General and special education teachers' knowledge of and attitudes toward students with HIV/AIDS

AIDS education is mandated in schools throughout the United States to educate students about the disease. Teachers are expected to assume the major role of disseminating this information; therefore it is reasonable to question how knowledgeable teachers are about HIV/AIDS and where their information is coming from. This study explored the knowledge and attitudes of general and special education teachers toward students with HIV/AIDS and investigated whether a relationship between knowledge and attitudes existed. Information was collected using the AIDS Knowledge and Attitude Survey (AKAS). The sample was limited to certified teachers resulting in 318 participants.^ Research questions were analyzed using descriptive statistics, frequencies, t-tests, one-way analysis of variance (ANOVA), Scheffe post hoc analysis, and Pearson Product-Moment Correlation. Results indicated that general and special education teachers did not have complete knowledge about HIV/AIDS. Participants were knowledgeable regarding modes of transmission which may be the area of greatest concern for teachers, however, deficiencies were present within teachers' knowledge of general statements and facts and pathology. Among the ten demographic variables analyzed, six (gender, race/ethnicity, level of education, certification, instructional level taught, and classroom AIDS instruction) contained statistical significance.^ Analysis of attitudes indicated that general and special education teachers' overall attitudes toward students with HIV/AIDS were generally positive within clusters of Instruction and Fear, but not within Sensitivity and Communication. Among the ten demographic variables used for analysis only three (age, graduate enrollment status, and classroom AIDS instruction) produced statistical significance. Results found statistically significant relationships between Total Knowledge, all knowledge subtests, Fear, and Overall Attitudes. Statistical significance was also located on Total Knowledge, Pathology and Transmission knowledge subtests, and Sensitivity, as well as between Pathology and Instruction, and General Statements and Facts and Communication.^ The only variable determined to have statistical significance on both knowledge and attitudes was classroom AIDS instruction. Participants with previous AIDS instruction showed greater knowledge and possessed more positive attitudes. A review of previous research indicated training to be effective in increasing knowledge and fostering more favorable behavior toward persons with AIDS. Therefore, this study finds AIDS training to be beneficial for all teachers and is recommended during preservice education or through inservices for teachers already in the field. ^

A study of state and trait anxiety and perceived causes of anxiety identified by licensed practical nurses returning to an associate degree nursing program

The purpose of this study was to identify the state and trait anxiety and the perceived causes of anxiety in licensed practical nurses (LPNs) returning to an associate degree nursing program in order to become registered nurses (RNs). The subjects for this study were 98 students enrolled in a transitional LPN/RN associate degree nursing program in two community colleges in the state of Florida. The State-Trait Anxiety Inventory (STAI) developed by Spielberger (1983), was used as the measuring instrument for this study.^ In addition, a Q-sort technique was used to obtain information from the subjects regarding perceived causes of anxiety. Anxiety causes for the Q-sort cards used in the study were developed from the themes identified by a sample of LPN/RN students in a pilot study. The state and trait anxiety levels were obtained using the STAI for college students scoring key and scales. Descriptive statistics were used to determine the state and trait anxiety of the students. Correlational statistics were used to determine if relationships existed between the state and trait anxiety levels and perceived causes of anxiety identified by LPN students returning to an associate degree nursing program.^ The analysis of the Q-sort was performed by computing the means, standard deviations, and frequencies of each cause. The mean trait anxiety level of the students was 57.56, $SD=29.69.$ The mean state anxiety level of the students was 68.21, $SD=25.78.$ Higher percentile scores of trait anxiety were associated with higher ranks of the Q-sort category, "failing out of the program," $\rm r\sb{s}=.27,\ p=.008.$ Implications for future nursing research and application of the findings to nursing education are presented. ^

Managerial work roles of health care executives in the changing environment of academic medical centers

The current U.S. health care system faces numerous environmental challenges. To compete and survive, health care organizations are developing strategies to lower costs and increase efficiency and quality. All of these strategies require rapid and precise decision making by top level managers. The purpose of this study is to determine the relationship between the environment, made up of unfavorable market conditions and limited resources, and the work roles of top level managers, specifically in the settings of academic medical centers. Managerial work roles are based on the ten work roles developed by Henry Mintzberg, in his book, The Nature of Managerial Work (1973). ^ This research utilized an integrated conceptual framework made up of systems theory in conjunction with role, attribution and contingency theories to illustrate that four most frequently performed Mintzberg's work roles are affected by the two environment dimensions. The study sample consisted of 108 chief executive officers in academic medical centers throughout the United States. The methods included qualitative methods in the form of key informants and case studies and quantitative in the form of a survey questionnaire. Research analysis involved descriptive statistics, reliability tests, correlation, principal component and multivariate analyses. ^ Results indicated that under the market condition of increased revenue based on capitation, the work roles increased. In addition, under the environment dimension of limited resources, the work roles increased when uncompensated care increased while Medicare and non-government funding decreased. ^ Based on these results, a typology of health care managers in academic medical centers was created. Managers could be typed as a strategy-formulator, relationship-builder or task delegator. Therefore, managers who ascertained their types would be able to use this knowledge to build their strengths and develop their weaknesses. Furthermore, organizations could use the typology to identify appropriate roles and responsibilities of managers for their specific needs. Consequently, this research is a valuable tool for understanding health care managerial behaviors that lead to improved decision making. At the same time, this could enhance satisfaction and performance and enable organizations to gain the competitive edge . ^

Education, earnings, and rates of return: The case of Taiwan

Educational planners and economists have long recognized the importance of education as a form of productive investment in both advanced countries and developing countries. In the case of Taiwan, along with impressive economic growth, there was an even faster rate of growth of the government's investment in education. This leads some to question whether education has any role in economic development. ^ The purpose of this study is to provide a broad overview of the role of education, in terms of private rates of return to education, in Taiwan. In the process, a variety of hypotheses about human capital theory are examined and an empirical study of Taiwan's earnings functions are tested to show that education can be an important instrument to increase private rate of return, even under conditions of scarcity of natural and physical resources. Data was collected using the Manpower Survey and Manpower Utilization Survey, conducted by the government. Research questions were analyzed using descriptive statistics, frequencies, and regression analysis. ^ Results indicated that the Manpower Development Plans have been the decisive influence in allowing Taiwan to develop its human resources and achieve success in meeting the needs of Taiwan's economy. The structure of age-earnings profiles showed a strong relationship between earnings and education, and the profiles that successively shift upward are associated with higher levels of education. In the cross-sectional results of the rate of return in 1997, each additional year of schooling leads to a 6.2% increase in income. As to the private rates of return to different levels of education, the results found that the private rates of return are 2.88%, 4.85% and 10.05% for primary, secondary and higher education respectively. In an intertemporal comparison for 1980, 1985, 1990 and 1997, the results showed no significant trend except the private rates of return for primary education have been falling from 3.9% to 2.88%. ^ On the basis of this study, for individual student or family in Taiwan, there is likely to be a strong demand for education, particularly at the higher level. Therefore, a well-developed higher educational level becomes essential and the content of curriculum in higher education becomes another crucial question facing planners in Taiwan if they are going to use education as a means to foster economic development. ^

Fever, methods of fever management, and caretakers' perceptions of pediatric after-hour telephone triage and advice services for children between the ages of twelve months and three years with fever

Despite the frequency with which fevers occur in children ages 1–3 years, lack of knowledge and understanding about the implications of fever and methods of fever management often results in anxiety among caretakers, sometimes prompting them to seek help at nearby emergency departments. Caretakers often look to health care professionals for advice and guidance over the telephone. The purpose of this study was to investigate caretakers' knowledge of the implications of fever, methods of fever management, perceptions of pediatric telephone triage and advice services regarding fever, and the effectiveness of after hour telephone triage directed toward improving the caretakers' ability to manage their child's fever at home. Pre-triage questionnaires were completed by 72 caretakers over the telephone before the triage encounter. Twenty-two of those same caretakers whose children were triaged using the fever guideline completed and returned the mailed post-triage questionnaire. Descriptive statistics were used to analyze responses for the larger pre-intervention group and describe comparisons for the pre and post-triage responses in the smaller sample subset (n = 22). ^

Exploring the role of therapy process and outcome in interventions that target adolescent identity and intimacy

This study examined the feasibility of using a session impact measure with a sample of 24 at risk high school students participating in an intervention targeting identity and intimacy. Three therapists led 3 intervention groups with the same format. The study investigated the impact of therapy process, including Group, Facilitator, Skills, and Exploration impacts as measured by the Session Evaluation Form (SEF). The study also investigated the differential impact of session process on intervention outcome as measured by the CPSS, EPSI, RAVS, EIPQ and Youth Report Form. Analyses were conducted using descriptive statistics, frequencies, one-way analysis of variance (ANOVA), and Chi square tests. The results supported the utility of the SEF and they tentatively supported the impact of the therapist on participants' perceptions of therapeutic processes and on intervention outcome. In particular, Group 1 performed better than Group 3. This study found that the SEF is a useful session impact measure. ^

Art teachers' attitudes toward the Florida Sunshine State Standards for the Visual Arts

The State of Florida developed the Sunshine State Standards For the Arts Curriculum Framework as part of an initiative to raise student achievement in response to national calls for educational reform. The content-based art education approach used in the Sunshine State Standards reflects a viewpoint advocated by prominent art educators and professional art education organizations for more than two decades. Successful implementation of the Sunshine State Standards curriculum approach requires that art teachers be acquainted with and knowledgeable in the four foundational content areas of the arts: studio art, art history, art criticism, and aesthetics. ^ The purpose of this study was to examine art teachers' viewpoints and attitudes toward the content-based art education approach contained in the Florida Curriculum Framework Sunshine State Standards for the Visual Arts. A survey was conducted in order to obtain these viewpoints. Surveys were sent to 440 Miami-Dade County Public School art teachers. A total of 138 elementary, middle and senior high school level art teachers participated in the study. ^ Factors and variables explored in this study included teachers' level of education, type of community, and grade levels taught. The principal methods of analyses employed in the study were descriptive statistics used to display frequencies and percentages. In addition, cross tabulations with Chi-square tests, and Mann-Whitney U tests were used to examine responses to the survey items. ^ The results of the study revealed that the majority of art teachers supported the content-based art education approach used in the Sunshine State Standards for the Arts. However significant differences appeared in the responses to survey items as a result of art teachers' level of education, type of community, and grade levels. The results of this study indicate a need for further examination of teacher training and professional development programs. ^

A comparison of content-based and context-based teaching on ninth-grade mathematics achievement

The purpose of this study was to determine if an experimental context-based delivery format for mathematics would be more effective than a traditional model for increasing the performance in mathematics of at-risk students in a public high school of choice, as evidenced by significant gains in achievement on the standards-based Mathematics subtest of the FCAT and final academic grades in Algebra I. The guiding rationale for this approach is captured in the Secretary's Commission on Achieving Necessary Skills (SCANS) report of 1992 that resulted in school-to-work initiatives (United States Department of Labor). Also, the charge for educational reform has been codified at the state level as Educational Accountability Act of 1971 (Florida Statutes, 1995) and at the national level as embodied in the No Child Left Behind Act of 2001. A particular focus of educational reform is low performing, at-risk students. ^ This dissertation explored the effects of a context-based curricular reform designed to enhance the content of Algebra I content utilizing a research design consisting of two delivery models: a traditional content-based course; and, a thematically structured, content-based course. In this case, the thematic element was business education as there are many advocates in career education who assert that this format engages students who are often otherwise disinterested in mathematics in a relevant, SCANS skills setting. The subjects in each supplementary course were ninth grade students who were both low performers in eighth grade mathematics and who had not passed the eighth grade administration of the standards-based FCAT Mathematics subtest. The sample size was limited to two groups of 25 students and two teachers. The site for this study was a public charter school. Student-generated performance data were analyzed using descriptive statistics. ^ Results indicated that contrary to the beliefs held by many, contextual presentation of content did not cause significant gains in either academic performance or test performance for those in the experimental treatment group. Further, results indicated that there was no meaningful difference in performance between the two groups. ^

The conflict resolution behaviors of occupational therapy students as a function of the personality types, demographic characteristics and contextual factors

Interpersonal conflicts have the potential for detrimental consequences if not managed successfully. Understanding the factors that contribute to conflict resolution has implications for interpersonal relationships and the workplace. Researchers have suggested that personality plays an important and predictable role in conflict resolution behaviors (Chanin & Schneer, 1984; Kilmann & Thomas, 1975; Mills, Robey & Smith, 1985). However, other investigators have contended that contextual factors are important contributors in triggering the behavioral responses (Shoda & Mischel, 2000; Mischel & Shoda, 1995). The purpose of this study was to investigate the relationships among personality types, demographic characteristics and contextual factors on the conflict resolution behaviors reported by graduate occupational therapy students (n = 125). ^ The study design was correlational. The Myers Briggs Type Indicator (MBTI) and the Thomas-Kilmann (MODE) Instrument were used to establish the personality types and the context independent conflict resolution behaviors respectively. The effects of contextual factors of task vs. relationship and power were measured with the Conflict Case Scenarios Questionnaire (CCSQ). One-way ANOVA and linear regression procedures were used to test the relationships between personality types and demographic characteristics with the context independent conflict behaviors. Chi-Square procedures of the personality types by contextual conditions ascertained the effects of contexts in modifying the resolution modes. Descriptive statistics established a profile of the sample. ^ The results of the hypotheses tests revealed significant relationships between the personality types of feeling-thinking and sensing-intuition with the conflict resolution behaviors. The contextual attributes of task vs. relationship orientation and of peer vs. supervisor relationships were shown to modify the conflict behaviors. Furthermore, demographic characteristics of age, gender, GPA and educational background were shown to have an effect on the conflict resolution behaviors. The knowledge gained has implications for students' training, specifically understanding their styles and use of effective conflict resolution strategies. It also contributes to the knowledge on management approaches and interpersonal competencies and how this might facilitate the students' transition to the clinical role. ^

Assessing administrative and political factors in implementing a living wage ordinance

Since 2000, the number of living wage ordinances has steadily increased throughout the country. While most of the current research has focused on the beneficial outcomes of living wages, little has been published on their administrative practices. To address this shortcoming, this study focused on the identification of key administrative and political factors involved impacting the implementation of living wage ordinances in Miami-Dade and Broward Counties. The study utilized a triangulation of interviews, surveys, and direct observation. The author conducted interviews of administrators and members of the living wage oversight boards in both counties and observed the monthly meetings held by each county's oversight board from January 2006 to June 2007. These findings were buttressed with a national survey of senior staff in other living wage communities. The study utilized descriptive statistics, Chi Square, Cronbach's Alpha, and Spearman's Rank Correlation Coefficient (Spearman's rho). Interviews indicated that administrators in Dade and Broward are seriously under-staffed and budgeted. Ambiguities in the enabling ordinances have lead to loopholes that undermine implementation and accountability for participating contractors. Survey results showed that policy ambiguity, organizational politics, and a lack of organizational capacity were significant negative factors in the implementation process while an organizational culture emphasizing consistent enforcement was a positive factor. Without the proper inputs, an organization hinders itself from meeting its outputs and outcomes. This study finds that Broward and Miami-Dade Counties do not provide the necessary administrative support to implement a living wage effectively – in stark contrast to the high hopes and strong political support behind their passage. For a living wage to succeed, it first needs an organizational culture committed to providing the necessary resources for implementation as well as transparent, consistent accountability mechanisms.

Human resource development professionals' perceptions about the Academy of Human Resource Development Standards on Ethics and Integrity

Professional standards of ethics proclaim the core values of a profession, describe expected professional duties and responsibilities, and provide a framework for ethical practice and ethical decision-making. The purpose of this mixed, quantitative and qualitative, survey study was to examine HRD professionals' perceptions about the AHRD Standards on Ethics and Integrity, how HRD professionals used the Standards for research and decision-making, and the extent to which the Standards provided guidance for ethical decision-making. Through an on-line survey instrument, 182 members of AHRD were surveyed. The open-ended questions were analyzed using thematic analysis to expand on, inform, and support the quantitative findings. The close-ended questions were analyzed with frequency distributions, descriptive statistics, cross tabulations, and Spearman rank correlations. The results showed a significant relationship between (a) years of AHRD membership and level of familiarity with the Standards, (b) years of AHRD membership and use of the Standards for research, and (c) level of familiarity with the Standards and use of the Standards for research. There were no significant differences among scholars, scholar practitioners, practitioners, and students regarding their perceptions about the Standards. The results showed that the Standards were not well known or widely used. Nevertheless, the results indicated overall positive perceptions about the Standards. Seventy percent agreed that the Standards provided an appropriate set of ethical principles and reflected respondents' own standards of conduct. Seventy-eight percent believed that the Standards were important for defining HRD as a profession and 54% believed they were important for developing a sense of belonging to the HRD profession. Fifty-one percent believed the Standards should be enforceable and 61% agreed members should sign the membership application form showing willingness to adhere to the Standards. Seventy-seven percent based work-related ethical decisions on personal beliefs of right and wrong and 56% on established professional values and rules of right and wrong. The findings imply that if the professional standards of ethics are to influence the profession, they should be widely publicized and discussed among members, they should have some binding power, and their use should be encouraged.

Maltreatment, psychiatric symptoms and human immunodeficiency virus/sexual transmitted infection risk behavior among youth with alcohol and other drug use problems: A person-centered analysis

Multi-problem youth undergoing treatment for substance use problems are at high behavioral risk for exposure to sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Specific risk factors include childhood adversities such as maltreatment experiences and subsequent forms of psychopathology. The current study used a person-centered analytical approach to examine how childhood maltreatment experiences were related to patterns of psychiatric symptoms and HIV/STI risk behaviors in a sample of adolescents (N = 408) receiving treatment services. Data were collected in face-to-face interviews at two community-based facilities. Descriptive statistics and Latent Profile Analysis (LPA) were used to (a) classify adolescents into groups based on past year psychiatric symptoms, and (b) examine relations between class membership and forms of childhood maltreatment experiences, as well as past year sexual risk behavior (SRB). ^ LPA results indicated significant heterogeneity in psychiatric symptoms among the participants. The three classes generated via the optimal LPA solution included: (a) a low psychiatric symptoms class, (b) a high alcohol symptoms class and (c) a high internalizing symptoms class. Class membership was associated significantly with adolescents’ self-reported scores for childhood sexual abuse and emotional neglect. ANOVAs documented significant differences in mean scores for multiple indices of SRB indices by class membership, demonstrating differential risk for HIV/STI exposure across classes. The two classes characterized by elevated psychiatric symptom profiles and more severe maltreatment histories were at increased behavioral risk for HIV/STI exposure, compared to the low psychiatric symptoms class. The high internalizing symptoms class reported the highest scores for most of the indices of SRB assessed. The heterogeneity of psychiatric symptom patterns documented in the current study has important implications for HIV/STI prevention programs implemented with multi-problem youth. The results highlight complex relations between childhood maltreatment experiences, psychopathology and multiple forms of health risk behavior among adolescents. The results underscore the importance of further integration between substance abuse treatment and HIV/STI risk reduction efforts to improve morbidity and mortality among vulnerable youth. ^

Managing small-medium cities in a time of globalization: Experiences and evidence from Florida's public managers

This study examines how public management practitioners in small and medium-sized Florida cities perceive globalization and its impact on public management practice. Using qualitative analysis, descriptive statistics and factor analysis methods, data obtained from a survey and semi-structured interviews were studied to comprehend how public managers view the management and control of their municipalities in a time of globalization. The study shows that the public managers’ perceptions of globalization and its impact on public management in Florida’s small-medium cities are nuanced. Whereas some public managers feel that globalization has significant impacts on municipalities’ viability, others opine that globalization has no local impact. The study further finds that globalization processes are perceived as altering the public management functions of decision-making, economic development and service delivery in some small-medium cities in Florida as a result of transnational shifts, rapidly changing technologies, and municipalities’ heightened involvement in the global economy. The study concludes that the globalization discourse does not resonate among some public managers in Florida’s small-medium cities in ways implied in extant literature.

Pressure ulcers and nutritional deficits in elderly long-term care patients: Effects of a comprehensive nutritional program on pressure ulcer healing, length of hospital stay and charges to patients

The elderly are at the highest risk of developing pressure ulcers that result in prolonged hospitalization, high health care costs, increased mortality, and decreased quality of life. The burden of pressure ulcers will intensify because of a rapidly increasing elderly population in the United States (US). Poor nutrition is a major predictor of pressure ulcer formation. The purpose of this study was to examine the effects of a comprehensive, interdisciplinary nutritional protocol on: (1) pressure ulcer wound healing (2) length of hospital stays, and (3) charges for pressure ulcer management. Using a pre-intervention/post intervention quasi-experimental design the study sample was composed of 100 patients 60 years or older, admitted with or acquiring a pressure ulcer. A pre-intervention group (n= 50) received routine pressure ulcer care (standard diet, dressing changes, and equipment). A post-intervention group received routine care plus an interdisciplinary nutrition intervention (physical therapy, speech therapy, occupational therapy, added protein and calories to the diet). Research questions were analyzed using descriptive statistics, frequencies, Chi-Square Tests, and T-tests. Findings indicated that the comprehensive, interdisciplinary nutritional protocol had a significant effect on the rate of wound healing in Week3 and Week4, total hospital length of stay (pre-intervention M= 43.2 days, SD=31.70 versus M=31.77, SID-12.02 post-intervention), and pressure ulcer length of stay (pre-intervention 25.28 days, SD5.60 versus 18.40 days, SD 5.27 post-intervention). Although there was no significant difference in total charges for the pre-intervention group ($727,245.00) compared to the post-intervention group ($702,065.00), charges for speech (m=$5885.12, SD=$332.55), pre albumin (m=$808.52,SD= $332.55), and albumin($278 .88, SD=55.00) were higher in the pre-intervention group and charges for PT ($5721.26, SD$3655.24) and OT($2544 .64, SD=1712.863) were higher in the post-intervention group. Study findings indicate that this comprehensive nutritional intervention was effective in improving pressure ulcer wound healing, decreasing both hospital length of stay for treatment of pressure ulcer and total hospital length of stay while showing no significant additional charges for treatment of pressure ulcers.

Low-income first time mothers: Effects on advanced practice nurse (APN) follow up telephone calls on maternal and infant health and health care charges

The United States has over 4 million births annually. Currently healthy women with non-complicated deliveries receive little to no routine postpartum support when discharged from the hospital. This is especially problematic if mothers are first time mothers, poor, have language barriers and little to no social support after giving birth. The purpose of this randomized clinical trial was to compare maternal and infant health outcomes, and health care charges between 2 groups of mothers and newborns. A control ( n = 69) group received routine posthospital discharge care. An intervention group (n = 70) received routine posthospital discharge care plus follow up telephone calls by advanced practice nurses (APNs) on days 3,7,14,21,28 and week 8. Both groups were followed for the first 8 weeks posthospital discharge following delivery to examine maternal health outcomes (perceived maternal stress, social support and perceived maternal physical health), infant health outcomes (routine medical follow up visits immunizations, weight gain), morbidity (urgent care visits, emergency room visits, rehospitalizations), health care charges (urgent care visits, emergency room visits, rehospitalizations) in both groups and charges for APN follow up in the intervention group only. Data were analyzed using descriptive statistics and two-sample t-tests. Study findings indicated that intervention group had significantly lower perceived maternal stress, significantly higher rating of perceived maternal health and higher levels of social support and by the end of the 2nd month posthospital discharge compared to control group mothers. Infants in the intervention group had: increased number of immunizations; fewer emergency room visits; and 1 infant rehospitalization compared to 3 infant rehospitalizations in the control group. The intervention groups' health care charges were significantly lower compared to the control group $14,333/$497 vs. $70,834/$1,068. These study results indicate that an intervention of APN follow up telephone calls in this sample of first time low-income culturally diverse mothers was an effective, safe, low cost, easy to apply intervention which improved mothers' and infants' health outcomes and reduced healthcare charges.