Adherence to treatment in children and adolescents with cystic fibrosis:a cross-sectional, multi-method study investigating the influence of beliefs about treatment and parental depressive symptoms

Background: Adherence to treatment is often reported to be low in children with cystic fibrosis. Adherence in cystic fibrosis is an important research area and more research is needed to better understand family barriers to adherence in order for clinicians to provide appropriate intervention. The aim of this study was to evaluate adherence to enzyme supplements, vitamins and chest physiotherapy in children with cystic fibrosis and to determine if any modifiable risk factors are associated with adherence. Methods: A sample of 100 children (≤18 years) with cystic fibrosis (44 male; median [range] 10.1 [0.2-18.6] years) and their parents were recruited to the study from the Northern Ireland Paediatric Cystic Fibrosis Centre. Adherence to enzyme supplements, vitamins and chest physiotherapy was assessed using a multi-method approach including; Medication Adherence Report Scale, pharmacy prescription refill data and general practitioner prescription issue data. Beliefs about treatments were assessed using refined versions of the Beliefs about Medicines Questionnaire-specific. Parental depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Results: Using the multi-method approach 72% of children were classified as low-adherers to enzyme supplements, 59% low-adherers to vitamins and 49% low-adherers to chest physiotherapy. Variations in adherence were observed between measurement methods, treatments and respondents. Parental necessity beliefs and child age were significant independent predictors of child adherence to enzyme supplements and chest physiotherapy, but parental depressive symptoms were not found to be predictive of adherence. Conclusions: Child age and parental beliefs about treatments should be taken into account by clinicians when addressing adherence at routine clinic appointments. Low adherence is more likely to occur in older children, whereas, better adherence to cystic fibrosis therapies is more likely in children whose parents strongly believe the treatments are necessary. The necessity of treatments should be reinforced regularly to both parents and children.

BOWL:augmenting the semantic web with beliefs

As the Semantic Web is an open, complex and constantly evolving medium, it is the norm, but not exception that information at different sites is incomplete or inconsistent. This poses challenges for the engineering and development of agent systems on the Semantic Web, since autonomous software agents need to understand, process and aggregate this information. Ontology language OWL provides core language constructs to semantically markup resources on the Semantic Web, on which software agents interact and cooperate to accomplish complex tasks. However, as OWL was designed on top of (a subset of) classic predicate logic, it lacks the ability to reason about inconsistent or incomplete information. Belief-augmented Frames (BAF) is a frame-based logic system that associates with each frame a supporting and a refuting belief value. In this paper, we propose a new ontology language Belief-augmented OWL (BOWL) by integrating OWL DL and BAF to incorporate the notion of confidence. BOWL is paraconsistent, hence it can perform useful reasoning services in the presence of inconsistencies and incompleteness. We define the abstract syntax and semantics of BOWL by extending those of OWL. We have proposed reasoning algorithms for various reasoning tasks in the BOWL framework and we have implemented the algorithms using the constraint logic programming framework. One example in the sensor fusion domain is presented to demonstrate the application of BOWL.

Learner support and discovery in a virtual non-judgmental environment

This thesis is a qualitative case study that draws upon a grounded genre analysis approach situated within the social constructivist paradigm. The study describes the various obligatory, desired, and optional moves used by post-graduate students as they interacted within an online, non-judgmental environment in order to seek solutions to issues they were experiencing with their research projects or teaching. The postgraduate students or case participants met individually online with me at pre-arranged times to take part in Instant Messenger Cooperative Development (IMCD) (Boon, 2005) 30-minute to one hour sessions via the text-chat function of Skype. Participants took on the role of ‘Explorer’ in order to articulate their thoughts and ideas about their research. I took on the role of ‘Understander’ to provide support to each Explorer by reflecting my understanding of the ongoing articulations as the Explorers investigated their specific issues, determined possible ways to overcome them, made new discoveries, and formulated plans of action regarding the best way for them to move forward. The description of generic moves covers 32 IMCD sessions collected over a threeyear period (2009-2012) from 10 different participants (A-J). Data collected is drawn from live IMCD sessions, field notes, and post-session email feedback from participants. In particular, the thesis focuses on describing the specific generic moves of Explorers within IMCD sessions as they seek satisfactory resolutions to particular research or pedagogic puzzles. It also provides a detailed description of a longitudinal case (Participant A – four sessions), a one-session case (Participant B – one session), and an outlier case in which the Explorer underwent a negative IMCD experience. The thesis concludes by arguing that IMCD is a highly effective tool that helps facilitate the research process for both distance-learning and on-campus students and has the potential to be utilized across all disciplines at the tertiary level.

Every hierarchy of beliefs is a type

When modeling game situations of incomplete information one usually considers the players’ hierarchies of beliefs, a source of all sorts of complications. Harsányi (1967-68)’s idea henceforth referred to as the ”Harsányi program” is that hierarchies of beliefs can be replaced by ”types”. The types constitute the ”type space”. In the purely measurable framework Heifetz and Samet (1998) formalize the concept of type spaces and prove the existence and the uniqueness of a universal type space. Meier (2001) shows that the purely measurable universal type space is complete, i.e., it is a consistent object. With the aim of adding the finishing touch to these results, we will prove in this paper that in the purely measurable framework every hierarchy of beliefs can be represented by a unique element of the complete universal type space.

Cognitive dissonance and the effect of acceptance of methodology, beliefs about religion, religious orientation, and dogmatism on the success of university students in a religious studies course

The problem investigated was negative effects on the ability of a university student to successfully complete a course in religious studies resulting from conflict between the methodologies and objectives of religious studies and the student's system of beliefs. Using Festinger's theory of cognitive dissonance as a theoretical framework, it was hypothesized that completing a course with a high level of success would be negatively affected by (1) failure to accept the methodologies and objectives of religious studies (methodology), (2) holding beliefs about religion that had potential conflicts with the methodologies and objectives (beliefs), (3) extrinsic religiousness, and (4) dogmatism. The causal comparative method was used. The independent variables were measured with four scales employing Likert-type items. An 8-item scale to measure acceptance of the methodologies and objectives of religious studies and a 16-item scale to measure holding of beliefs about religion having potential conflict with the methodologies were developed for this study. These scales together with a 20-item form of Rokeach's Dogmatism Scale and Feagin's 12-item Religious Orientation Scale to measure extrinsic religiousness were administered to 144 undergraduate students enrolled in randomly selected religious studies courses at Florida International University. Level of success was determined by course grade with the 27% of students receiving the highest grades classified as highly successful and the 27% receiving the lowest grades classified as not highly successful. A stepwise discriminant analysis produced a single significant function with methodology and dogmatism as the discriminants. Methodology was the principal discriminating variable. Beliefs and extrinsic religiousness failed to discriminate significantly. It was concluded that failing to accept the methodologies and objectives of religious studies and being highly dogmatic have significant negative effects on a student's success in a religious studies course. Recommendations were made for teaching to diminish these negative effects.

Beliefs and attitudes of nurses regarding visitation in the pediatric intensive care unit

The purpose of this study was to investigate the beliefs and attitudes of nurses regarding the effects of visitation in pediatric intensive care units (PICU).^ Questionnaires were used to gather data from nurses (n = 48) in four study sites. Data were analyzed according to the Theory of Reasoned Action.^ A predominant theme among the beliefs was that visitation should be individualized. It was found that PICU nurses have more positive attitudes regarding traditional visitation as opposed to open visitation (p $<$.01). Significant relationships were found between nurses' years of education and attitudes toward traditional (p $<$.01) and open (p $<$.05) visitation.^ In light of the literature suggesting the positive effects of open visitation, it appears that PICU nurses' attitudes may present a barrier when implementing open policies. Since years of education shows a positive correlation with nurses' attitudes, educational intervention may be helpful in overcoming this obstacle. ^

Health beliefs and health care options of disparate black communities in the United States

According to the 1999 U.S. Census, there were approximately thirty-three million African Americans and approximately 1.8 million non-Hispanic black immigrants in the United States. The 1997 U.S. Census estimated that there were as many as 554,000 foreign-born Haitians and 505,000 foreign-born Jamaicans living in the United States, mainly residing in Florida and New York. The U.S. Census claims that blacks are one of the largest emerging ethnic groups in America constituting at least twelve percent of this country's population. Because of this increase, their specific health beliefs and health care options are increasingly nationally significant. ^ In the present intra-black and inter-ethnic study, two hundred seventy African Americans, Haitian immigrants, and Jamaican immigrants residing in South Florida were quantitatively and qualitatively surveyed in order to investigate their health beliefs and health care options. According to the reviewed literature, the three black ethnic groups researched in this study have not been compared or contrasted before in relation to these beliefs and health care choices. ^ As was discovered by the present research, differing health beliefs and health care options were the cultural products of the ethnic differences of the researched communities. It was expected that differing health beliefs among the researched black groups might indicate disparate patterns of health care utilization of either western or non-western models. Additionally, it was projected that by investigating the health beliefs and the health care options of these emerging black ethnic groups, western health care providers in the United States could become better versed in medically servicing growing ethnically-disparate black populations. The study yielded results about the researched groups that supported major findings in the reviewed literature. The data were reported and examined, and theoretical generalizations from the data were discussed. The most important of these findings was that, within a race, health beliefs and health care options were determined by specific ethno-cultural variables dependent on national origins. ^

Use of conjoint analysis to examine beliefs related to the practice of early literacy instruction

The purpose of the study was to examine the relationship between teacher beliefs and actual classroom practice in early literacy instruction. Conjoint analysis was used to measure teachers' beliefs on four early literacy factors—phonological awareness, print awareness, graphophonic awareness, and structural awareness. A collective case study format was then used to measure the correspondence of teachers' beliefs with their actual classroom practice. ^ Ninety Project READS participants were given twelve cards in an orthogonal experimental design describing students that either met or did not meet criteria on the four early literacy factors. Conjoint measurements of whether the student is an efficient reader were taken. These measurements provided relative importance scores for each respondent. Based on the relative important scores, four teachers were chosen to participate in a collective case study. ^ The conjoint results enabled the clustering of teachers into four distinct groups, each aligned with one of the four early literacy factors. K-means cluster analysis of the relative importance measurements showed commonalities among the ninety respondents' beliefs. The collective case study results were mixed. Implications for researchers and practitioners include the use of conjoint analysis in measuring teacher beliefs on the four early literacy factors. Further, the understanding of teacher preferences on these beliefs may assist in the development of curriculum design and therefore increase educational effectiveness. Finally, comparisons between teachers' beliefs on the four early literacy factors and actual instructional practices may facilitate teacher self-reflection thus encouraging positive teacher change. ^

A study of teachers' espoused instructional beliefs

The purpose of this study was to investigate teachers' espoused instructional beliefs and whether they differed in relation to schools' socioeconomic status, extent of teachers' educational background, or extent of teachers' classroom experience. The study comprised a total of 242 Miami-Dade County public school educators who responded to a thirty-nine question Likert scale, Literacy Instructional Practices Questionnaire. Eighteen schools, three from each of the six regions, were purposively selected based on the socioeconomic status of students. Nine participants were interviewed using semi-standardized interview procedures and open-ended questioning techniques. ^ Multivariate Analysis of Variance (MANOVA) results revealed that teachers' espoused beliefs concerning the instruction of literacy and forces and influences affecting instruction do not significantly differ depending on schools' socioeconomic status, extent of teachers' educational background, or extent of teachers' classroom experience. The majority of teachers appear to follow a top-down generated direct instruction model. Generally, students are taught as a whole class and ability grouped for specific skill instruction utilizing commercially produced reading and language arts texts. ^ There was no evidence of a relationship between teachers' espoused beliefs concerning the model of instruction that they practice or teachers' espoused beliefs concerning research and its application to practice and the three independent variables. Interview data corroborated much of the information garnered through the questionnaire. However, interview participants espoused the belief that research did not influence their selection of instructional practices. ^ Although teachers perceive of themselves as eclectic in their espoused instructional beliefs, they appear to follow a skills based direct instruction pedagogy in practice. Much of what teachers believe constitutes effective practice, few researchers recommend, affirming the findings of Calderhead (1993) and the National Educational Research Policy and Priorities Board (U.S. Department of Education, 1998, p. 18) that “educators rarely know research, seek it out, or act in accordance with its results.” ^

Assessing the influence of organizational personality, applicants' need motivation, expectancy beliefs, and person-organization fit on applicant attraction

This research explored the thesis that organizational personality is related to applicants’ attraction to an organization through a process which involves need motivation, expectancy beliefs, and applicants’ perceptions of person-organization fit. Organizational personality may be defined as a collection of trait-like characteristics that individuals use to describe organizational practices, policies, values, and culture. Specifically, this research investigated the hypothesis that organizational personality information is useful to applicants because it helps individuals to determine their perceptions of fit. A sample of students (N = 198) and working adults (N = 198) participated in an online experiment. Findings indicated that individuals’ beliefs about the instrumentality of desirable work related outcomes are essential to determining their perceptions of fit and organizational attraction. Additionally, organizational personality perceptions interacted with need motivation to affect perceptions of fit and organizational attraction. For instance, perceptions of fit mediated the influence of the interaction between need for achievement and perceptions of innovativeness on organizational attraction. The interaction of need motivation and perceptions of organizational personality helped individuals to better determine their perceptions of fit and subsequent attraction toward organizations.^

Secondary school inclusion rates: The relationship between the training and beliefs of school site principals and the implementation of inclusion

Programs require strong support and guidance from those in leadership positions to ensure proper implementation (Fullen, 2001). Consequently, school site principals must rely on the training they have received to support them in making appropriate decisions. It is the school site principal’s leadership that is pivotal in the success of students with disabilities (DiPaola & Walther-Thomas, 2003; Monteith, 2000). In fact, the principal has a moral obligation to provide an environment that supports social justice in schools (Grogan & Andrews, 2002). The inclusion of students with disabilities does just that—it ensures that these students are not segregated to a “separate but equal” education. This study utilized a participant survey to collect data on principals’ beliefs and training in special education. This information was compared to the percentage of time students with disabilities spent with their non-disabled peers in the principals’ respective schools. An analysis was conducted to identify if a linear relationship exists between the selected variables and the inclusion percentages. Open-ended questions were included in the original survey which allowed for a thematic analysis of the responses. These responses were utilized to allow participants to further express their thoughts on the identified variables. Results indicated that there were no statistically significant relationships identified between the beliefs and training of secondary school site principals and the percentage of time that their students in special education spend with their non-disabled peers. Although the original research questions were not supported, further post hoc analysis indicated that the results obtained did support that the principals believed inclusion had a social benefit to students. Additional investigation into the academic benefits of inclusion is still needed. In addition, principals who indicated that they had some type of training in special education indicated a higher percentage that the individual student should be the focal point when making placement decisions. These results support the need for further research in the area of principal preparation programs and their relationships to the daily practice of school site principals.

Secondary Teachers’ Knowledge, Beliefs, and Self-Efficacy to Teach Reading in the Content Areas: Voices Following Professional Development

This study explored 24 content area teachers’ knowledge, beliefs, and self-efficacy about teaching reading in the content areas at the end of a state-wide professional development experience. The findings suggest that the participating teachers held positive beliefs, gained valuable knowledge, and were confident about teaching reading in their content areas.

The Food Service Industry: Beliefs Held by Academics

In his study - The Food Service Industry: Beliefs Held by Academics - by Jack Ninemeier, Associate Professor, School of Hotel, Restaurant and Institutional Management at Michigan State University, Associate Professor Ninemeier initially describes his study this way: “Those in the academic sector exert a great deal of influence on those they are training to enter the food service industry. One author surveyed educational institutions across the country to ascertain attitudes of teachers toward various segments of the industry.” Those essential segments of the industry serve as the underpinnings of this discussion and are four-fold. They are lodging, institutional, multi-unit, and single-unit properties. For each segment the analysis addressed factors relating to Marketing, management and operating concerns: Marketing, operations, fiscal management, innovation, future of the segment Employee-related concerns: quality of work life, training/education opportunities, career opportunities The study uses a survey of academicians as a guide; they point to segments of the food service industry students might be inclined to enter, or even ignore. The survey was done via a questionnaire sent from the campus of the School of Hotel, Restaurant and Institutional Management at Michigan State University to 1850 full-time faculty members in two and four-year hospitality programs in the United States. Through the survey, Ninemeier wishes to reasonably address specific problems now confronting the food service industry. Those problems include but are not limited to: reducing employee turnover, retaining staff, increasing productivity and revenue, and attracting new staff. “Teachers in these programs are, therefore, an important plank in industry's platform designed to recruit students with appropriate background knowledge and interest in their operations,” Ninemeier says. Your author actually illustrates the survey results, in table form. The importance to an employee, of tangibles and intangibles such as morale, ego/esteem, wages, and benefits are each explored through the survey. According to the study, an interesting dichotomy exists in the institutional property element. Although, beliefs the academics hold about the institutional element suggest that it offers low job stress, attractive working conditions, and non-demanding competitive pressures, the survey and Ninemeier also observe: “Academics do not believe that many of their graduates will enter the institutional segment.” “If academic beliefs are incorrect, an educational program to educate academics about management and employee opportunities in the segment may be in order,” Ninemeier waxes philosophically.

Waking the sleeping giant: Beliefs of Brazilian and *American teachers concerning liberation curriculum

The school curriculum is a matter mandated by the educational system rather than determined by the school stakeholders of a community, as Freire (1993) suggests. At the present time, one significant vision of school is challenging the current order of curriculum practice. It focuses on school as a liberating agency grounded on the belief that the abilities to access information and to think critically about it will educate an individual capable of making independent decisions. This dissertation investigates teacher's beliefs concerning curriculum. It was assumed that there is a discrepancy between what has been the position proposed by critical theorists including Freire (1998a, 1993); Apple (1979); Giroux (1998), and the position on curriculum which school systems are typically advancing. ^ There were four purposes of this study. The major purpose of this study was to determine whether or not Brazilian and American Teachers believe that a school curriculum based on Freirean principles could be implemented in the schools in which they worked. Also, this study sought to determine the differences found between teachers' beliefs in the Brazilian and American contexts. Another purpose was to determine how Brazilian and American teachers justify their beliefs and actions when these may represent conflicting values. Finally, this study sought to determine if these teachers believe that the curriculum is in need of change or if they accept the current curriculum as adequate. This study consisted of quantitative and qualitative data collection through multiple methods involving surveys and interviews. The study involved 171 teachers (88 Brazilian and 83 American) from multiple settings with the majority working for public systems. Overall, it seems that Brazilian and American teachers believe that a curriculum based on Freirean principles of education can be implemented in their schools, if ongoing education is provided. The majority of Brazilian teachers believe a curriculum change is necessary while half of the American teachers believe a curriculum change is needed and the other half seems to believe curriculum is adequate. Teachers explain that it is hard to implement a curriculum they believe to be most appropriate for students because the current curriculum is mandated by the school system or by national guidelines. The majority of Brazilian teachers and those American teachers who believed a curriculum change is necessary explained their rationale for change in terms of social justice, problem-solving, collective work, student-centered and context-based curriculum. American teachers, who believed that the curriculum is adequate, explained that they are satisfied with their student's achievements. They stated that their students are doing well on tests and are learning what is required. ^

An investigation of parents' and children's beliefs of early literacy acquisition from a cross -cultural perspective

It has been reported that the cultural-historical experiences of ethnic group members can play a role in the literacy beliefs of those members. Socioeconomic conditions can also influence the belief system of the groups' constituents. This study investigated parents' and children's beliefs pertaining to early literacy acquisition as related to the ethnicity and socioeconomic status (SES) of the participants. The objectives were to determine (a) the differential patterns regarding emergent literacy and traditional skills approaches as they interact with ethnicity and SES and (b) the correspondence between parents and children's beliefs about literacy acquisition. ^ The study was conducted with 152 parents (38 low-income Hispanic, 38 middle-income Hispanic, 38 low-income African-American, and 38 middle-income African-American) and 36 of their 3-, 4-, or 5-year-old children (18 male and 18 female). ^ The parents were asked to check those items with which they agreed on a survey that consisted of an equal number of items from the traditional skills-based and emergent literacy orientations. These responses were used to determine the differences and interaction by ethnicity and SES. The children responded to open-ended questions related to the instruction of reading and writing skills. The parents' responses and children's answers were compared to ascertain the matching parent-child dyads by ethnicity and SES. ^ An item analysis was conducted to strengthen the internal reliability consistency coefficient of the traditional skills-based and emergent literacy scales as measured by the Cronbach Alpha. ^ A two-way multivariate analysis of variance (MANOVA) revealed a significant difference in traditional skill-based beliefs for the low-income African-American and Hispanic parents. There were no significant findings for the parents' traditional skill based or emergent literacy beliefs based on ethnicity, for the interaction between ethnicity and SES, or for the relationship between parents' and children's literacy beliefs by ethnicity and SES. ^ It can be concluded that low-income African-American and Hispanic parents believe in the traditional skills approach, indicating that these parents find it necessary for children to have sufficient school readiness skills prior to learning to read or write. In addition, the parent and child dyads had a strong tendency toward emergent literacy beliefs. ^