Evaluation of an accident and emergency teleconsultation service for north-east Scotland

We evaluated an accident and emergency teleconsultation service provided to 14 community hospitals in north-east Scotland. Each community hospital was equipped with a videoconferencing system and a document camera to allow transmission of radiographs. The network used 384 kbit/s ISDN connections. A total of 1392 teleconsultations were recorded during a 12-month study period. Seventy-seven per cent of patients (n=1072) were managed locally and 23% (n=320) were transferred to Aberdeen. The majority (95%) of teleconsultations were conducted on weekdays, and 90% of these occurred between the hours of 09:00 and 16:00. The mean delay in contacting a doctor was 9 min and the mean consultation time was 10 min. The majority of patients were suffering from fractures or suspected fractures of the limbs. Radiograph transmission was used in 75% of all teleconsultations. A high degree of satisfaction was recorded by all users of the service.

Teenage mothers' experiences of stigma and formal support services

This research has two focal points: experiences of stigma and experiences of formal support services among teenage mothers. Twenty teenage mothers were interviewed in depth, ten from a one-to-one support service, and ten from a group based support service. Contributions to knowledge consisted of the following. First, regarding experiences of stigma, this research integrated concepts from the social psychology literature and established the effects of stigma which are experienced by teenage mothers, offering reasons for the same. Additionally, further coping mechanisms in response to being stigmatized were discovered and grouped into two new headings: active and passive coping mechanisms. It is acknowledged that for a minority of participants, stigma does have negative effects, however, the majority experiences no such serious negative effects. Secondly, regarding experiences of support services, this research was able to directly compare one-to-one with group based support for teenage mothers. Knowledge was unearthed as to influential factors in the selection of a mode of support and the functions of each of the modes of support, which were categorised under headings for ease of comparison. It was established that there is indeed a link between these two research foci in that both the one-to-one and group based support services fulfil a stigma management function, in which teenage mothers discuss the phenomenon, share experiences and offer advice to others. However, it was also established that this function is of minor importance compared to the other functions fulfilled by the support services.

Parental absence and academic achievement in immigrant students

Academic achievement and educational expectations as a function of parental absence were examined among 268 newly immigrant elementary, middle, and high-school students from Spanish-speaking countries. Data collected as part of a longitudinal study of adaptation and achievement in newly immigrant students were analyzed. Participants had varying experiences with parental absence, in terms of length of absence, gender of absent parent, and reason for absence. Reasons for parental absence included parental divorce, parental death, and serial migration, a cause unique to immigrant children. Students who experienced parental absence reported lower educational expectations. Students who experienced the death of a parent had lower achievement scores and lower expectations than students who did not experience parental death. Prolonged absence was also important, with students who experienced parental absence for more than one year performing worse than students who had minimal parental separation. In addition, boys who experienced parental absence because of serial migration performed worse academically than boys who did not have this occurrence. Educational expectations were reduced among students who experienced parental absence as a result of the migratory process, especially for younger students. The extent to which parental absence related to achievement and expectations through potential mediating factors, such as economic hardship, perceived school support, and parental school involvement was assessed with structural equation modeling. Overall, the model was able to explain some of the relationship between parental absence and the academic achievement and educational expectations of immigrant students from Spanish-speaking countries.^

Risk -taking propensity of faculty, administrators, and academic department heads at a large, urban, multi -campus community college

This research was undertaken to explore dimensions of the risk construct, identify factors related to risk-taking in education, and study risk propensity among employees at a community college. Risk-taking propensity (RTP) was measured by the 12-item BCDQ, which consisted of personal and professional risk-related situations balanced for the money, reputation, and satisfaction dimensions of the risk construct. Scoring ranged from 1.00 (most cautious) to 6.00 (most risky).^ Surveys including the BCDQ and seven demographic questions relating to age, gender, professional status, length of service, academic discipline, highest degree, and campus location were sent to faculty, administrators, and academic department heads. A total of 325 surveys were returned, resulting in a 66.7% response rate. Subjects were relatively homogeneous for age, length of service, and highest degree.^ Subjects were also homogeneous for risk-taking propensity: no substantive differences in RTP scores were noted within and among demographic groups, with the possible exception of academic discipline. The mean RTP score for all subjects was 3.77, for faculty was 3.76, for administrators was 3.83, and for department heads was 3.64.^ The relationship between propensity to take personal risks and propensity to take professional risks was tested by computing Pearson r correlation coefficients. The relationships for the total sample, faculty, and administrator groups were statistically significant, but of limited practical significance. Subjects were placed into risk categories by dividing the response scale into thirds. A 3 x 3 factorial ANOVA revealed no interaction effects between professional status and risk category with regard to RTP score. A discriminant analysis showed that a seven-factor model was not effective in predicting risk category.^ The homogeneity of the study sample and the effect of a risk-encouraging environment were discussed in the context of the community college. Since very little data on risk-taking in education is available, risk propensity data from this study could serve as a basis for comparison to future research. Results could be used by institutions to plan professional development activities, designed to increase risk-taking and encourage active acceptance of change. ^

Risk-taking propensity of faculty, administrators and academic departament heads at large, urban, multicampus community college

This research was undertaken to explore dimensions of the risk construct, identify factors related to risk-taking in education, and study risk propensity among employees at a community college. Risk-taking propensity (RTP) was measured by the 12-item BCDQ, which consisted of personal and professional risk-related situations balanced for the money, reputation, and satisfaction dimensions of the risk construct. Scoring ranged from 1.00 (most cautious) to 6.00 (most risky). Surveys including the BCDQ and seven demographic questions relating to age, gender, professional status, length of service, academic discipline, highest degree, and campus location were sent to faculty, administrators, and academic department heads. A total of 325 surveys were returned, resulting in a 66.7% response rate. Subjects were relatively homogeneous for age, length of service, and highest degree. Subjects were also homogeneous for risk-taking propensity: no substantive differences in RTP scores were noted within and among demographic groups, with the possible exception of academic discipline. The mean RTP score for all subjects was 3.77, for faculty was 3.76, for administrators was 3.83, and for department heads was 3.64. The relationship between propensity to take personal risks and propensity to take professional risks was tested by computing Pearson r correlation coefficients. The relationships for the total sample, faculty, and administrator groups were statistically significant, but of limited practical significance. Subjects were placed into risk categories by dividing the response scale into thirds. A 3 X 3 factorial ANOVA revealed no interaction effects between professional status and risk category with regard to RTP score. A discriminant analysis showed that a seven-factor model was not effective in predicting risk category. The homogeneity of the study sample and the effect of a risk encouraging environment were discussed in the context of the community college. Since very little data on risk-taking in education is available, risk propensity data from this study could serve as a basis for comparison to future research. Results could be used by institutions to plan professional development activities, designed to increase risk-taking and encourage active acceptance of change.

Palliative Medicine:Scoping the level and extent of service provision to people with intellectual disability at end of life Poster Presentation

Background: Concerns exist about the end of life care
that people with intellectual disabilities receive. This population
are seldom referred to palliative care services and
inadequate data sets exist about their place of death.
Aim: To scope the extent of service provision to people
with intellectual disabilities at the end of life by specialist
palliative care and intellectual disability services in one
region of the United Kingdom.
Methods: As part of a larger doctoral study a regional survey
took place of a total sample (n=66) of specialist palliative
care and intellectual disability services using a postal
questionnaire containing forty items. The questionnaire
was informed by the literature and consultation with an
expert reference group. Data were analysed using SPSS to
obtain descriptive statistics.
Results: A total response rate from services of 71.2%
(n=47) was generated. Findings showed a range of experience
among services in providing end of life care to people
with intellectual disabilities in the previous five years, but
general hospitals were reported the most common place of
death. A lack of accessible information on end of life care
for people with learning disabilities was apparent. A few
services (n=14) had a policy to support this population to
make decisions about their care or had used adapted Breaking
Bad News guidelines (n=5) to meet their additional
needs. Both services recognised the value of partnership
working in assessing and meeting the holistic needs of
people with intellectual disabilities at end of life.
Conclusions: A range of experience in caring for people
with intellectual disabilities was present across services,
but more emphasis is required on adapting communication
for this population to facilitate them to participate in their
care. These findings could have international significance
given that studies in other countries have highlighted a
need to widen access to palliative care for this group of
people.

Predictive Analytics and Decision Support for Heart Failure patients

Thesis (Master's)--University of Washington, 2016-08

Service Loyalty: An Integrative Model and Examination across Service Contexts

Marketing academics and practitioners generally agree that customer loyalty is vital to business success. There is less agreement on the factors that determine customer loyalty, particularly in service contexts. Research on the determinants of service loyalty has taken three distinct paths: 1) quality/value/satisfaction; 2) relationship quality; and, 3) relational benefits. In this research, the authors coalesce these paths to derive a model that links dimensions of customer loyalty (cognitive, affective, intention, and behavioral) with a system of determinants. The model is tested with data from varied services (airlines, banks, beauty salons, hospitals, hotels, and mobile telephone) and 3,500 customers in China. Results are consistent across contexts and support a multidimensional view of customer loyalty. Key loyalty determinants are customer satisfaction, commitment, service fairness, service quality, trust, and a construct new to service loyalty models—commercial friendship. The research contributes to the literature by providing a more complete, integrated view of customer loyalty and its determinants in services contexts.

Exploring the intersections of creative and academic life among Australian academic creative writing practitioners

Test Anxiety, Coping, Gender and Academic Performance in English Exams: A Study of Finnish Upper Secondary School Students

In this MA thesis, test anxiety related to English exams among Finnish upper secondary school students was studied. In addition, the ways students try to cope with test anxiety were investigated. The purpose of the study was to investigate gender differences in test anxiety, the effects of test anxiety on academic performance and relationships between test anxiety, academic performance and coping strategies. Test anxiety and coping strategies were analysed as scores of questionnaire responses. Coping strategies comprised of three categories – task-orientation and preparation, seeking social support and avoidance. Academic performance was analysed as teacher ratings of general performance in English exams. In total 67 subjects were studied. The subjects were Finnish general upper secondary school students. The data were collected by using online questionnaires. This data were mainly quantitative, but also qualitative elements were included. The quantitative data were analysed by using statistical methods. The results showed that females experienced statistically significantly more test anxiety than males. In addition, a statistically significant correlation was found between test anxiety levels and academic performance ratings of the subjects: the higher the test anxiety score, the lower the academic performance rating. A meaningful correlation was found between test anxiety and seeking social support as a coping strategy: a higher test anxiety score was related to using social support as a coping strategy. However, no relationships were found between academic performance and the three coping strategies when quantitative and qualitative data were analysed. Therefore, different coping strategies per se did not seem to be related to academic performance, but instead it was assumed that the effectiveness of coping strategies is dependent on individual differences. In order to obtain more generalisable results and to gain more understanding of test anxiety and coping with it, a larger number of subjects form different areas of Finland and of different ages could be examined in future studies. Moreover, cross-national and cross-cultural studies could provide valuable information. As a practical recommendation for educational purposes, the results of this study indicated that a more individualised approach is needed.

Career and work-family relationship among academics : An exploratory study

Despite the increase, in recent years, of women’s participation in the labour market, sex discrimination remains a reality in most work organisations. In this matter, academic organisations are no exception. Evidence of sex inequalities is well documented in the literature. At the individual level, inequalities are partly explained by family responsibilities mainly held by women. Having to spend a considerable amount of time in home and children related activities women are left with less time available for scientific work than their male colleagues. With the purpose of understanding how academics experience the relationship between work and family, 32 in-depth interviews were conducted among Portuguese academics of both sexes in one particular university. The findings confirmed that work-family conflict is stronger among female faculty than among their male counterparts. Additionally, the prejudice against maternity and the way it is compatible with a successful career appears to survive the new gender relations. Difficulties felt by female academics could be minimised by the introduction of «family-friendly» policies and the development of a positive organisational climate towards maternity and family issues.

How do servant leaders ignite absorptive capacity?: the role of epistemic motivation and organizational support

This study examines the role of servant leadership in absorptive capacity. Data from manufacturing and service sector organizations found that: a) there was moderation of servant leadership influence on knowledge identification through POS by high need for cognition, b) there was moderation of servant leadership influence on knowledge application through POS by low time pressure, and c) POS mediated relationship between servant leadership and knowledge dissemination. The findings illustrate and support the importance of a comprehensive model integrating servant leadership, POS, and epistemic motivation in determining absorptive capacity.

Text message and internet support for coronary heart disease self-management: results from the text4heart randomized controlled trial

BACKGROUND: Mobile technology has the potential to deliver behavior change interventions (mHealth) to reduce coronary heart disease (CHD) at modest cost. Previous studies have focused on single behaviors; however, cardiac rehabilitation (CR), a component of CHD self-management, needs to address multiple risk factors. OBJECTIVE: The aim was to investigate the effectiveness of a mHealth-delivered comprehensive CR program (Text4Heart) to improve adherence to recommended lifestyle behaviors (smoking cessation, physical activity, healthy diet, and nonharmful alcohol use) in addition to usual care (traditional CR). METHODS: A 2-arm, parallel, randomized controlled trial was conducted in New Zealand adults diagnosed with CHD. Participants were recruited in-hospital and were encouraged to attend center-based CR (usual care control). In addition, the intervention group received a personalized 24-week mHealth program, framed in social cognitive theory, sent by fully automated daily short message service (SMS) text messages and a supporting website. The primary outcome was adherence to healthy lifestyle behaviors measured using a self-reported composite health behavior score (≥3) at 3 and 6 months. Secondary outcomes included clinical outcomes, medication adherence score, self-efficacy, illness perceptions, and anxiety and/or depression at 6 months. Baseline and 6-month follow-up assessments (unblinded) were conducted in person. RESULTS: Eligible patients (N=123) recruited from 2 large metropolitan hospitals were randomized to the intervention (n=61) or the control (n=62) group. Participants were predominantly male (100/123, 81.3%), New Zealand European (73/123, 59.3%), with a mean age of 59.5 (SD 11.1) years. A significant treatment effect in favor of the intervention was observed for the primary outcome at 3 months (AOR 2.55, 95% CI 1.12-5.84; P=.03), but not at 6 months (AOR 1.93, 95% CI 0.83-4.53; P=.13). The intervention group reported significantly greater medication adherence score (mean difference: 0.58, 95% CI 0.19-0.97; P=.004). The majority of intervention participants reported reading all their text messages (52/61, 85%). The number of visits to the website per person ranged from zero to 100 (median 3) over the 6-month intervention period. CONCLUSIONS: A mHealth CR intervention plus usual care showed a positive effect on adherence to multiple lifestyle behavior changes at 3 months in New Zealand adults with CHD compared to usual care alone. The effect was not sustained to the end of the 6-month intervention. A larger study is needed to determine the size of the effect in the longer term and whether the change in behavior reduces adverse cardiovascular events. TRIAL REGISTRATION: ACTRN 12613000901707; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364758&isReview=true (Archived by WebCite at http://www.webcitation.org/6c4qhcHKt).

Students’ Involvement in School and Parental Support: Contributions to the Socio-Educational Intervention

Student involvement in the school and the perception of parental support are core variables in the context of studies on personal and school adjustment of children and adolescents and should be considered in the context of socio-educational intervention. In this study, we formulated the following objectives: i) to understand the differences in students’ involvement in school and the perception of parental support, according to several socio- demographic and school variables, ii) to analyse the relationship between involvement and the perception of parental support iii) to outline socio-educational intervention strategies in the contexts of children’s lives. This is a non-experimental, correlational and cross-sectional study by means of a non-probabilistic convenience sample consisting of 150 children, aged between 10 and 16 years, attending the 2nd and 3rd cycles basic education [5th – 9th years of schooling] attending a school in the central region of Portugal. The data collection instruments were “Students’ Engagement in School: a Four-Dimensional Scale – SES-4DS” (Veiga 2013, 2016), the “Perceived Parental Support Scale” (Veiga, 2011) and a part with socio-demographic and school questions was added. We found significant differences in overall (and partial) amounts of student involvement and the perception of parental support, depending on the age, gender (in agency and behaviour subscales), school difficulties/retentions and methods of study (time, a place to study and a study schedule). We also found positive and significant relationships between student involvement and perception of parental support. The results are in line with the scientific literature in the field, which highlights the key role of the variables, student involvement and perception of parental support in the academic and psychosocial adjustment of young people. These should be considered in the context of socio-educational intervention. Given the above, we present areas and action strategies promoting parent and student involvement in the educational process.