Self -management behavior in patients with cystic fibrosis

Self-management is being promoted in cystic fibrosis (CF). However, it has not been well studied. Principal aims of this research were (1) to evaluate psychometric properties of a CF disease status measure, the NIH Clinical Score; (2) to develop and validate a measure of self-management behavior, the SMQ-CF scale, and (3) to examine the relation between self-management and disease status in CF patients over two years.^ In study 1, NIH Clinical Scores for 200 patients were used. The scale was examined for internal consistency, interrater reliability, and content validity using factor analysis. The Cronbach's alpha (.81) and interrater reliability (.90) for the total scale were high. General scale items were less reliable. Factor analysis indicated that most of the variance in disease status is accounted for by Factor 1 which consists of pulmonary disease items.^ The SMQ-CF measures the performance of CF self-management. Pilot testing was done with 98 CF primary caregivers. Internal consistency reliability, social desirability bias, and content validity using factor analysis were examined. Internal consistency was good (alpha =.95). Social desirability correlation was low (r =.095). Twelve factors identified were consistent with conceptual groupings of behaviors. Around two hundred caregivers from two CF centers were surveyed and multivariate analysis of variance was used to assess construct validity. Results confirmed expected relations between self-management, patient age, and disease status. Patient age accounted for 50% and disease status 18% of the variance in the SMQ-CF scale.^ It was hypothesized that self-management would positively affect future disease status. Data from 199 CF patients (control and education intervention groups) were examined. Models of hypothesized relations were tested using LISREL structural equation modeling. Results indicated that the relations between baseline self-management and Time 1 disease status were not significant. Significant relations were observed in self-management behaviors from time 1 to time 2 and patterns of significant relations differed between the two groups.^ This research has contributed to refinements in the ability to measure self-management behavior and disease status outcomes in cystic fibrosis. In addition, it provides the first steps in exploratory behavioral analysis with regard to self-management in this disease. ^

Predictors of benzodiazepine self -administration behavior in anxious patients

The purpose of this study was to examine factors that may be associated with benzodiazepine (BZ) self-administration and risks of dependence in anxious patients. Preliminary work included examination of psychosocial characteristics and subjective drug response as potential predictors of medication use. Fifty-five M, F patients with generalized anxiety or panic disorder participated in a 3-week outpatient Choice Procedure in which they self-medicated “as needed” with alprazolam (Alz) and placebo. Findings showed that a large amount of variance in alprazolam preference, frequency, and quantity of use could be predicted by measures of anxiety, drug liking, and certain personality characteristics. The primary study extended this work by examining whether individual differences in Alz sensitivity also predict patterns of use. Twenty anxious patients participated in the study, which required 11 weekly clinic visits. Ten of these also participated in a baseline assessment of HPA-axis function that involved 24-hour monitoring of cortisol and ACTH levels and a CRH Stimulation Test. This assessment was conducted on the basis of prior evidence that steroid metabolites exert neuromodulatory effects on the GABA A receptor and that HPA-axis function may be related to BZ sensitivity and long-term disability in anxious patients. Patients were classified as either HIGH or LOW users based on their p.r.n. patterns of Alz use during the first 3 weeks of the study. They then participated in a 4-week dose response trial in which they received prescribed doses of medication (placebo, 0.25, 0.5, and 1.0mg Alz), each taken TID for 1 week. The dose response trial was followed by a second 3-week Choice Procedure. Findings were not indicative of biological differences in Alz sensitivity between the HIGH and LOW users. However, the HIGH users had higher baseline anxiety and greater anxiolytic response to Alz than the LOW users. Anxiolytic benefits of p.r.n. and prescribed dosing were shown to be comparable, and patients' conservative patterns of p.r.n. medication use were not affected by the period of prescribed dosing. Although there was not strong evidence to suggest relationships between HPA-axis function and Alz use or sensitivity, interesting findings emerged about the relationship between HPA-axis function and anxiety. ^

Self-Injurious Behavior And Its Relationship To Eating Disorder Symptom Severity

Widely held clinical assumptions about self-harming eating disorder patients were tested in this project. Specifically, the present study had two aims: (1) to confirm research that suggests patients with self-injurious behavior exhibit greater severity in eating disorder symptomology; and (2) to document the treatment course for these patients (e.g. reported change in eating disorder attitudes, beliefs, and behaviors) from admission to discharge. Data from 43 participants who received treatment at a Partial Hospitalization Program (PHP) for Eating Disorders were used in the current study. The length of treatment required for study inclusion reflected mean lengths of stay (Williamson, Thaw, & Varnardo-Sullivan, 2001) and meaningful treatment lengths in prior research (McFarlane et al., 2013; McFarlane, Olmsted, & Trottier, 2008): five to eight weeks. Scores on the Eating Disorder Inventory-III (Garner, 2004) at the time of admission and discharge were compared. These results suggest that there are no significant differences between eating disordered patients who engage in self-injury and those who do not in terms of symptom severity or pathology at admission. The results further suggest that patients in both groups see equivalent reductions in symptoms from admission to discharge across domains and also share non-significant changes in emotional dysregulation over the course of treatment. Importantly, these results also suggest that general psychological maladjustment is higher at discharge for eating disordered patients who engage in self-injury.

Self-directed Learning in the Technological Age

Concerns arising out of technology often being used as an add-on to self-directed learning practices in the workplace and factors affecting such learning were investigated through a literature analysis. What is needed is an exploration of new possibilities of computational media on how self-directed learners think, create and learn.

Learning Behind Bars: Exploring Prison Educators’ Facilitation of Inmates’ Self-directed Learning through Garrison’s Model

Formal education programs in prisons have had success in reducing recidivism, but the introduction of informal learning can have additional benefits and longer lasting effects. This paper addresses recidivism and its effects on inmates and society at large and how prison educators can facilitate self-directed learning in prisons through Garrison’s model.

The development of a self-directed learning module for rural emergency nurses on pediatric diabetic ketoacidosis

Background: Newfoundland and Labrador has a high incidence of type 1 diabetes and diabetic ketoacidosis (DKA) is a complication of type 1 diabetes. A clinical practice guideline was developed for the treatment of pediatric diabetic ketoacidosis (DKA) to standardize care in all Emergency Departments and improve patient outcomes. Rural emergency nurses are requires to maintain their competency and acquire new knowledge as stated by the Association of Registered Nurses of Newfoundland and Labrador (ARNNL). Purpose: The purpose of this practicum was to develop a self-learning module for rural emergency nurses to increase their knowledge and understanding of the clinical practise guideline to assess, treat, and prevent pediatric ketoacidosis. Methods: Two methodologies were used in this practicum. A review of the literature and consultations with key stakeholders were completed. Results: The self-learning module created was composed of three units and focused on the learning needs of rural emergency nurses in the areas of assessment, treatment, and prevention of pediatric DKA. Conclusion: The goal of the practicum was to increase rural emergency nurses’ knowledge and implementation of the clinical practice guideline when assessing and treating children and families experiencing DKA to improve patient outcomes. A planned evaluation of the self-learning module will be conducted following dissemination of the module throughout the rural Emergency Departments.

THE ELEMENTARY TEACHERS’ PERCEPTIONS OF MOTIVATION FOR AND THE PRINCIPAL’S INFLUENCE ON THEIR ENGAGEMENT IN SELF-DIRECTED PROFESSIONAL DEVELOPMENT

All teachers participate in self-directed professional development (PD) at some point in their careers; however, the degree to which this participation takes place varies greatly from teacher to teacher and is influenced by the leadership of the school principal. The motivation behind why teachers choose to engage in PD is an important construct. Therefore, there is a need for better understanding of the leader’s role with respect to how and why teachers engage in self-directed professional development. The purpose of the research was to explore the elementary teachers’ motivation for and the school principal’s influence on their engagement in self-directed professional development. Three research questions guided this study: 1. What motivates teachers to engage in self-directed professional development? 2. What are the conditions necessary for promoting teachers’ engagement in self-directed professional development? 3. What are teachers’ perceptions of the principal’s role in supporting, fostering, encouraging, and sustaining the professional development of teachers? A qualitative research approach was adopted for this study. Six elementary teachers from one south-eastern Ontario school board, consisting of three novice and three more experienced teachers, provided their responses to a consistent complement of 14 questions. Their responses were documented via individual interviews, transcribed verbatim, and thematically analysed. The findings suggested that, coupled with the individual motivating influences, the culture of the school was found to be a conditional dynamic that either stimulated or dissuaded participation in self-directed PD. The school principal provided an additional catalyst or deterrence via relational disposition. When teachers felt their needs for competency, relatedness, and autonomy were satisfied, the conditions necessary to motivate teachers to engage in PD were fulfilled. A principal who personified the tenets of transformational leadership served to facilitate teachers’ inclinations to take on PD. A leadership style that was collaborative and trustful and allowed for personal autonomy was a dominant foundational piece that was critical for participant participation in self-directed PD. Finally, the principals were found to positively impact school climate by partaking in PD alongside teachers and ensuring there was a shared vision of the school so that teachers could tailor PD to parallel school interests.

Fostering postgraduate student engagement: online resources supporting self-directed learning in a diverse cohort

The research question for this study was: ‘Can the provision of online resources help to engage and motivate students to become self-directed learners?’ This study presents the results of an action research project to answer this question for a postgraduate module at a research-intensive university in the United Kingdom. The analysis of results from the study was conducted dividing the students according to their programme degree – Masters or PhD – and according to their language skills. The study indicated that the online resources embedded in the module were consistently used, and that the measures put in place to support self-directed learning (SDL) were both perceived and valued by the students, irrespective of their programme or native language. Nevertheless, a difference was observed in how students viewed SDL: doctoral students seemed to prefer the approach and were more receptive to it than students pursuing their Masters degree. Some students reported that the SDL activity helped them to achieve more independence than did traditional approaches to teaching. Students who engaged with the online resources were rewarded with higher marks and claimed that they were all the more motivated within the module. Despite the different learning experiences of the diverse cohort, the study found that the blended nature of the course and its resources in support of SDL created a learning environment which positively affected student learning.

Professional development among educators pursuing a B.Ed. program in special education in Tanzania : a study of motives and perceived outcomes

Implementation of different policies and plans aiming at providing education for all is a challenge in Tanzania. The need for educators and professionals with relevant knowledge and qualifications in special education is substantial. Teacher education does not equip educators with sufficient knowledge and skills in special education and professional development programs in special education are few in number. Up to 2005 no degree programs in special education at university level were available in Tanzania. The B.Ed. Special Education program offered by the Open University of Tanzania in collaboration with Åbo Akademi University in Finland was one of the efforts aimed at addressing the big national need for teachers and other professionals with degree qualifications in special education. This pilot program offered unique possibilities to study professional development in Tanzania. The research group in this study consisted of the group of students who participated in the degree program 2005-2007. The study is guided by three theoretical perspectives: individual, social and societal. The individual perspective emphasizes psychological factors as motives, motivation, achievement, self-directed behavior and personal growth. Within social perspective, professional development is viewed as situated within the social and cultural context. The third perspective, the societal, focuses on change, reforms, innovations and transformation of school systems and societies. Accordingly, professional development is viewed as an individual, social and societal phenomenon. The overall aim of the study is to explore the participants’ motives for participating in a B.Ed. Special Education program and the perceived outcomes of the program in terms of professional development. In order to achieve the objectives of the study, a case study approach was adopted. Questionnaires and semi-structured interviews were administered in three waves between January 2007 and February 2009 to the 35 educators participating in the B.Ed. Special Education program. The findings of the study reveal that the participants expressed motives which were related to job performance, knowledge, skills, academic degree and career. Also altruistic motives were expressed by the participants in terms of helping and supporting students with special needs and their communities. The perceived outcomes of the program were in line with the expressed motives. However, the results indicate that the participants also learned new skills, as interaction skills and guidance and counseling skills. Increased self-confidence was also mentioned as an outcome. The participants also got deepened understanding of disability issues. In addition, they learned strategies for creating awareness of persons with disability in the communities. Thus the findings of the study indicate positive outcomes of the program in terms of professional development. The conclusion of the study is that individual, social and societal factors interact when it comes to explaining why Tanzanian educators in special education choose to pursue a degree program in special education. The individual motives, as increased knowledge and better prospects of career development interact with the social and societal motives to help and support vulnerable student groups. The study contributes to increased understanding of the complexity of professional development and of the realities educators meet when educational reforms are implemented in a developing country.

Witnessing reconciliation reduces arousal of bystanders in a baboon group (Papio hamadryas hamadryas)

Reconciliation is the occurrence of friendly behaviour between opponents shortly after an aggressive conflict. In primate groups, reconciliation reduces aggression and post-conflict arousal. Aggression within a group can also increase arousal of bystanders (e.g. increase bystanders’ rates of self-directed behaviour). Since reconciliation reduces aggression between opponents, we tested whether it also reduces self-directed behaviour in bystanders. Following aggression in a captive group of hamadryas baboons, one observer conducted a focal sample on one of the combatants to document reconciliation and a second observer simultaneously conducted a focal sample on a randomly selected bystander. Matched control observations were then collected on the same individuals in a nonaggressive context to obtain baseline levels of behaviour. The self-directed behaviour of bystanders was elevated after witnessing a fight compared to baseline levels. If combatants reconciled aggression, bystander rates of self-directed behaviour significantly decreased. If combatants did not reconcile aggression, bystander rates of self-directed behaviour remained at elevated levels, significantly higher than after reconciliation. If combatants affiliated with partners other than their original opponent, bystander rates of self-directed behaviour did not decrease. The rate of bystander self-directed behaviour after a combatant affiliated with its opponent was significantly lower than the rate after a combatant affiliated with other animals. Witnessing aggression increased arousal in bystanders, and reconciliation between the combatants was accompanied by reduced bystander arousal. The reduction was specific to contexts in which former opponents interacted. We suggest that bystanders recognized the functional significance of this conflict resolution mechanism when it occurred in their group.

New self-assembling multifunctional templates for the biofabrication and controlled self-release of cultured tissue

The need to source live human tissues for research and clinical applications has been a major driving force for the development of new biomaterials. Ideally, these should elicit the formation of scaffold-free tissues with native-like structure and composition. In this study, we describe a biologically interactive coating that combines the fabrication and subsequent self-release of live purposeful tissues using template–cell–environment feedback. This smart coating was formed from a self-assembling peptide amphiphile comprising a proteasecleavable sequence contiguous with a cell attachment and signaling motif. This multifunctional material was subsequently used not only to instruct human corneal or skin fibroblasts to adhere and deposit discreet multiple layers of native extracellular matrix but also to govern their own self-directed release from the template solely through the action of endogenous metalloproteases. Tissues recovered through this physiologically relevant process were carrier-free and structurally and phenotypically equivalent to their natural counterparts. This technology contributes to a new paradigm in regenerative medicine, whereby materials are able to actively direct and respond to cell behavior. The novel application of such materials as a coating capable of directing the formation and detachment of complex tissues solely under physiological conditions can have broad use for fundamental research and in future cell and tissue therapies.

How minimal grade goals and self-control capacity interact in predicting test grades

The present research examined the prediction of school students' grades in an upcoming math test via their minimal grade goals (i.e., the minimum grade in an upcoming test one would be satisfied with). Due to its significance for initiating and maintaining goal-directed behavior, self-control capacity was expected to moderate the relation between students' minimal grade goals and their actual grades. Self-control capacity was defined as the dispositional capacity to override or alter one's dominant response tendencies. Prior to a scheduled math test, 172 vocational track students indicated their minimal grade goal for the test and completed a measure of self-control capacity. The test grade was assessed at a second time of measurement. As expected, minimal grade goals more strongly predicted the actual test grades the higher the students' self-control capacity. Implications can be seen in terms of optimizing the prediction and advancement of academic performance.