A qualitative analysis of the lived experience of nursing staff developers in the process of changing to a new educational model

The purpose of this study was to document and critically analyze the lived experience of selected nursing staff developers in the process of moving toward a new model for hospital nursing education. Eleven respondents were drawn from a nation-wide population of about two hundred individuals involved in nursing staff development. These subjects were responsible for the implementation of the Performance Based Development System (PBDS) in their institutions.^ A purposive, criterion-based sampling technique was used with respondents being selected according to size of hospital, primary responsibility for orchestration of the change, influence over budgetary factors and managerial responsibility for PBDS. Data were gathered by the researcher through both in-person and telephone interviews. A semi-structured interview guide, designed by the researcher was used, and respondents were encouraged to amplify on their recollections as desired. Audiotapes were transcribed and resulting computer files were analyzed using the program "Martin". Answers to interview questions were compiled and reported across cases. The data was then reviewed a second time and interpreted for emerging themes and patterns.^ Two types of verification were used in the study. Internal verification was done through interview transcript review and feedback by respondents. External verification was done through review and feedback on data analysis by readers who were experienced in management of staff development departments.^ All respondents were female, so Gilligan's concept of the "ethic of care" was examined as a decision making strategy. Three levels of caring which influenced decision making were found. They were caring: (a) for the organization, (b) for the employee, and (c) for the patient. The four existentials of the lived experience, relationality, corporeality, temporality and spatiality were also examined to reveal the everydayness of making change. ^

Examining the process of regime change in the North Atlantic Treaty Organization: The divide between rhetoric and reality

The North Atlantic Treaty Organization (NATO) is a product of the Cold War through which its members organized their military forces for the purpose of collective defense against the common threat of Soviet-backed aggression. Employing the terminology of regime theory, the creation of NATO can be viewed as the introduction of an international security regime. Throughout the Cold War, NATO member states preserved their commitment to mutual defense while increasingly engaging in activities aimed at overcoming the division of Europe and promoting regional stability. The end of the Cold War has served as the catalyst for a new period of regime change as the Alliance introduced elements of a collective security regime by expanding its mandate to address new security challenges and reorganizing both its political and military organizational structures. ^ This research involves an interpretive analysis of NATO's evolution applying ideal theoretical constructs associated with distinct approaches to regime analysis. The process of regime change is investigated over several periods throughout the history of the Alliance in an effort to understand the Alliance's changing commitment to collective security. This research involves a review of regime theory literature, consisting of an examination of primary source documentation, including official documents and treaties, as well as a review of numerous secondary sources. This review is organized around a typology of power-based, organization-based, and norm-based approaches to regime analysis. This dissertation argues that the process of regime change within NATO is best understood by examining factors associated with multiple theoretical constructs. Relevant factors provide insights into the practice of collective security among NATO member states within Europe, while accounting for the inability of the NATO allies to build on the experience gained within Europe to play a more central role in operations outside of this region. This research contributes to a greater understanding of the nature of international regimes and the process of regime change, while offering recommendations aimed at increasing NATO's viability as a source of greater security and more meaningful international cooperation.^

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.

Developing a process to create and validate an instrument assessing student attainment of competencies at an intercultural university in Mexico

This study took place at one of the intercultural universities (IUs) of Mexico that serve primarily indigenous students. The IUs are pioneers in higher education despite their numerous challenges (Bertely, 1998; Dietz, 2008; Pineda & Landorf, 2010; Schmelkes, 2009). To overcome educational inequalities among their students (Ahuja, Berumen, Casillas, Crispín, Delgado et al., 2004; Schmelkes, 2009), the IUs have embraced performance-based assessment (PBA; Casillas & Santini, 2006). PBA allows a shared model of power and control related to learning and evaluation (Anderson, 1998). While conducting a review on PBA strategies of the IUs, the researcher did not find a PBA instrument with valid and reliable estimates. The purpose of this study was to develop a process to create a PBA instrument, an analytic general rubric, with acceptable validity and reliability estimates to assess students' attainment of competencies in one of the IU's majors, Intercultural Development Management. The Human Capabilities Approach (HCA) was the theoretical framework and a sequential mixed method (Creswell, 2003; Teddlie & Tashakkori, 2009) was the research design. IU participants created a rubric during two focus groups, and seven Spanish-speaking professors in Mexico and the US piloted using students' research projects. The evidence that demonstrates the attainment of competencies at the IU is a complex set of actual, potential and/or desired performances or achievements, also conceptualized as "functional capabilities" (FCs; Walker, 2008), that can be used to develop a rubric. Results indicate that the rubric's validity and reliability estimates reached acceptable estimates of 80% agreement, surpassing minimum requirements (Newman, Newman, & Newman, 2011). Implications for practice involve the use of PBA within a formative assessment framework, and dynamic inclusion of constituencies. Recommendations for further research include introducing this study's instrument-development process to other IUs, conducting parallel mixed design studies exploring the intersection between HCA and assessment, and conducting a case study exploring assessment in intercultural settings. Education articulated through the HCA empowers students (Unterhalter & Brighouse, 2007; Walker, 2008). This study aimed to contribute to the quality of student learning assessment at the IUs by providing a participatory process to develop a PBA instrument.

Curriculum Review: A Model

Hospitality programs in the United States are continually undergoing curriculum review to stay current and to produce graduates who will excel in the industry. This article describes the revision process used by one university.

Participative Budgeting and Participant Motivation: A Review of the Literature

In their discussion - Participative Budgeting and Participant Motivation: A Review of the Literature - by Frederick J. Demicco, Assistant Professor, School of Hotel, Restaurant and Institutional Management, The Pennsylvania State University and Steven J. Dempsey, Fulton F. Galer, Martin Baker, Graduate Assistants, College of Business at Virginia Polytechnic Institute and State University, the authors initially observe: “In recent years behavioral literature has stressed the importance of participation In goal-setting by those most directly affected by those goals. The common postulate is that greater participation by employees in the various management functions, especially the planning function, will lead to improved motivation, performance, coordination, and functional behavior. The authors analyze this postulate as it relates to the budgeting process and discuss whether or not participative budgeting has a significant positive impact on the motivations of budget participants.” In defining the concept of budgeting, the authors offer: “Budgeting is usually viewed as encompassing the preparation and adoption of a detailed financial operating plan…” In furthering that statement they also furnish that budgeting’s focus is to influence, in a positive way, how managers plan and coordinate the activities of a property in a way that will enhance their own performance. In essence, framing an organization within its described boundaries, and realizing its established goals. The authors will have you know, to control budget is to control operations. What kind of parallels can be drawn between the technical methods and procedures of budgeting, and managerial behavior? “In an effort to answer this question, Ronen and Livingstone have suggested that a fourth objective of budgeting exists, that of motivation,” say the authors with attribution. “The managerial function of motivation is manipulative in nature.” Demicco, Dempsey, Galer, and Baker attempt to quantify motivation as a psychological premise using the expectancy theory, which encompasses empirical support, intuitive appeal, and ease of application to the budgetary process. They also present you with House's Path-Goal model; essentially a mathematics type formula designed to gauge motivation. You really need to see this. The views of Argyris are also explored in particular detail. Although, the Argyris study was primarily aimed at manufacturing firms, and the effects on line-supervisors of the manufacturing budgets which were used to control and evaluate their performance, its application is relevant to the hospitality industry. As the title suggests, other notables in the field of behavioral motivation theory, and participation are also referenced. “Behavioral theory has been moving away from models of purported general applicability toward contingency models that are suited for particular situations,” say the authors in closing. “It is conceivable that some time in the future, contingency models will make possible the tailoring of budget strategies to individual budget holder personalities.”

Discipline And Due Process In The Workplace

In the article - Discipline and Due Process in the Workplace – by Edwin B. Dean, Assistant Professor, the School of Hospitality Management at Florida International University, Assistant Professor Dean prefaces his article with the statement: “Disciplining employees is often necessary for the maintenance of an effective operation. The author discusses situations which require discipline and methods of handling employees, including the need for rules and due process.” In defining what constitutes appropriate discipline and what doesn’t, Dean says, “Fair play is the keystone to discipline in the workplace. Discrimination, caprice, favoritism, and erratic and inconsistent discipline can be costly and harmful to employee relations, and often are a violation of law.” Violation of law is a key phrase in this statement. The author offers a short primer on tact in regard to disciplining an employee. “Discipline must be tailored to the individual,” Dean offers a pearl of wisdom. “A frown for one can cause a tearful outbreak; another employee may need the proverbial two-by-four in order to get his attention.” This is a perceptive comment, indeed, and one in which most would concede but not all would follow. Dean presents a simple outline for steps in the disciplinary process by submitting this suggestion for your approval: “The steps in the disciplinary process begin perhaps with a friendly warning or word of advice. The key here is friendly,” Dean declares. “It could progress to an oral or written reprimand, followed by a disciplinary layoff, terminating in that equivalent of capital punishment, discharge.” Ouch [!]; in order from lenient to strident. Dean suggests these steps are necessary in order to maintain decorum in the workplace. Assistant Professor Dean references the Weingarter Rule. It is a rule that although significant, most employees, at least non-union employees, don’t know is in their quiver. “If an interview is likely to result in discipline, the employee is entitled to have a representative present, whether a union is involved or not,” the rule states. “The employer is not obligated to inform the employee of the rule, but he is obligated to honor the employee's request, if made,” Dean explains. Dean makes an interesting point by revealing that a termination often reflects as much on the institution as it does the employee suffering the termination. The author goes on to list several infractions that could warrant an employee disciplinary action, with possible approaches toward each. Dean also cautions against capricious disciplinary action; if not handled properly a discipline could and can result in a lawsuit against the institution itself.

Achievement of generic baccalaureate student nurses using computer -assisted instruction simulations during a nursing review course

The use of computer assisted instruction (CAI) simulations as an instructional strategy provides nursing students with a critical thinking approach for evaluating risks and benefits and choosing correct alternatives in "safe" patient care situations. It was hypothesized that using CAI simulations during an upper level nursing review course would have a positive effect on the students' posttest scores. Subjects (n = 36) were senior nursing students enrolled in a nursing review course in an undergraduate baccalaureate program. A limitation of the study was the small sample size. The study employed a modified group experimental design using the t test for independent samples. The group who received the CAI simulations during the physiological system review demonstrated a significant increase (p $<$.01) in the posttest score mean when compared to the lecture-discussion group score mean. There was no significant difference between high and low clinical grade point average (GPA) students in the CAI and lecture-discussion groups and their score means on the posttest. However, score mean differences of the low clinical GPA students showed a greater increase for the CAI group than the lecture-discussion group. There was no significant difference between the groups in their system content subscore means on the exit examination completed three weeks later. It was concluded that CAI simulations are as effective as lecture-discussion in assisting upper level students to process information for clinical decision making. CAI simulations can be considered as an instructional strategy to supplement or replace lecture content during a review course, allowing more efficient use of faculty time. It is recommended that the study be repeated using a larger sample size. Further investigations are recommended in comparing the effectiveness of computer software formats and various instructional strategies for other learning situations and student populations. ^

Process of privatization: Benefits of *reform in management of public housing

The study of the private management of public housing is an important topic to be critically analyzed as the government search for ways to increase efficiency in providing housing for the poor. Public Housing Authorities must address the cost for repairing or replacing the deteriorating housing stock, the increase in the need for affordable housing, and the lack of supply. There is growing pressure on efficient use of public funds that has heightened the need for profound structural reform. An important strategy for carrying out such reform is through privatization. Although privatization does not work in every case, the majority position in the traditional privatization literature is that reliance on private organizations normally, but not always, results in cost savings. ^ The primary purpose of this dissertation is to determine whether a consensus exist among decision-makers on the efficiency of privatizing the management of public housing. A secondary purpose is to review the techniques (best practices) used by the private sector that results in cost-efficiencies in the management of public housing. The study employs the use of a triangulated research design utilizing cross-sectional survey methodology that included use of a survey instrument to solicit responses from the private managers. The study consists of qualitative methods using interviews from key informants of private-sector management firms and public housing agencies, case studies, focus groups, archival records and housing authorities documents. ^ Results indicated that important decision-makers perceive that private managers made a positive contribution to cost-efficiencies in the management of public housing. The performance of private contractors served as a yardstick for comparison of efficiency of services that are produced in-house. The study concluded that private managers made the benefits of their management techniques well known creating a sense of competition between public and private managers. Competition from private contractors spurred municipal worker and management productivity improvements creating better management results for the public housing authorities. The study results are in concert with a review of recent research and studies that also concluded private managers have some distinct advantages to controlling costs in the management of public housing. ^

Adherence to latent tuberculosis treatment among immigrants in low endemic settings : a scoping review

Contexte : En dépit du fait que la tuberculose est un problème de santé publique important dans les pays en voie de développement, les pays occidentaux doivent faire face à des taux d'infection important chez certaines populations immigrantes. Le risque de développer la TB active est 10% plus élevé chez les personnes atteintes de TB latente si elles ne reçoivent pas de traitement adéquat. La détection et le traitement opportun de la TB latente sont non seulement nécessaires pour préserver la santé de l'individu atteint mais aussi pour réduire le fardeau socio- économique et sanitaire du pays hôte. Les taux d'observance des traitements préventifs de TB latente sont faibles et une solution efficace à ce problème est requise pour contrôler la prévalence de l'infection. L'objectif de ce mémoire est d'identifier les facteurs qui contribuent à l'observance thérapeutique des traitements de TB latente auprès de nouveaux arrivants dans les pays occidentaux où les taux endémiques sont faibles. Méthodologie : Une revue systématique a été effectuée à partir de bases de données et répertoires scientifiques reconnus tels Medline, Medline in Process, Embase, Global Health, Cumulative Index to Nursing, le CINAHL et la librairie Cochrane pour en citer quelques un. Les études recensées ont été publiées après 1997 en français, en anglais, conduites auprès de populations immigrantes de l'occident (Canada, Etats-Unis, Europe, Royaume-Uni, Australie et la Nouvelle Zélande) dont le statut socio-économique est homogène. Résultats : Au total, neuf (9) études réalisées aux Etats-Unis sur des immigrants originaires de différents pays où la TB est endémique ont été analysées: deux (2) études qualitatives ethnographiques, six (6) quantitatives observationnelles et une (1) quantitative interventionnelle. Les facteurs sociodémographiques, les caractéristiques individuelles, familiales, ainsi que des déterminants liés à l'accès et à la prestation des services et soins de santé, ont été analysés pour identifier des facteurs d'observance thérapeutique. L'âge, le nombre d'années passées dans le pays hôte, le sexe, le statut civil, l'emploi, le pays d'origine, le soutien familiale et les effets secondaires et indésirables du traitement de la TB ne sont pas des facteurs ii déterminants de l'adhésion au traitement préventif. Toutefois, l’accès à l'information et de l'éducation adaptées aux langues et cultures des populations immigrantes, sur la TB et des objectifs de traitement explicites, l'offre de plan de traitement plus court et mieux tolérés, un environnement stable, un encadrement et l'adhésion au suivi médical par des prestataires motivés ont émergés comme des déterminants d'observance thérapeutique. Conclusion et recommandation : Le manque d'observance thérapeutique du traitement de la TB latente (LTBI) par des populations immigrantes, qui sont déjà aux prises avec des difficultés d'intégration, de communication et économique, est un facteur de risque pour les pays occidentaux où les taux endémiques de TB sont faibles. Les résultats de notre étude suggèrent que des interventions adaptées, un suivi individuel, un encadrement clinique et des plans de traitement plus courts, peuvent grandement améliorer les taux d'observance et d'adhésion aux traitements préventifs, devenant ainsi un investissement pertinent pour les pays hôtes.

Adherence to latent tuberculosis treatment among immigrants in low endemic settings : a scoping review

Contexte : En dépit du fait que la tuberculose est un problème de santé publique important dans les pays en voie de développement, les pays occidentaux doivent faire face à des taux d'infection important chez certaines populations immigrantes. Le risque de développer la TB active est 10% plus élevé chez les personnes atteintes de TB latente si elles ne reçoivent pas de traitement adéquat. La détection et le traitement opportun de la TB latente sont non seulement nécessaires pour préserver la santé de l'individu atteint mais aussi pour réduire le fardeau socio- économique et sanitaire du pays hôte. Les taux d'observance des traitements préventifs de TB latente sont faibles et une solution efficace à ce problème est requise pour contrôler la prévalence de l'infection. L'objectif de ce mémoire est d'identifier les facteurs qui contribuent à l'observance thérapeutique des traitements de TB latente auprès de nouveaux arrivants dans les pays occidentaux où les taux endémiques sont faibles. Méthodologie : Une revue systématique a été effectuée à partir de bases de données et répertoires scientifiques reconnus tels Medline, Medline in Process, Embase, Global Health, Cumulative Index to Nursing, le CINAHL et la librairie Cochrane pour en citer quelques un. Les études recensées ont été publiées après 1997 en français, en anglais, conduites auprès de populations immigrantes de l'occident (Canada, Etats-Unis, Europe, Royaume-Uni, Australie et la Nouvelle Zélande) dont le statut socio-économique est homogène. Résultats : Au total, neuf (9) études réalisées aux Etats-Unis sur des immigrants originaires de différents pays où la TB est endémique ont été analysées: deux (2) études qualitatives ethnographiques, six (6) quantitatives observationnelles et une (1) quantitative interventionnelle. Les facteurs sociodémographiques, les caractéristiques individuelles, familiales, ainsi que des déterminants liés à l'accès et à la prestation des services et soins de santé, ont été analysés pour identifier des facteurs d'observance thérapeutique. L'âge, le nombre d'années passées dans le pays hôte, le sexe, le statut civil, l'emploi, le pays d'origine, le soutien familiale et les effets secondaires et indésirables du traitement de la TB ne sont pas des facteurs ii déterminants de l'adhésion au traitement préventif. Toutefois, l’accès à l'information et de l'éducation adaptées aux langues et cultures des populations immigrantes, sur la TB et des objectifs de traitement explicites, l'offre de plan de traitement plus court et mieux tolérés, un environnement stable, un encadrement et l'adhésion au suivi médical par des prestataires motivés ont émergés comme des déterminants d'observance thérapeutique. Conclusion et recommandation : Le manque d'observance thérapeutique du traitement de la TB latente (LTBI) par des populations immigrantes, qui sont déjà aux prises avec des difficultés d'intégration, de communication et économique, est un facteur de risque pour les pays occidentaux où les taux endémiques de TB sont faibles. Les résultats de notre étude suggèrent que des interventions adaptées, un suivi individuel, un encadrement clinique et des plans de traitement plus courts, peuvent grandement améliorer les taux d'observance et d'adhésion aux traitements préventifs, devenant ainsi un investissement pertinent pour les pays hôtes.

Program evaluation primer: A review of three evaluations

Program evaluation—a “tool used to assess the implementation and outcomes of a program, to increase a program’s efficiency and impact over time, and to demonstrate accountability” (MacDonald et. al, 2001, p. 1)—is an essential process to program assessment and improvement. This paper overviews three published program evaluations and considers important aspects of program evaluation more broadly.

Building Information Modelling in UK Construction Projects: A State of the Art Review

This paper aims to present a state-of-the-art review of the scope and practical implications of the Building Information Modelling (BIM) platform in the UK construction practice. Theoretical developments suggest that BIM is an integration of both product and process innovation, not just a disparate set of software tools. BIM provides effective collaboration, visual representation and data management, which enable the smooth flow of information throughout the project’s lifecycle. The most frequently reported benefits are related to Capital Cost (capex) and Operational costs (opex) and time savings. Key challenges, however, focus on the interoperability of software, capital installation costs, in-house experience, client preference and cultural issues within design teams and within the organisation. The paper concludes with a critical commentary on the changing roles and a process required to implement BIM in UK construction projects, and suggests areas for further research.

Utilizing ICT to prevent loneliness and social isolation of the elderly. A literature review

Ageing of the population is a worldwide phenomenon. Numerous ICT-based solutions have been developed for elderly care but mainly connected to the physiological and nursing aspects in services for the elderly. Social work is a profession that should pay attention to the comprehensive wellbeing and social needs of the elderly. Many people experience loneliness and depression in their old age, either as a result of living alone or due to a lack of close family ties and reduced connections with their culture of origin, which results in an inability to participate actively in community activities (Singh & Misra, 2009). Participation in society would enhance the quality of life. With the development of information technology, the use of technology in social work practice has risen dramatically. The aim of this literature review is to map out the state of the art of knowledge about the usage of ICT in elderly care and to figure out research-based knowledge about the usability of ICT for the prevention of loneliness and social isolation of elderly people. The data for the current research comes from the core collection of the Web of Science and the data searching was performed using Boolean? The searching resulted in 216 published English articles. After going through the topics and abstracts, 34 articles were selected for the data analysis that is based on a multi approach framework. The analysis of the research approach is categorized according to some aspects of using ICT by older adults from the adoption of ICT to the impact of usage, and the social services for them. This literature review focused on the function of communication by excluding the applications that mainly relate to physical nursing. The results show that the so-called ‘digital divide’ still exists, but the older adults have the willingness to learn and utilise ICT in daily life, especially for communication. The data shows that the usage of ICT can prevent the loneliness and social isolation of older adults, and they are eager for technical support in using ICT. The results of data analysis on theoretical frames and concepts show that this research field applies different theoretical frames from various scientific fields, while a social work approach is lacking. However, a synergic frame of applied theories will be suggested from the perspective of social work.

Evolution of the diatoms: major steps in their evolution and a review of the supporting molecular and morphological evidence.

Over the years, many reviews of different aspects of diatom biology, ecology and evolution have appeared. Since 1993 many molecular trees have been produced to infer diatom phylogeny. In 2004, Medlin & Kaczmarska revised the systematics of the diatoms based on more than 20 years of consistent recovery of two major clades of diatoms that did not correspond to a traditional concept of centrics and pennates and established three classes of diatoms: Clade 1 = Coscinodiscophyceae (radial centrics) and Clade 2 = Mediophyceae (polar centrics + radial Thalassiosirales) and Bacillariophyceae (pennates). However, under certain analytical conditions, an alternative view of diatom evolution, a grades of clades, has been recovered that suggests a gradual evolution from centric to pennate symmetry. These two schemes of diatom evolution are evaluated in terms of whether or not the criteria advocated by Medlin & Kaczmarska that should be met to recover monophyletic classes have been used. The monophyly of the three diatom classes can only be achieved if (1) a secondary structure of the small subunit (SSU) rRNA gene was used to construct the alignment and not an alignment based on primary structure and (2) multiple outgroups were used. These requirements have not been met in each study of diatom evolution; hence, the grade of clades, which is useful in reconstructing the sequence of evolution, is not useful for accepting the new classification of the diatoms. Evidence for how these two factors affect the recovery of the three monophyletic classes is reviewed here. The three classes have been defined by clear morphological differences primarily based on gametangia and auxospore ontogeny and envelope structure, the presence or absence of a structure (tube process or sternum) associated with the annulus and the location of the cribrum in those genera with loculate areolae. New evidence supporting the three clades is reviewed. Other features of the cell are examined to determine whether they can also be used to support the monophyly of the three classes.