Perspective d'étudiantes infirmières de leur environnement d'apprentissage de la pratique en contexte de diversité culturelle lors d'une immersion clinique à l'international

Il existe une grande diversité dans les programmes de formation en sciences infirmières concernant l’organisation de stages d’immersion clinique à l’international et le soutien offert aux étudiantes (Kokko, 2011). Cette étude de cas qualitative explore, selon la perspective d’étudiantes infirmières, les éléments de l’environnement d’apprentissage de la pratique en contexte de diversité culturelle dans le cadre d’une immersion clinique à l’international. Le modèle constructiviste de développement de la compétence culturelle de Blanchet Garneau (2013 ; Blanchet Garneau et Pepin, 2015a) a servi de cadre de référence à cette étude. Dix étudiantes ayant participé à l’immersion clinique ont pris part à une entrevue individuelle en profondeur. Suite à une analyse qualitative thématique des données inspirée de Miles, Huberman et Saldana (2014), trois thèmes inter reliés ressortent : accompagnement par de multiples collaborations, trouver sa place dans le milieu d’accueil et écart entre les attentes des étudiantes et l’expérience vécue. Ces thèmes permettent de comprendre l’environnement d’apprentissage des étudiantes dans le développement de leur compétence culturelle, notamment leur capacité de s’ouvrir aux différentes réalités en contexte de diversité culturelle. Puisque peu d’écrits abordent spécifiquement les éléments de l’environnement d’apprentissage liés à la capacité de s’ouvrir aux différentes réalités de la pratique en contexte de diversité culturelle à l’étranger, cette étude contribue à l’approfondissement des éléments de l’environnement d’apprentissage présenté dans le modèle de Blanchet Garneau (2013 ; Blanchet Garneau et Pepin, 2015) et constitue un ajout aux connaissances actuelles liées au développement de la compétence culturelle.

INCORPORATING STIMULATING QUICK-WRITE PROMPTS WITHIN A SECONDARY SCIENCE CLASSROOM: A CASE STUDY IN LESOTHO

The use of intriguing open-ended quick-write prompts within the Basotho science classroom could potentially provide a way for secondary teachers in Lesotho to have a time-efficient alternative to stimulate student thinking and increase critical thinking or application of scientific principles. Writing can be used as a powerful means to improve the achievement of students across many subject areas, including the sciences (Moore, 1993; Rivard, 1994; Rillero, Zambo, Cleland, and Ryan, 1996; Greenstein, 2013). This study focuses on the use of a non-traditional nor extensively studied writing method that could potentially support learning in science. A quasi-experimental research design, with a control and experimental group, was applied. The study was conducted at two schools, with one experimental classroom in one school and a second control group classroom in the second school for a period of 4 weeks. 51 Form B (US Grade 9 equivalent) students participated as the experimental group and 43 Form B students as the control group. In an effort to assess learning achievement, a 1 hour (35 mark) pre-test evaluation was made by and given to students by Basotho teachers at the beginning of this study to have an idea of student’s previous knowledge. Topics covered were Static Electricity, Current Electricity, Electromagnetic Waves, and Chemistry of Water. After the experimental trial period, an almost completely identical post-test evaluation was given to students in the same fashion to observe and compare gains in achievement. Test data was analyzed using an inferential statistics procedure that compared means and gains in knowledge made by the experimental and control groups. Difference between the gains of mean pre-test and post-test scores were statistically significant within each group, but were not statistically significant when the control and experimental groups were compared. Therefore, there was no clear practical effect. Qualitative data from teachers’ journals and students’ written feedback provides insight on the assessments, incorporation of the teaching method, and the development of participating students. Both mid and post-study student feedback shows that students had an overall positive and beneficial experience participating in this activity. Assessments and teacher journals showed areas of strength and weaknesses in student learning and on differences in teaching styles. They also helped support some feedback claims made by students. Areas of further research and improvement of the incorporation of this teaching method in the Basotho secondary science classroom are explored.

An interprofessional approach to improving paediatric medication safety

Safe drug prescribing and administration are essential elements within undergraduate healthcare curricula, but medication errors, especially in paediatric practice, continue to compromise patient safety. In this area of clinical care, collective responsibility, team working and communication between health professionals have been identified as key elements in safe clinical practice. To date, there is limited research evidence as to how best to deliver teaching and learning of these competencies to practitioners of the future.An interprofessional workshop to facilitate learning of knowledge, core competencies, communication and team working skills in paediatric drug prescribing and administration at undergraduate level was developed and evaluated. The practical, ward-based workshop was delivered to 4th year medical and 3rd year nursing students and evaluated using a pre and post workshop questionnaire with open-ended response questions.Following the workshop, students reported an increase in their knowledge and awareness of paediatric medication safety and the causes of medication errors (p < 0.001), with the greatest increase noted among medical students. Highly significant changes in students' attitudes to shared learning were observed, indicating that safe medication practice is learnt more effectively with students from other healthcare disciplines. Qualitative data revealed that students' participation in the workshop improved communication and teamworking skills, and led to greater awareness of the role of other healthcare professionals.This study has helped bridge the knowledge-skills gap, demonstrating how an interprofessional approach to drug prescribing and administration has the potential to improve quality and safety within healthcare.

Not Getting By: Poverty Management and Homelessness in Miami

Urban inequality has emerged as one of the dominant themes of modern life and globalization. More than three million people experienced homelessness in the United States last year; in Miami-Dade, more than 15,000 individuals were homeless. Surviving extreme poverty, and exiting or avoiding homelessness, involves negotiating a complex mix of public and private assistance. However, a range of factors influence what types of help are available and how they can be accessed. Frequently, larger social structures determine which resource are available, leaving many choices entirely out of the individual’s control. For single men, who are ineligible for many benefits, homelessness can be difficult to avoid and even harder to exit. My study seeks to better understand how adult, minority men living in extreme poverty in Miami-Dade negotiate their daily survival. Specific research questions address: Do black and Hispanic men who are homeless or at risk of homelessness have different personal characteristics and different experiences in avoiding or exiting homelessness? How does Miami’s response to extreme poverty/homelessness, including availability of public benefits and public and private service organizations, either maximize or constrain the choices available to this population? And, what is the actual experience of single, adult men who are homeless or at risk of homelessness, in negotiating their daily survival? A mixed methods approach combines quantitative survey data from 7,605 homeless men, with qualitative data from 54 semi-structured interviews incorporating the visual ethnography techniques of Photo Elicitation Interviewing. Results show the differences experienced by black and Hispanic men who are poor and homeless in Miami. Findings also highlight how the community’s official and unofficial responses to homelessness intersect with the actual experiences of the persons targeted by the policies and programs, challenging preconceived notions regarding the lives of persons living in extreme poverty. It adds to the existing body of literature by focusing on the urban Miami context, emphasizing disparities amongst racial and ethnic groups. Findings are intended to provide an empirically grounded thesis that humanizes the subjects and illuminates their personal experiences, helping to inform public policy around the needs of extremely poor populations.

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.^

Selection and Passage of County Land Preservation Voter Referendum: The Role of Government

County jurisdictions in America are increasingly exercising self-government in the provision of public community services through the context of second order federalism. In states exercising this form of contemporary governance, county governments with “reformed” policy-making structures and professional management practices, have begun to rival or surpass municipalities in the delivery of local services with regional implications such as environmental protection (Benton 2002, 2003; Marando and Reeves, 1993). The voter referendum, a form of direct democracy, is an important component of county land preservation and environmental protection governmental policies. The recent growth and success of land preservation voter referendums nationwide reflects an increase in citizen participation in government and their desire to protect vacant land and its natural environment from threats of over-development, urbanization and sprawl, loss of open space and farmland, deterioration of ecosystems, and inadequate park and recreational amenities. The study’s design employs a sequential, mixed method. First, a quantitative approach employs the Heckman two-step model. It is fitted with variables for the non-random sample of 227 voter referendum counties and all non-voter referendum counties in the U.S. from 1988 to 2009. Second, the qualitative data collected from the in-depth investigation of three South Florida county case studies with twelve public administrator interviews is transformed for integration with the quantitative findings. The purpose of the qualitative method is to complement, explain and enrich the statistical analysis of county demographic, socio-economic, terrain, regional, governance and government, political preference, environmentalism, and referendum-specific factors. The research finds that government factors are significant in terms of the success of land preservation voter referendums; more specifically, the presence of self-government authority (home rule charter), a reformed structure (county administrator/manager or elected executive), and environmental interest groups. In addition, this study concludes that successful counties are often located coastal, exhibit population and housing growth, and have older and more educated citizens who vote democratic in presidential elections. The analysis of case study documents and public administrator interviews finds that pragmatic considerations of timing, local politics and networking of regional stakeholders are also important features of success. Further research is suggested utilizing additional public participation, local government and public administration factors.

Neuroscience and Hindu Aesthetics: A Critical Analysis of V.S. Ramachandran’s “Science of Art”

Neuroaesthetics is the study of the brain’s response to artistic stimuli. The neuroscientist V.S. Ramachandran contends that art is primarily “caricature” or “exaggeration.” Exaggerated forms hyperactivate neurons in viewers’ brains, which in turn produce specific, “universal” responses. Ramachandran identifies a precursor for his theory in the concept of rasa (literally “juice”) from classical Hindu aesthetics, which he associates with “exaggeration.” The canonical Sanskrit texts of Bharata Muni’s Natya Shastra and Abhinavagupta’s Abhinavabharati, however, do not support Ramachandran’s conclusions. They present audiences as dynamic co-creators, not passive recipients. I believe we could more accurately model the neurology of Hindu aesthetic experiences if we took indigenous rasa theory more seriously as qualitative data that could inform future research.

Tocqueville in Miami : political culture and political organizing in Miami's Cuban community

This study examines the effectiveness of civic organizations focusing on leadership and the role of culture in politics. The study is based on a quasi-experimental research design and relies primarily on qualitative data. The study focuses on Miami's Cuban community in order to examine the role of public initiative in grassroots civic and community organizations. The Miami Cuban community is a large, institutionally complex and cohesive ethnic community with dense networks of community organizations. The political and economic success of the community makes it an opportune setting for a study of civic organizing. The sheer number of civic organizations to be found in Miami's Cuban community suggests that the community's civic organizations have something to do with the considerable vibrancy and civic capacity of the community. How have the organizations managed to be so successful over so many years and what can be learned about successful civic organizing from their experience? Civic organizations in Miami's Cuban community are overwhelmingly ethnic-based organizations. The organizations recreate collective symbols that come from community members' memories of and attachments to the place of origin they hold dear as ethnic Cubans. They recreate a collective Cuban past that community members remember and that is the very basis of the community to which they belong. Cuban Miami's ethnically based civic organizations have generally performed better than the literature on civic organizations says they should. They gained greater access to community ties and social capital, and they exhibited greater organizational longevity. The fit between the political culture of civic organizations and that of the broader political community helps to explain this success. Yet they do not perform in the same way or in support of the same social purposes. Some stress individual agency rather than community agency, and some pursue an externally-oriented social purpose, whereas others focus on building an internal community.

Using alcohol unit-marked glasses enhances capacity to monitor intake:evidence from a mixed-method intervention trial

AIMS: In the UK, people tend to have poor knowledge of government guidelines for alcohol use, and lack the motivation and skills required to use them to monitor their drinking. The study aim was to determine whether using glasses marked with such guidelines would improve knowledge and attitudes, increase frequency of counting units and lower alcohol intake. METHODS: A total of 450 adults in the UK participated in an intervention vs control study with 1-month follow-up. The intervention group was encouraged to use glasses supplied by the researchers that indicated the unit content of drinks of different strengths and volumes, and stated the intake guidelines. Data were collected online. A further more in-depth interview with 13 intervention group participants enquired into their experiences of using the glasses. RESULTS: Analyses adjusted for baseline variables showed that the intervention improved the following: knowledge of unit-based guidelines, ability to estimate the unit content of drinks, attitudes toward the guidelines and frequency of counting unit intake. However, there was no significant difference in alcohol consumption between the groups at follow-up. Interviews suggested that the glasses encouraged people to think about their drinking and to discuss alcohol with other people. The design of the glasses was not appealing to all, and their initial impact did not always persist. CONCLUSION: Use of unit-marked glasses led to changes in people's reported use of unit-based guidelines to monitor their drinking but, in the short term, no change in consumption. Qualitative data suggested that the glasses could have an impact at the individual level (on knowledge and attitudes) and at a broader level (by prompting discussion of alcohol use).

Perspective d'étudiantes infirmières de leur environnement d'apprentissage de la pratique en contexte de diversité culturelle lors d'une immersion clinique à l'international

Il existe une grande diversité dans les programmes de formation en sciences infirmières concernant l’organisation de stages d’immersion clinique à l’international et le soutien offert aux étudiantes (Kokko, 2011). Cette étude de cas qualitative explore, selon la perspective d’étudiantes infirmières, les éléments de l’environnement d’apprentissage de la pratique en contexte de diversité culturelle dans le cadre d’une immersion clinique à l’international. Le modèle constructiviste de développement de la compétence culturelle de Blanchet Garneau (2013 ; Blanchet Garneau et Pepin, 2015a) a servi de cadre de référence à cette étude. Dix étudiantes ayant participé à l’immersion clinique ont pris part à une entrevue individuelle en profondeur. Suite à une analyse qualitative thématique des données inspirée de Miles, Huberman et Saldana (2014), trois thèmes inter reliés ressortent : accompagnement par de multiples collaborations, trouver sa place dans le milieu d’accueil et écart entre les attentes des étudiantes et l’expérience vécue. Ces thèmes permettent de comprendre l’environnement d’apprentissage des étudiantes dans le développement de leur compétence culturelle, notamment leur capacité de s’ouvrir aux différentes réalités en contexte de diversité culturelle. Puisque peu d’écrits abordent spécifiquement les éléments de l’environnement d’apprentissage liés à la capacité de s’ouvrir aux différentes réalités de la pratique en contexte de diversité culturelle à l’étranger, cette étude contribue à l’approfondissement des éléments de l’environnement d’apprentissage présenté dans le modèle de Blanchet Garneau (2013 ; Blanchet Garneau et Pepin, 2015) et constitue un ajout aux connaissances actuelles liées au développement de la compétence culturelle.

Health professionals’ and patients’ perspectives on pelvic floor muscle training adherence : 2011 ICS State-of-the-Science Seminar research paper IV of IV

Aims There is scant information on pelvic floor muscle training (PFMT) adherence barriers and facilitators. A web-based survey was conducted (1) to investigate whether responses from health professionals and the public broadly reflected findings in the literature, (2) if responses differed between the two groups, and (3) to identify new research directions. Methods Health professional and public surveys were posted on the ICS website. PFMT adherence barriers and facilitators were divided into four categories: physical/condition, patient, therapy, and social-economic. Responses were analyzed using descriptive statistics from quantitative data and thematic data analysis for qualitative data. Results Five hundred and fifteen health professionals and 51 public respondents participated. Both cohorts felt “patient-related factors” constituted the most important adherence barrier, but differed in their rankings of short- and long-term barriers. Health professionals rated “patient-related” and the public “therapy-related” factors as the most important adherence facilitator. Both ranked “perception of PFMT benefit” as the most important long-term facilitator. Contrary to published findings, symptom severity was not ranked highly. Neither cohort felt the barriers nor facilitators differed according to PFM condition (urinary/faecal incontinence, pelvic organ prolapse, pelvic pain); however, a large number of health professionals felt differences existed across age, gender, and ethnicity. Half of respondents in both cohorts felt research barriers and facilitators differed from those in clinical practice. Conclusions An emphasis on “patient-related” factors, ahead of “condition-specific” and “therapy-related,” affecting PFMT adherence barriers was evident. Health professionals need to be aware of the importance of long-term patient perception of PFMT benefits and consider enabling strategies.

EQUASS Assurance Certification: The View of Pioneer Adopters

Purpose – The paper examines from a practitioner’s perspective the European Quality in Social Services (EQUASS) Assurance standard, a certification programme for European social service organisations to implement a sector-specific Quality Management System. In particular, it analyses the adoption motives, the internalisation of the standard, the impacts, the satisfaction and the renew intentions. Design/methodology/approach – This study uses a cross-sectional, questionnaire-based survey methodology. From the 381 organisations emailed, 196 responses coming from eight different European countries were considered valid (51.4%). Data from closed-ended questions were analysed using simple descriptive statistical techniques. Content analysis was employed to analyse practitioner’s comments to open-ended questions. Findings – It shows that social service providers typically implement the certification for internal reasons, and internalise EQUASS principles and practices in daily usage. EQUASS Assurance produces benefits mainly at the operational and customer levels, whereas its main pitfalls include increased workload and bureaucracy. The majority of respondents (85.2%) are very satisfied or satisfied with the certification, suggesting that it meets their expectations. Certification renewal intentions are also high but some respondents report that the final decision depends on several factors. The insights gained through the qualitative data are also described. Practical implications – It can be helpful to managers, consultants and Local License Holders working (or planning to work) with this standard. It can inform the work of the EQUASS Technical Working Group in the forthcoming revision of the standard. Originality/value – This is the largest survey conducted so far about EQUASS Assurance in terms of number of respondents, participating countries and topics covered.

Nurses', midwives' and key stakeholders' experiences and perceptions on requirements to demonstrate the maintenance of professional competence.

Aim: To present the qualitative findings from a study on the development of scheme(s) to give evidence of maintenance of professional competence for nurses and midwives. Background: Key issues in maintenance of professional competence include notions of self- assessment, verification of engagement and practice hours, provision of an evidential record, the role of the employer and articulation of possible consequences for non-adherence with the requirements. Schemes to demonstrate the maintenance of professional competence have application to nurses, midwives and regulatory bodies and healthcare employers worldwide. Design: A mixed methods approach was used. This included an online survey of nurses and midwives and focus groups with nurses and midwives and other key stakeholders. The qualitative data are reported in this study. Methods: Focus groups were conducted among a purposive sample of nurses, midwives and key stakeholders from January–May 2015. A total of 13 focus groups with 91 participants contributed to the study. Findings: Four major themes were identified: Definitions and Characteristics of Competence; Continuing Professional Development and Demonstrating Competence; Assessment of Competence; The Nursing and Midwifery Board of Ireland and employers as regulators and enablers of maintaining professional competence. Conclusion: Competence incorporates knowledge, skills, attitudes, professionalism, application of evidence and translating learning into practice. It is specific to the nurse's/midwife's role, organizational needs, patient's needs and the individual nurse's/midwife's learning needs. Competencies develop over time and change as nurses and midwives work in different practice areas. Thus, role-specific competence is linked to recent engagement in practice.

Efeitos do suster-relaxar na cinemática tridimensional, função neuromuscular e sintomatologia álgica de um atleta de crossfit com dor lombar

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia

Health professionals’ and patients’ perspectives on pelvic floor muscle training adherence : 2011 ICS State-of-the-Science Seminar research paper IV of IV

Aims There is scant information on pelvic floor muscle training (PFMT) adherence barriers and facilitators. A web-based survey was conducted (1) to investigate whether responses from health professionals and the public broadly reflected findings in the literature, (2) if responses differed between the two groups, and (3) to identify new research directions. Methods Health professional and public surveys were posted on the ICS website. PFMT adherence barriers and facilitators were divided into four categories: physical/condition, patient, therapy, and social-economic. Responses were analyzed using descriptive statistics from quantitative data and thematic data analysis for qualitative data. Results Five hundred and fifteen health professionals and 51 public respondents participated. Both cohorts felt “patient-related factors” constituted the most important adherence barrier, but differed in their rankings of short- and long-term barriers. Health professionals rated “patient-related” and the public “therapy-related” factors as the most important adherence facilitator. Both ranked “perception of PFMT benefit” as the most important long-term facilitator. Contrary to published findings, symptom severity was not ranked highly. Neither cohort felt the barriers nor facilitators differed according to PFM condition (urinary/faecal incontinence, pelvic organ prolapse, pelvic pain); however, a large number of health professionals felt differences existed across age, gender, and ethnicity. Half of respondents in both cohorts felt research barriers and facilitators differed from those in clinical practice. Conclusions An emphasis on “patient-related” factors, ahead of “condition-specific” and “therapy-related,” affecting PFMT adherence barriers was evident. Health professionals need to be aware of the importance of long-term patient perception of PFMT benefits and consider enabling strategies.