Stress Urinary Incontinence in Female Athletes

Objective: The purpose of this study is to educate allied health professionals and female athletes of the anatomy of the pelvic floor, and the pathology, etiology, and prevalence of stress urinary incontinence in female athletes. Background: Urinary incontinence is not a life-threatening or dangerous condition, but it is socially embarrassing, may cause the individual to remove herself from social situations, and decrease quality of life. While typically associated with parous women who had vaginal delivery, research has shown prevalence of the condition in physically active women of all ages. Stress urinary incontinence has shown to lead to withdrawal from participation in high-impact activities such as gymnastics, aerobics, and running. It may be considered a barrier for life-long athletics participation in women. Description: An in-depth introduction to the cause and origin of stress urinary incontinence including review of the female pelvic floor anatomy and prevalence of stress urinary incontinence in the female athletic population. Clinical Advantages: Athletic trainers and other allied health professionals will develop an understanding of the multiple mechanisms that cause stress urinary incontinence. Clinician competency of the dynamics and mechanism of urinary incontinence prepares the individual to learn diagnostics, prevention, pharmacological intervention, and treatment of this pathology.

Transcriptional Response of Two Core Photosystem Genes in Symbiodinium spp. Exposed to Thermal Stress

Mutualistic symbioses between scleractinian corals and endosymbiotic dinoflagellates (Symbiodinium spp.) are the foundation of coral reef ecosystems. For many coral-algal symbioses, prolonged episodes of thermal stress damage the symbiont's photosynthetic capability, resulting in its expulsion from the host. Despite the link between photosynthetic competency and symbiont expulsion, little is known about the effect of thermal stress on the expression of photosystem genes in Symbiodinium. This study used real-time PCR to monitor the transcript abundance of two important photosynthetic reaction center genes, psbA(encoding the D1 protein of photosystem II) and psaA (encoding the P700 protein of photosystem I), in four cultured isolates (representing ITS2-types A13, A20, B1, and F2) and two in hospite Symbiodinium spp. within the coral Pocillopora spp. (ITS2-types C1b-c and D1). Both cultured and in hospite Symbiodinium samples were exposed to elevated temperatures (32°C) over a 7-day period and examined for changes in photochemistry and transcript abundance. Symbiodinium A13 and C1b-c (both thermally sensitive) demonstrated significant declines in both psbA and psaA during the thermal stress treatment, whereas the transcript levels of the other Symbiodinium types remained stable. The downregulation of both core photosystem genes could be the result of several different physiological mechanisms, but may ultimately limit repair rates of photosynthetic proteins, rendering some Symbiodinium spp. especially susceptible to thermal stress.

The effects of jigsaw cooperative learning on motivation to learn English at Chung -Hwa Institute of Technology, Taiwan

The Ministry of Education (MOE) of the Republic of China in Taiwan considers English to be one of the keys to raising Taiwan's international competitiveness and requires students attending institutes of technology to receive instruction in English as a foreign language (EFL). This study focused on impacts of the use of cooperative learning as a teaching method on EFL learners. The setting was the English classes of Chung-Hwa Institute of Technology (CHIT). The subjects were 77 students from two classes, majoring in Business Administration. ^ The purpose of this study was to determine the differential effects (i.e., achievement in learning English, motivation orientation and intensity, and attitude concerning English language and culture) on students between the traditional Chinese teaching method and the Jigsaw cooperative learning method at CHIT. ^ The research design for the study was quasi-experimental and descriptive. This study utilized three survey instruments and final exam grades to investigate the effect of Jigsaw on the EFL students' competency in English, and on their attitudes about, and level of motivation toward learning English. The independent variable was the instructional method: one class utilized the Jigsaw approach to cooperative learning while the other utilized the traditional Chinese approach. The dependent variables were academic performance, motivation orientation toward English, motivation intensity toward learning English, and attitude toward learning of English and English culture as determined by final exam and questionnaire scores. The questionnaires and exam were administrated at the beginning and end of the semester. ^ Data analysis indicated that students learning cooperatively had higher final course grades and made more integrative statements on the measure of orientation toward learning English than students who learned using the traditional Chinese methods. Participants who learned using cooperative strategies had more positive attitudes about learning English connected with their desire to associate with English speakers and had more positive attitudes about the learning mechanism they experienced than those instructed though traditional Chinese learning strategies. There were no differences between the groups on the measure of motivation intensity. Recommendations were made to improve the use of the Jigsaw method of cooperative learning through both pedagogical and policy modifications. ^

Comparison of Linear Functions in Middle Grades Textbooks from Singapore and the United States

Many U.S. students do not perform well on mathematics assessments with respect to algebra topics such as linear functions, a building-block for other functions. Poor achievement of U.S. middle school students in this topic is a problem. U.S. eighth graders have had average mathematics scores on international comparison tests such as Third International Mathematics Science Study, later known as Trends in Mathematics and Science Study, (TIMSS)-1995, -99, -03, while Singapore students have had highest average scores. U.S. eighth grade average mathematics scores improved on TIMMS-2007 and held steady onTIMMS-2011. Results from national assessments, PISA 2009 and 2012 and National Assessment of Educational Progress of 2007, 2009, and 2013, showed a lack of proficiency in algebra. Results of curriculum studies involving nations in TIMSS suggest that elementary textbooks in high-scoring countries were different than elementary textbooks and middle grades texts were different with respect to general features in the U.S. The purpose of this study was to compare treatments of linear functions in Singapore and U.S. middle grades mathematics textbooks. Results revealed features currently in textbooks. Findings should be valuable to constituencies who wish to improve U.S. mathematics achievement. Portions of eight Singapore and nine U.S. middle school student texts pertaining to linear functions were compared with respect to 22 features in three categories: (a) background features, (b) general features of problems, and (c) specific characterizations of problem practices, problem-solving competency types, and transfer of representation. Features were coded using a codebook developed by the researcher. Tallies and percentages were reported. Welch's t-tests and chi-square tests were used, respectively, to determine whether texts differed significantly for the features and if codes were independent of country. U.S. and Singapore textbooks differed in page appearance and number of pages, problems, and images. Texts were similar in problem appearance. Differences in problems related to assessment of conceptual learning. U.S. texts contained more problems requiring (a) use of definitions, (b) single computation, (c) interpreting, and (d) multiple responses. These differences may stem from cultural differences seen in attitudes toward education. Future studies should focus on density of page, spiral approach, and multiple response problems.

Investigating the Effects of Cognitive Apprenticeship-Based Instructional Coaching on Science Teaching Efficacy Beliefs

The overall purpose of this collected papers dissertation was to examine the utility of a cognitive apprenticeship-based instructional coaching (CAIC) model for improving the science teaching efficacy beliefs (STEB) of preservice and inservice elementary teachers. Many of these teachers perceive science as a difficult subject and feel inadequately prepared to teach it. However, teacher efficacy beliefs have been noted as the strongest indicator of teacher quality, the variable most highly correlated with student achievement outcomes. The literature is scarce on strong, evidence-based theoretical models for improving STEB. This dissertation is comprised of two studies. STUDY #1 was a sequential explanatory mixed-methods study investigating the impact of a reformed CAIC elementary science methods course on the STEB of 26 preservice teachers. Data were collected using the Science Teaching Efficacy Belief Instrument (STEBI-B) and from six post-course interviews. A statistically significant increase in STEB was observed in the quantitative strand. The qualitative data suggested that the preservice teachers perceived all of the CAIC methods as influential, but the significance of each method depended on their unique needs and abilities. STUDY #2 was a participatory action research case study exploring the utility of a CAIC professional development program for improving the STEB of five Bahamian inservice teachers and their competency in implementing an inquiry-based curriculum. Data were collected from pre- and post-interviews and two focus group interviews. Overall, the inservice teachers perceived the intervention as highly effective. The scaffolding and coaching were the CAIC methods portrayed as most influential in developing their STEB, highlighting the importance of interpersonal relationship aspects in successful instructional coaching programs. The teachers also described the CAIC approach as integral in supporting their learning to implement the new inquiry-based curriculum. The overall findings hold important implications for science education reform, including its potential to influence how preservice teacher training and inservice teacher professional development in science are perceived and implemented. Additionally, given the noteworthy results obtained over the relatively short durations, CAIC interventions may also provide an effective means of achieving improvements in preservice and inservice teachers’ STEB more expeditiously than traditional approaches.

Framework for Enterprise Systems Engineering

This research aimed at developing a research framework for the emerging field of enterprise systems engineering (ESE). The framework consists of an ESE definition, an ESE classification scheme, and an ESE process. This study views an enterprise as a system that creates value for its customers. Thus, developing the framework made use of system theory and IDEF methodologies. This study defined ESE as an engineering discipline that develops and applies systems theory and engineering techniques to specification, analysis, design, and implementation of an enterprise for its life cycle. The proposed ESE classification scheme breaks down an enterprise system into four elements. They are work, resources, decision, and information. Each enterprise element is specified with four system facets: strategy, competency, capacity, and structure. Each element-facet combination is subject to the engineering process of specification, analysis, design, and implementation, to achieve its pre-specified performance with respect to cost, time, quality, and benefit to the enterprise. This framework is intended for identifying research voids in the ESE discipline. It also helps to apply engineering and systems tools to this emerging field. It harnesses the relationships among various enterprise aspects and bridges the gap between engineering and management practices in an enterprise. The proposed ESE process is generic. It consists of a hierarchy of engineering activities presented in an IDEF0 model. Each activity is defined with its input, output, constraints, and mechanisms. The output of an ESE effort can be a partial or whole enterprise system design for its physical, managerial, and/or informational layers. The proposed ESE process is applicable to a new enterprise system design or an engineering change in an existing system. The long-term goal of this study aims at development of a scientific foundation for ESE research and development.

Perceptions of beginning teachers in Florida regarding their preparation as it relates to the Florida essential generic competencies

The purpose of the study is to investigate how beginning teachers in the state of Florida perceive their preparation to demonstrate the 27 Florida Essential Generic Competencies. The basic research question of this study was: How do beginning teachers perceive their level of preparation regarding their implementation of the Florida Essential Generic Competencies? This study identified and categorized the perceived degree of preparation for each of the competencies. Also, elementary, middle, and high school beginning teachers were compared to find significant differences and similarities in their perception of their preparation. A comparison was also done for graduates from in-state versus out-of-state and private versus public institutions. A survey developed in collaboration with the Department of Education, Florida State University, members of the Professional Orientation Program (POP) Coordinators, and the Project Director of Program Review in the College of Education at the University of South Florida, was sent to 5,076 beginning teachers. A total of 1,995 returned the survey in February of 1993. The Multivariate Analysis of Variance (MANOVA) procedure was used (Alpha = .05). Statistical analysis of the data involved a comparison of the different groups of beginning teachers by school level and kind of graduating institutions. The dependent variables analyzed were the responses to all items representing the generic competencies. The study identified and categorized the degree of preparation for each competency. The competencies receiving the lowest ratings for degree of preparation were: integrate computers in instruction; manage situations involving child abuse and/or neglect; severe emotional stress; alcohol and drug abuse. The Wilkes lambda and the Hotellings multivariate tests of significance were used to examine the differences among the groups. The competency items were further analyzed by a univariate F test. Results indicated that: (1) significant differences were found in nine competency items in which elementary teachers felt better prepared than middle and high school beginning teachers, (2) graduates from a Florida teacher education program felt they were better prepared in demonstrating the competencies than those from out-of-state schools, and (3) no significant difference was found in the perceptions of those who graduated from public versus private institutions. Based on the findings of this study, the following recommendations are made: (1) Florida's institutions responsible for teacher preparation programs need to focus on those competencies receiving the lowest ratings, (2) Districts should provide an orientation program for out-of-state beginning teachers, and (3) The survey instrument should be used annually to evaluate teacher education programs.

The relationship between student characteristics, computer literacy,technology acceptance, and distance education student satisfaction

The purpose of this study is to identify the relationship between the characteristics of distance education students, their computer literacy and technology acceptance and distance education course satisfaction. The theoretical framework for this study will apply Rogers and Havelock's Innovation, Diffusion & Utilization theories to distance education. It is hypothesized that technology acceptance and computer competency will influence the student course satisfaction and explain the decision to adopt or reject distance education curriculum and technology. Distance education delivery, Institutional Support, Convenience, Interactivity and five distance education technologies were studied. The data were collected by a survey questionnaire sent to four Florida universities. Three hundred and nineteen and students returned the questionnaire. A factor and regression analysis on three measure of satisfaction revealed significant difference between the three main factors related to the overall satisfaction of distance education students and their adoption of distance education technology as medium of learning. Computer literacy is significantly related to greater overall student satisfaction. However, when competing with other factors such as delivery, support, interactivity, and convenience, computer literacy is not significant. Results indicate that age and status are the only two student characteristics to be significant. Distance education technology acceptance is positively related to higher overall satisfaction. Innovativeness is also positively related to student overall satisfaction. Finally, the technology used relates positively to greater satisfaction levels within the educational experience. Additional research questions were investigated and provided insights into the innovation decision process.

The development of a learning module for youth care counsellors working with incarcerated youth

Background: A shift toward a rehabilitative model of care has prompted the Newfoundland and Labrador Youth Centre to institute a policy restricting seclusion and restraint as a means of behavioural management. This policy has been received with skepticism by youth counsellors who use these methods to contain disruptive behaviours. Insufficient training in mental health has precipitated feelings of inadequacy as they feel ill-equipped to do their jobs. Purpose: The purpose of my practicum is to develop a mental health learning module for youth counsellors to reduce seclusion and restraint in youth corrections. Methods: A literature search illustrated what is known on the topic of seclusion and restraint in youth corrections. Consultation with stakeholders revealed staff attitudes regarding the policy and its operational impact. An environmental scan revealed the availability of other resources intended to address disruptive behaviours. Conclusion: The learning module is focused on mental illnesses to increase youth counsellors’ competency in managing disruptive behaviours while minimizing the use of seclusion and restraint.

CAUTI prevention bundles: improving best practices within Western Health for continued success

Background: Persons in acute care settings who have indwelling urethral catheters are at higher risk of acquiring a urinary tract infection (UTI). Other complications related to prolonged indwelling urinary catheters include decreased mobility, damage to the meatus and/or urethra, increase use of antibiotics, increased length of stay, and pain. UTIs in acute care settings account for 30 to 40% of all health care associated infections (HAIs). Of these, 80% are catheter associated UTIs (CAUTIs). Purpose: To utilized the CDC (2009) bundle approach for CAUTI prevention and create a program which supports a multimodal method to improving urinary catheter use, maintenance, and removal, including a continuing competency program where role expansion is anticipated. Methods: A comprehensive review of the literature was conducted. Physicians were consulted through a power point presentation followed by a letter explaining the project, a questionnaire, and two selections of relevant literature. Nursing staff and allied health professionals from the target units of 3A and 3B medicine attended one of two lunch and learns. They were presented the project via a power point presentation and the same questionnaire as distributed to physicians. Results: Five e-learning modules, a revised policy, and clinical pathway have been developed to support staff with best practice knowledge transfer. Conclusion: Behaviour changes need to be approached with a framework, extensive consultation, and education. Sustainability of any practice change cannot occur without having completed the background work to ensure staff have access to tools to support the change.

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.

A pilot study of orthopaedic resident self-assessment using a milestones' survey just prior to milestones implementation.

OBJECTIVE: To pilot test if Orthopaedic Surgery residents could self-assess their performance using newly created milestones, as defined by the Accreditation Council on Graduate Medical Education. METHODS: In June 2012, an email was sent to Program Directors and administrative coordinators of the 154 accredited Orthopaedic Surgery Programs, asking them to send their residents a link to an online survey. The survey was adapted from the Orthopaedic Surgery Milestone Project. Completed surveys were aggregated in an anonymous, confidential database. SAS 9.3 was used to perform the analyses. RESULTS: Responses from 71 residents were analyzed. First and second year residents indicated through self-assessment that they had substantially achieved Level 1 and Level 2 milestones. Third year residents reported they had substantially achieved 30/41, and fourth year residents, all Level 3 milestones. Fifth year, graduating residents, reported they had substantially achieved 17 Level 4 milestones, and were extremely close on another 15. No milestone was rated at Level 5, the maximum possible. Earlier in training, Patient Care and Medical Knowledge milestones were rated lower than the milestones reflecting the other four competencies of Practice Based Learning and Improvement, Systems Based Practice, Professionalism, and Interpersonal Communication. The gap was closed by the fourth year. CONCLUSIONS: Residents were able to successfully self-assess using the 41 Orthopaedic Surgery milestones. Respondents' rate improved proficiency over time. Graduating residents report they have substantially, or close to substantially, achieved all Level 4 milestones. Milestone self-assessment may be a useful tool as one component of a program's overall performance assessment strategy.

IL-10-producing Regulatory B Cell Development in Human Autoimmune Disease

B cell abnormalities contribute to the development and progress of autoimmune disease. Traditionally, the role of B cells in autoimmune disease was thought to be predominantly limited to the production of autoantibodies. Nevertheless, in addition to autoantibody production, B cells have other functions potentially relevant to autoimmunity. Such functions include antigen presentation to and activation of T cells, expression of costimulatory molecules and cytokine production. Recently, the ability of B cells to negatively regulate cellular immune responses and inflammation has been described and the concept of “regulatory B cells” has emerged. A variety of cytokines produced by regulatory B cell subsets have been reported with interleukin-10 (IL-10) being the most studied. IL-10-producing regulatory B cells predominantly localize within a rare CD1dhiCD5+ B cell subset in mice and the CD24hiCD27+ B cell subset in adult humans. This specific IL-10-producing subset of regulatory B cells have been named “B10 cells” to highlight that the regulatory function of these rare B cells is primarily mediated by IL-10, and to distinguish them from other regulatory B cell subsets that regulate immune responses through different mechanisms. B10 cells have been studies in a variety of animal models with autoimmune disease and clinical settings of human autoimmunity. There are many unsolved questions related to B10 cells including their surface phenotype, their origin and development in vivo, and their role in autoimmunity.

In Chapter 3 of this dissertation, the role of the B cell receptor (BCR) in B10 cell development is highlighted. First, the BCR repertoire of mouse peritoneal cavity B10 cells is examined by single cell sequencing; peritoneal cavity B10 cells have clonally diverse germline BCRs that are predominantly unmutated. Second, mouse B10 cells are shown to have higher frequencies of λ+ BCRs compared to non-B10 cells which may indicate the involvement of BCR light chain editing early in the process of B10 cell development in vivo. Third, human peripheral blood B10 cells are examined and are also found to express higher frequencies of λ chains compared to non-b10 cells. Therefore, B10 cell BCRs are clonally diverse and enriched for unmutated germline sequences and λ light chains.

In Chapter 4 of this dissertation, B10 cells are examined in the healthy developing human across the entire age range of infancy, childhood and adolescence, and in a large cohort of children with autoimmunity. The study of B10 cells in the developing human documents a massive transient expansion during middle childhood when up to 30% of blood B cells were competent to produce IL-10. The surface phenotype of pediatric B10 cells was variable and reflective of overall B cell development. B10 cells down-regulated CD4+ T cell interferon-gamma (IFN-γ) production through IL-10-dependent pathways and IFN-γ inhibited whereas interleukin-21 (IL-21) promoted B cell IL-10 competency in vitro. Children with autoimmunity had a contracted B10 cell compartment, along with increased IFN-γ and decreased IL-21 serum levels compared to age-matched healthy controls. The decreased B10 cell frequencies and numbers in children with autoimmunity may be partially explained by the differential regulation of B10 cell development by IFN-γ and IL-21 and alterations in serum cytokine levels. The age-related changes of the B10 cell compartment during normal human development provide new insights into immune tolerance mechanisms involved in inflammation and autoimmunity.

These studies collectively demonstrate that BCR signals are the most important early determinant of B10 cell development in vivo, that human B10 cells are not a surface phenotype defined developmental B cell subset but a functionally defined regulatory B cell subset that regulates CD4+ T IFN-γ production through IL-10-dependent pathways and that human B10 cell development can be regulated by soluble factors in vivo such as the cytokine milieu. The findings of these studies provide new insights into immune tolerance mechanisms involved in human autoimmunity and the potent effects of IL-21 on human B cell IL-10 competence in vitro open new horizons in the development of autologous B10 cell-based therapies as an approach to treat human autoimmune disease in the future.

The Role of Enjoyment and Motivational Climate in Relation to the Personal Development of Team Sport Athletes

Sport has been identified as a context in which youth encounter positive and negative experiences. However, relatively little is known about the factors that lead to positive and negative personal development among sport participants. The purpose of this study was to investigate the role of enjoyment and motivational climate on positive and negative personal development of team sport participants. A sample of 510 athletes between the ages of 9 and 19 completed questionnaires on positive and negative personal development, enjoyment, and motivational climate. Stepwise multiple regression analyses examined the effects of enjoyment and motivational climate on the personal development of the athletes. Results demonstrated that positive experiences in sport were most strongly predicted by affiliation with peers, self-referenced competency, effort expenditure, and a task climate. Negative experiences were most strongly predicted by an ego climate and other-referenced competency. Results suggest that creating an environment that encourages peer affiliation and personal achievement can result in the positive personal development of youth sport participants.

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.