tissues as those of the kittiwakes. (Abstract shortened by ProQuest.)

A Call for Change: The Social and Educational Factors Contributing to the Outcomes of Black Males in Urban Schools

The Council of the Great City Schools is a coalition of 65 of the country's biggest urban school systems. Educating nearly 30 percent of the country's African-American males, urban schools are vital to black male achievement. This study draws attention to new analyses of disaggregated education data, profiles black males who have achieved academic success, and provides a plan of action moving forward

The role of focus groups in a randomised controlled trial : the ADEPT study

In a recent study we developed a decision aid for prenatal testing of fetal abnormalities. The effectiveness of the decision aid compared with a pamphlet in increasing women\u27s informed choice and decreasing conflict was evaluated using a cluster randomised controlled trial, A DEcision aid for Prenatal Testing for fetal abnormalities (ADEPT) [ISRCTN22532458]. Challenged with the need to ensure that the decision aid best suited the needs of women and health professionals involved General Practitioners (GPs), we explored the potential of both quantitative and qualitative methodologies to inform the development phase. In this article we discuss our rationale for, and provide some insights regarding our experience of, using qualitative methods during the development phase of the decision aid.<br /