The effects of peer teaching of infant massage on general elf-efficacy and mother infant attachment among mothers in a residential rehabilitation facility for drug addiction and substance abuse

Approximately 200 million people, 5% aged 15-64 worldwide are illicit drug or substance abusers (World Drug Report, 2006). Between 2002 and 2005, an average of 8.2% of 12 year olds and older in the Miami, Fort Lauderdale metropolitan areas used illicit drugs (SAMHSA, 2007). Eight percent of pregnant women, aged 15 to 25, were more likely to have used illicit drugs during pregnancy than pregnant women aged 26 to 44. Alcohol use was 9.8% and cigarette use was 18% for pregnant women aged 15 to 44 (SAMHSA, 2005). Approximately a quarter of annual birth defects are attributed to the exposure of drugs or substance abuse in utero (General Accounting Office, 1991). Physical, psychological and emotional challenges may be present for the illicit drug/substance abuse (ID/SA) mother and infant placing them at a disadvantage early in their relationship (Shonkoff & Marshall, 1990). Mothers with low self efficacy have insecurely attached infants (Donovan, Leavitt, & Walsh, 1987). As the ID/SA mother struggles with wanting to be a good parent, education is needed to help her care for her infant. In this experimental study residential rehabilitating ID/SA mothers peer taught infant massage. Massage builds bonding/attachment between mother and infant (Reese & Storm, 2008) and peer teaching is effective because participants have faced similar challenges and speak the same language (Boud, Cohen, & Sampson 2001). Quantitative data were collected using the General Self-Efficacy and Maternal Attachment Inventory-Revised Scale before and after the 4-week intervention program. A reported result of this study was that empowering ID/SA mothers increased their self-efficacy, which in turn allowed the mothers to tackle challenges encountered and created feelings of being a fit mother to their infants. This research contributes to the existing database promoting evidence-based practice in drug rehabilitation centers. Healthcare personnel, such as nurse educators and maternal-child health practitioners, can develop programs in drug rehabilitation centers that cultivate an environment where the ID/SA rehabilitating mothers can peer teach each other, while creating a support system. Using infant massage as a therapeutic tool can develop a healthy infant and nurture a more positive relationship between mother and infant.

Use of the DACUM process in the identification and verification of competencies for the medical administrative assistant

Medicine has changed in recent years. Medicare will all of its rules and regulations, worker's compensation laws, managed care and the trend toward more and larger group practices all contributed to the creation of an extremely structured regulatory environment which in turn demanded highly trained medical administrative assistants.^ The researcher noted three primary problems in the identification of competencies for the medical administrative assistant position: A lack of curricula, diverse roles, and a complex environment which has undergone radical change in recent years and will continue to evolve. Therefore, the purposes of the study were to use the DACUM process to develop a relevant list of competencies required by the medical administrative assistant practicing in physicians' offices in South Florida; determine the rank order of importance of each competency using a scale of one to five; cross-validate the DACUM group scores with a second population who did not participate in the DACUM process; and establish a basis for a curriculum framework for an occupational program.^ The DACUM process of curriculum development was selected because it seemed best suited to the need to develop a list of competencies for an occupation for which no programs existed. A panel of expert medical office administrative staff was selected to attend a 2-day workshop to describe their jobs in great detail. The panel, led by a trained facilitator, listed major duties and the respective tasks of their job. Brainstorming techniques were used to develop a consensus.^ Based upon the DACUM workshop, a survey was developed listing the 8 major duties and 71 tasks identified by the panel. The survey was mailed to the DACUM group and a second, larger population who did not participate in the DACUM. The survey results from the two groups were then compared. The non-DACUM group validated all but 3 of the 71 tasks listed by the DACUM panel. Because the three tasks were rated by the second group as at least "somewhat important" and rated "very important" by the DACUM group, the researcher recommended the inclusion of all 71 tasks in program development for this occupation. ^

The Effects of Peer Teaching of Infant Massage on General Self-Efficacy and Mother Infant Attachment Among Mothers in a Residential Rehabilitation Facility for Drug Addiction and Substance Abuse

Approximately 200 million people, 5% aged 15-64 worldwide are illicit drug or substance abusers (World Drug Report, 2006). Between 2002 and 2005, an average of 8.2% of 12 year olds and older in the Miami, Fort Lauderdale metropolitan areas used illicit drugs (SAMHSA, 2007). Eight percent of pregnant women, aged 15 to 25, were more likely to have used illicit drugs during pregnancy than pregnant women aged 26 to 44. Alcohol use was 9.8% and cigarette use was 18% for pregnant women aged 15 to 44 (SAMHSA, 2005). Approximately a quarter of annual birth defects are attributed to the exposure of drugs or substance abuse in utero (General Accounting Office, 1991). Physical, psychological and emotional challenges may be present for the illicit drug/substance abuse (ID/SA) mother and infant placing them at a disadvantage early in their relationship (Shonkoff & Marshall, 1990). Mothers with low self efficacy have insecurely attached infants (Donovan, Leavitt, & Walsh, 1987). As the ID/SA mother struggles with wanting to be a good parent, education is needed to help her care for her infant. In this experimental study residential rehabilitating ID/SA mothers peer taught infant massage. Massage builds bonding/attachment between mother and infant (Reese & Storm, 2008) and peer teaching is effective because participants have faced similar challenges and speak the same language (Boud, Cohen, & Sampson 2001). Quantitative data were collected using the General Self-Efficacy and Maternal Attachment Inventory-Revised Scale before and after the 4-week intervention program. A reported result of this study was that empowering ID/SA mothers increased their self-efficacy, which in turn allowed the mothers to tackle challenges encountered and created feelings of being a fit mother to their infants. This research contributes to the existing database promoting evidence-based practice in drug rehabilitation centers. Healthcare personnel, such as nurse educators and maternal-child health practitioners, can develop programs in drug rehabilitation centers that cultivate an environment where the ID/SA rehabilitating mothers can peer teach each other, while creating a support system. Using infant massage as a therapeutic tool can develop a healthy infant and nurture a more positive relationship between mother and infant.

The effect of a breakfast program on nutritional status, quality of life, and health care use among frail homebound older adults

The population of older adults is rapidly increasing, creating a need for community services that assist vulnerable older adults in maintaining independence and quality of life. Recent evidence confirms the importance of food and nutrition in reaching this objective. The Elderly Nutrition Program (ENP) is part of a system of federally funded community based programs, authorized through the Older Americans Act. ENP services include the home-delivered meals program, which targets frail homebound older adults at nutritional risk. Traditionally, ENP services provide a noon meal 5 days/week. This study evaluated the impact of expanding the home-delivered meals service to include breakfast + lunch, on the nutritional status, quality of life and health care utilization of program participants. ^ This cross-sectional study compared 2 groups. The Breakfast group (n = 167) received a home-delivered breakfast + lunch, 5 days/week. The Comparison group (n = 214) received lunch 5 days/week. Participants, recruited from 5 ENP programs, formed a geographically, racially/ethnically diverse sample. Participants ranged in age from 60–100 years, they were functionally limited, at high nutritional risk, low income, and they lived alone and had difficulty shopping or preparing food. Participant data were collected through in-home interviews and program records. A 24-hour food recall and information on participant demographics, malnutrition risk, functional status, health care use, and applicable quality of life factors were obtained. Service and cost data were collected from program administrators. ^ Breakfast group participants had greater energy/nutrient intakes (p < .05), fewer health care contacts (p < .05), and greater quality of life measured as food security (p < .05) and fewer depressive symptoms (p < .05), than comparison group participants. These benefits were achieved for $1.30/person/day. ^ The study identified links from improvements in nutritional status to enhanced quality of life to diminished health care utilization and expenditures. A model of health, loneliness, food enjoyment, food insecurity, and depression as factors contributing to quality of life for this population, was proposed and tested (p < .01). ^ The breakfast service is an inexpensive addition to traditional home-delivered meals services and can improve the lives of frail homebound older adults. Agencies should be encouraged to expand meals programs to include a breakfast service. ^

A case study: Perceptions of the induction process of intern principals in Broward County Public Schools

The case study is a qualitative study of the perceptions of a purposeful sample of intern principal participants in Broward County Public School's 2001-2003 principal leadership induction program through survey, interview and document analysis of their experiences concerning their success or failure in achieving the position of principal. The study focused on constructs of professional and organizational socialization and instructional leadership that research suggests are vital and integrated components of the effective development of aspiring instructional leaders. ^ The findings revealed that purposeful mentoring, a variety of site placement, hands on practical experiences, in addition to the quality of experience measured by the number of years prior experience are positively reported to affect the degrees of success perceived by intern principals. The study validated the interrelatedness of the three constructs professional and organizational socialization and instructional leadership as components that are realized in the development process through formal and informal characteristics of socialization. The data gathered would be of benefit to principal leadership program designers to assist in their understanding of participants' successes and failures that influence individual needs based on their experience as perceived by this group. ^ Implications for further study are the need for better understanding of leadership development, continued reinforcement of best practices such as mentoring, site shadowing and coaching, clarification of the administrator's role, data analysis, curriculum implementation and student achievement. Organizations need to implement a common set of expectations, reasoning, attitudes, and understanding of purpose that guide behaviors. Recommendations are to design leadership induction programs to meet individual strengths and weaknesses not a one-size-fits-all program including a constructive and prescriptive two-way feedback system, select and assign mentors based on their expertise and candidate needs, varied site placements, develop skills to build collaborative relationships, and a standards based monitoring and assessment system to document program mastery and completion. ^

Assessing the effectiveness of the internationalization process in Higher Education Institutions: A case study of Florida International University

The purpose of this study was to examine a Higher Education Institution’s (HEI) process of internationalization. The theoretical model developed by Van Dijk and Miejer (1997) was used to review Florida International University (FIU)’s policy, support, and implementation dimensions and determine its position on the Internationalization Cube, and assess how FIU’s international activities fit into its different organizational processes. In addition, the study sought to shed light on student and faculty attitudes toward internationalization. Qualitative and quantitative data were collected from examining organizational documents, interviews, descriptive data on FIU’s international activities using the International Dimension Index, and the Student and Faculty Survey on Internationalization. FIU’s international activities results were analyzed in relation to a panel of experts’ item relevancy index. The Likert-type survey scales’ frequencies and percentages were calculated as well as Spearman Rho correlations between the survey’s three scales and demographic and experiences variables. The study found that FIU is located on position six of a possible eight positions on the Van Dijk and Meijer Internationalization Cube with the following characteristics: Priority Policy, One-Sided Support, and Structured Implementation toward internationalization. The analysis of FIU’s results on international activities showed that FIU exhibits all the activities considered to be strong indicators of internationalization but for position seven placement special attention is needed in the areas of foreign language study, international students, study abroad, faculty movement and involvement in international projects. The survey indicated students and faculty rated the Benefits of Internationalization highly but didn’t perceive strong institutional Support for Internationalization. Faculty age and offshore programs participation; student gender, race/ethnicity and class status; and for both, study abroad and knowledge of students travel grant had significant positive correlations with student and faculty attitudes. The study concluded that an association exists between FIU’s position on the Internationalization Cube and its international activities. Recommendations for policy, implementation, and future studies were made. It was concluded that advancing FIU’s position on the Cube will require adjustments in FIU’s policy, support and implementation dimensions. Differences in student and faculty views toward internationalization should be taken into account when planning internationalization efforts.

Assessment of the occurrence and potential effects of pharmaceuticals and personal care products in South Florida waters and sediments

A LLE-GC-MS method was developed to detect PPCPs in surface water samples from Big Cypress National Park, Everglades National Park and Biscayne National Park in South Florida. The most frequently found PPCPs were caffeine, DEET and triclosan with detected maximum concentration of 169 ng/L, 27.9 ng/L and 10.9 ng/L, respectively. The detection frequencies of hormones were less than PPCPs. Detected maximal concentrations of estrone, 17β-estradiol, coprostan-3-ol, coprostane and coprostan-3-one were 5.98 ng/L, 3.34 ng/L, 16.5 ng/L, 13.5 ng/L and 6.79 ng/L, respectively. An ASE-SPE-GC-MS method was developed and applied to the analysis of the sediment and soil area where reclaimed water was used for irrigation. Most analytes were below detection limits, even though some of analytes were detected in the reclaimed water at relatively high concentrations corroborating the fact that PPCPs do not significantly partition to mineral phases. An online SPE-HPLC-APPI-MS/MS method and an online SPE-HPLC-HESI-MS/MS method were developed to analyze reclaimed water and drinking water samples. In the reclaimed water study, reclaimed water samples were collected from the sprinkler for a year-long period at Florida International University Biscayne Bay Campus, where reclaimed water was reused for irrigation. Analysis results showed that several analytes were continuously detected in all reclaimed water samples. Coprostanol, bisphenol A and DEET's maximum concentration exceeded 10 μg/L (ppb). The four most frequently detected compounds were diphenhydramine (100%), DEET (98%), atenolol (98%) and carbamazepine (96%). In the study of drinking water, 54 tap water samples were collected from the Miami-Dade area. The maximum concentrations of salicylic acid, ibuprofen and DEET were 521 ng/L, 301 ng/L and 290 ng/L, respectively. The three most frequently detected compounds were DEET (93%), carbamazepine (43%) and salicylic acid (37%), respectively. Because the source of drinking water in Miami-Dade County is the relatively pristine Biscayne aquifer, these findings suggest the presence of wastewater intrusions into the delivery system or the onset of direct influence of surface waters into the shallow aquifer.

Perceptions of the Induction Process of Intern Principals in a Large Urban School District

This study presents perceptions of principals in a leadership induction program in a large urban school district in the southeastern United States. Qualitative research procedures were used to document experiences of principals. Theoretical constructs guiding the study were professional socialization, organizational socialization, and instructional leadership.

A descriptive study of the empowerment process of mothers of children who have disabilities

The purpose of this study was to examine the phenomenological aspect in the empowerment process of mothers of children with disabilities, and to determine if the coding categories used by Dunst & Trivette (1996) could be replicated. Three mothers of children with disabilities agreed to participate in the study. A semistructured interview was used to determine the specific events that lead to empowerment. Interviews were audio-taped and transcribed by the researcher. Fifteen coding categories and four majors themes of empowerment were identified. Triangulation was used to assure reliability and validity. The findings demonstrated that the coding stages of empowerment as outlined by Dunst & Trivette (1996) are reproducible, as well as the envisionment of the future for their children is the essence of empowerment for these mothers. Specific suggestions are made by which occupational therapists can facilitate the empowerment process of mothers who have children with disabilities.

Nursing case management : a new perspective to caring for patients with hip fracture

Nursing Case Management has motivated nurses to examine the effects of care provided to patients, and to devise means of improving this care. The success of this nursing care delivery model is well documented among a variety of acute and chronically ill patients. Utilizing nonparametric ANOVA for comparison of two means, this study investigates the outcome of the implementation of a nursingcase management model on an orthopedic unit of a local hospital. A convenience sample (N=149) of hip-fracture patients for two separate eight months charting periods were used. The first period was pre-case management and the second period was after the implementation of nursing managed care on the unit. Results suggested that nursing case management was effective in reducing the total length of hospital stay and post-operative days significantly.