Frequency of fear of needles and impact of a multidisciplinary educational approach towards pregnant women with diabetes

PURPOSE: To evaluate the frequency of fear of needles and the impact of a multidisciplinary educational program in women with pre-gestational and gestational diabetes taking insulin during pregnancy. METHODS: The short Diabetes Fear of Injecting and Self-testing Questionnaire (D-FISQ), composed by two subscales that access fear of self injection (FSI) and fear of self testing (FST), was administered twice during pregnancy to 65 pregnant women with pre-gestational and gestational diabetes: at the first endocrine consult and within the last two weeks of pregnancy or postpartum. An organized multidisciplinary program provided diabetes education during pregnancy. Statistical analysis was carried out by Wilcoxon and McNemar tests and Spearman correlation. A p<0.05 was considered to be significant. RESULTS: Data from the short D-FISQ questionnaire shows that 43.1% of pregnant women were afraid of needles in the first evaluation. There was a significant reduction in scores for FSI and FST subscales between the first and second assessments (first FSI 38.5% compared with second 12.7%, p=0.001; first FST 27.7% compared with second FST 14.3%, p=0.012). CONCLUSIONS: The fear of needles is common in pregnant women on insulin therapy and an organized multidisciplinary educational diabetes program applied during pregnancy reduces scores of such fear.

Impact of Word-of-Mouth on consumer decision-making: An information processing perspective in the context of a high-involvement service

This doctoral study conducts an empirical analysis of the impact of Word-of-Mouth (WOM) on marketing-relevant outcomes such as attitudes and consumer choice, during a high-involvement and complex service decision. Due to its importance to decisionmaking, WOM has attracted interest from academia and practitioners for decades. Consumers are known to discuss products and services with one another. These discussions help consumers to form an evaluative opinion, as WOM reduces perceived risk, simplifies complexity, and increases the confidence of consumers in decisionmaking. These discussions are also highly impactful as WOM is a trustworthy source of information, since it is independent from the company or brand. In responding to the calls for more research on what happens after WOM information is received, and how it affects marketing-relevant outcomes, this dissertation extends prior WOM literature by investigating how consumers process information in a highinvolvement service domain, in particular higher-education. Further, the dissertation studies how the form of WOM influences consumer choice. The research contributes to WOM and services marketing literature by developing and empirically testing a framework for information processing and studying the long-term effects of WOM. The results of the dissertation are presented in five research publications. The publications are based on longitudinal data. The research leads to the development of a proposed theoretical framework for the processing of WOM, based on theories from social psychology. The framework is specifically focused on service decisions, as it takes into account evaluation difficulty through the complex nature of choice criteria associated with service purchase decisions. Further, other gaps in current WOM literature are taken into account by, for example, examining how the source of WOM and service values affects the processing mechanism. The research also provides implications for managers aiming to trigger favorable WOM through marketing efforts, such as advertising and testimonials. The results provide suggestions on how to design these marketing efforts by taking into account the mechanism through which information is processed, or the form of social influence.

The Impact of Foreign Direct Investment Inflows on the Economic Growth of Bangladesh. The Roles of Infrastructural Facilities

Foreign direct investment (FDI) inflow has been a key concern for Bangladesh to obtain additional support for the economic development. The Government of Bangladesh continuously competing with other South Asian countries and putting more effort to increase the number of FDI inflows in the country. From the country’s perspective, the constant increasing rate of economic growth shows a positive outcome of FDI inflow. However, the country still not performing up to the mark to pull enough FDI inflows to its potential. Thus, this study discusses about the major determinants and factors affecting FDI inflows in Bangladesh. Among those determinants and factors, infrastructural facility is considered as the most important to affect FDI inflows. FDI inflow is fundamentally depending upon infrastructural facilities to achieve its desire success. Foreign investors take this issue very seriously because based on this they can measure their ease of doing business in the host country. Despite of providing a large market size, due to having weak and lack of infrastructural facilities, Bangladesh is facing trouble in drawing attention of the foreign investors. In order to make the infrastructural facilities happen, it is highly required to organize each of the systems under of it. The body of this study discussed about the weak infrastructures in Bangladesh such as transport and communication, power and energy, education system, and governance services. Improvement in one of these systems cannot provide valuable positive changes on FDI inflows. It requires improvement in all the weak systems to grasp multinational companies and attract foreign investors. On the basis of this research problem, research questions are established. Both qualitative and quantitative methods are used to answer the research questions. Furthermore, several theories have been applied to justify possible scenarios from the research problem. In addition, the history in between Bangladesh, trade liberalization, and FDI inflows is presented briefly.

The Impact of Foreign Direct Investment Inflows on the Economic Growth of Bangladesh. The Roles of Infrastructural Facilities

Foreign direct investment (FDI) inflow has been a key concern for Bangladesh to obtain additional support for the economic development. The Government of Bangladesh continuously competing with other South Asian countries and putting more effort to increase the number of FDI inflows in the country. From the country’s perspective, the constant increasing rate of economic growth shows a positive outcome of FDI inflow. However, the country still not performing up to the mark to pull enough FDI inflows to its potential. Thus, this study discusses about the major determinants and factors affecting FDI inflows in Bangladesh. Among those determinants and factors, infrastructural facility is considered as the most important to affect FDI inflows. FDI inflow is fundamentally depending upon infrastructural facilities to achieve its desire success. Foreign investors take this issue very seriously because based on this they can measure their ease of doing business in the host country. Despite of providing a large market size, due to having weak and lack of infrastructural facilities, Bangladesh is facing trouble in drawing attention of the foreign investors. In order to make the infrastructural facilities happen, it is highly required to organize each of the systems under of it. The body of this study discussed about the weak infrastructures in Bangladesh such as transport and communication, power and energy, education system, and governance services. Improvement in one of these systems cannot provide valuable positive changes on FDI inflows. It requires improvement in all the weak systems to grasp multinational companies and attract foreign investors. On the basis of this research problem, research questions are established. Both qualitative and quantitative methods are used to answer the research questions. Furthermore, several theories have been applied to justify possible scenarios from the research problem. In addition, the history in between Bangladesh, trade liberalization, and FDI inflows is presented briefly

Changing roles of nurse educators employed in acute and chronic care settings : the impact of professional and statutory mandates in Ontario at four sites of one hospital corporation /

The role of the hospital-employed nurse educator is evolving. Factors influencing this change include the introduction of standards for nurse educators by the College of Nurses of Ontario (CNO), a change in the way nurses are educated, the emergence of nursing as a profession, and hospital restructuring as a result of budgetary constraints. Two of these influencing factors: the introduction of the updated Standards of Practice for Registered Nurses and Registered Practical Nurses (1996) and hospital restructuring occurred over the last 7 years at several hospitals in southern Ontario. Current literature as well as the Standards of Practice (1996) were utilized to examine the current roles and responsibilities of nurse educators and subsequently develop a questionnaire to study the impact of these influencing factors on the role of the nurse educator. This questionnaire was piloted and revised before its distribution at 4 hospitals in southern Ontario. Twenty-five of the 41 surveys (61%) distributed were returned for analysis. The data reflected that the Standards of Practice had a positive influence on the role of the nurse educator, while hospital restructuring had a negative impact. In addition, many of the roles and responsibilities identified in the literature were indeed part of the current role of nurse educators, as well as several responsibilities not captured in the literature. The predictions for the future of this role in its current state were not positive given the financial status of the health care system as well as the lack of clarity for the role and the current level ofjob satisfaction among practicing nurse educators. However, a list of recommendations were generated which, if implemented, could add clarity to the role and improve job satisfaction. This could enhance the retention of current nurse educators and the possibility of recruiting competent nurse educators to the role in the future.

Teaching Principled negotiation skills to parents and their children : the impact of parental involvement /

This study explored the impact of training parents and children concurrently in principled negotiation skills for the purpose of developing negotiation skills and problem solving abilities in children. A second experimental group was utilized to determine the viability of negotiation skills training of junior elementary students for the purpose of improving problem solving and conflict resolving abilities. The student population in each experimental group was trained using The Program for Young Negotiators (Curhan, 1996). A control group was also established using the remaining grade four and five students attending the participating school. These students did not receive training as part of this study. Student group distribution was as follows: Experimental group 1 (students with parent participant) consisted of 10 (5 grade five and 5 grade 4 students), Experimental group 2 students without parent participant) consisted of 48 (20 grade 4 and 28 grade 5 students), and the Control group 3 (55 grade 4 and 5 students). The impact of training was measured using the Five Factor Negotiation Scale developed for use with the Program for Young Negotiators (Curhan, 1996). This measure was employed as a pre- and post-test questionnaire to the total student population, (113 students) to determine levels of ability in each of the key elements of negotiation, personal initiative, collaboration, communication, conflict based perspective taking, and conflict resolution approach (Nakkula & Nikitopoulos, unpublished). This measure has a coefficient alpha of .75 which is acceptable for this type of affective instrument. As well, open ended ability questions designed to measure ability, knowledge, and behaviour as they relate to negotiation skill application were given to the total student population, (113 students). Finally, journals were maintained by the students in both experimental groups, and informal feedback discussions were held with students and parents participating in the study.The intent of using both qualitative and quantitative measures was to provide an overall perspective of student abilities as they related to principled negotiation skills. While the quantitative measures were from the student perspective, more qualitative information was sought from parents and teachers through informal interviews, discussions, and use of confidential feedback cards. For analysis purposes, the ability questions were randomly selected for Experimental group 2 and Control group 3 in an effort to balance the groups more equitably with Experimental group 1. The findings of this study indicate that students of the junior elementary school age can be taught how to perceive conflict in a more constructive way. However, they are not as likely to use their skills when the conflict is with a sibling as they are with a peer, a teacher, or a parent. While no statistically significant differences between mean scores for Experimental groups 1 and 2 exist some subtle differences are noted. Overall, increases in mean scores for grade 4 students exceeded the increases for grade 5 students within Experimental group 1 . The implication being that younger students benefit more from having a parent trained in principled negoUation skills than older students. The skill level of a parent in principled negotiation can not be underesUmated. Without a consistent and effective role model the likelihood of developing student skill level to a point of automaticity is greatly reduced. Enough so that perhaps the emphasis should be placed on training parents more so than the students.

The impact of scheduling on the implementation of the new Ontario curriculum: teachers' perceptions /

This qualitative study explored secondary teachers' perceptions of scheduling in relation to pedagogy, curriculum, and observation of student learning. Its objective was to determine the best way to organize the scheduling for the delivery of Ontario's new 4-year curriculum. Six participants were chosen. Two were teaching in a semestered timetable, 1 in a traditional timetable, and 3 had experience in both schedules. Participants related a pressure cooker "lived experience" with weaker students in the semester system experiencing a particularly harsh environment. The inadequate amount of time for review in content-heavy courses, gap scheduling problems, catch-up difficulties for students missing classes, and the fast pace of semestering are identified as factors negatively impacting on these students. Government testing adds to the pressure by shifting teachers' time and attention in the classroom from deeper learning to a superficial coverage of material, from curriculum as lived to curriculum as text to be covered. Scheduling choice should be available in public education to accommodate the needs of all students. Curriculum guidelines need to be revamped to reflect the content that teachers believe is necessary for a successful course delivery. Applied level courses need to be developed for students who are not academically inferior but learn differently.

Grade 9 students' perceptions of the impact of a Drop Everything and Read (D.E.A.R.) program /

Educators continually look for strategies to enhance and improve the reading practices of their students. This is an especially challenging task for secondary level teachers as high school students often lack intrinsic motivation to read for pleasure (Bucher & Manning, 2004; Horton, 2005; Wooicott, Research Pty. Ltd. 2001). The purpose of this study was to detennine the effects of the Drop Everything and Read (D.E.A.R.) program on writing, on reading, and on grades, from the perspective of eight Grade 9 students. Of particular interest were the students' perceptions of the effect that participation in the program had on their grades, their writing, their motivation to reading, and their concept of themselves as readers. The eight participants were tracked over the course of a semester. Using qualitative research techniques, data were collected from four sources: two student surveys, researcher's daily field observations, students' weekly reading logs, and three open-ended one-on-one interviews. In order to gain an understanding of the impact of the D.E.A.R program, the data were corroborated, and analyzed with NVivo: N7 (2006). From the data analysis, five themes emerged as a function of the Grade 9 students' experiences in the D.E.A.R. program: Reading Preferences, Time Spent Reading, Making Associations with Reading for Pleasure, Perceptions of Self-as-Reader, and Evaluations of the D.E.A.R Program. In the interest of supporting students' positive reading habits and for the future implementation, these five themes are presented as a series of findings together with recommendations for practice.

Education, sport and myth in the community of Glengarry, Ontario : the athletic career of Roderick R. McLennan. 260 St. Catharines, Ont. : Faculty of Education, Brock University ;

This study examined how the athletic career of Roderick R. McLennan contributed to the popularization and subsequent development of Caledonian games in Ontario during the latter nineteenth century. Initially, the development of Caledonian games during the 1800s was examined to provide a contextual framework for McLennan's career. This investigation revealed that the games emerged from rural athletic events at pioneer working bees in the first quarter of the nineteenth century to regional sporting events by the mid-1800s, and finally into annual federated Caledonian games in 1870. Noteworthy primary source material for this chapter included the John MacGillivray Papers at the National Archives of Canada, the Scottish American Journal (NY) and the files retained by the Glengarry Sport Hall of Fame in Maxville, Ontario. Following the investigation of Caledonian games, McLennan's early athletic career was studied. Analysis of the Roderick and Farquhar McLennan Papers at the Archives of Ontario and the newspapers from the period revealed that McLennan rose to popularity in 1865 through a "Championship of the World" hammer throwing match in Cornwall and two "Starring Tours". The next chapter examined the height of McLennan's career through an investigation of the Roderick McLennan versus Donald Dinnie rivalry of the early .. n 1870s. It was detennined that the rivalry between McLennan and Dinnie, the champion athlete of Highland games in Scotland, was a popular attraction and had an impact on the Toronto and Montreal games of 1870 and the Toronto games of 1872. Finally, the athletic records established by McLennan during the 1860s and 1870s were investigated. These records were examined through the context of a media controversy over McLennan's feats that developed in the early 1880s between two newspapers. This controversy erupted between the Toronto Mail and the Spirit of the Times. Caledonian games in Canada have only been briefly examined and a thorough examination of prominent Canadian figures in this context has yet to be undertaken. This study unearths a prominent Canadian athlete of Scottish decent and details his involvement in the Caledonian games of nineteenth century Ontario.

Exploring the impact of a hands-on intervention on grade 7 girls and their feelings about self, mathematics, science, technology and related careers

Forty-five 12- and 13-year-old females attending Grade 7 in North York, Ontario were randomly selected from a group of 100 females who had volunteered to participate in a oneday hands-on workshop called It's Your Choice at Seneca College. The goals of this intervention were to broaden the career horizons of these students and to help them realize the need to continue mathematics and science through high school in order to keep occupational options unlimited. The young women were given a pre- and post-attitude survey to provide background information. In the month following participation in the workshop the students were interviewed in small groups (S students per group) to discover their perceptions of the impact of the workshop. The interviews revealed that participants felt that after the workshop their feelings of self-confidence increased, specifically with respect to working with their hands. Participants felt more aware of the usefulness and importance of the study of mathematics, science and technology, They also felt that It's Your Choice increased their interest in careers in these domains and helped them to see that these careers are viable choices for females. The interviews also revealed that many of the participants felt that in this society their roles and their choices were influenced and probably limited by the fact that they are female.

Improving the use of the nursing process: the impact of charting methodology developed from King's conceptual framework on the use of the nursing process

The purpose of this study was to assess the effects of changing a nursing documentation system, developed from King's Conceptual Framework, on the use of the nursing process. The null hypothesis was that there would be no significant increase in the reflection of the use of the nursing process on the nursing care plan or nurses' notes, as a result of using a nursing documentation system developed using King's Conceptual Framework (1981). The design involved the development of a questionnaire that was used to review health records pre and post implementation of a documentation system developed based on King's Conceptual Framework and Theory of Goal Attainment (1981). A Record Completeness Score was obtained from some of the questions. The null hypothesis was rejected. The results of the study have implications for nursing administration and the evaluation of nursing practice. If the use of a documentation system developed from a conceptual framework increases the reflection of the nursing process on the patient's health record, nursing will have the means to measure patient outcomes/goal attainment. All health care organizations and levels of government are focusing on methods to monitor and control the health-care dollar. In order for nursing to clearly determine the costs associated with nursing care, measurement of patient outcomes/goal attainment will need to be possible. In order to measure patient outcomes/goals attainment nurses will need to be able to collect data on their practice. It will be critical that nursing have a documentation system in place which facilitates the reflection of the nursing process within a theoretical framework.

The impact of a training program in phonological awareness on children's early writing

This study examined the effects that a training program in phonological awareness had on the early writing skills of children in a Grade One class in the Lincoln County Separate school system. The intent of the training program was to provide consistent and systematic practice in the manipulation of the phonological structure of language. The games and activities of the training program were related to a framework of developmental phonological skills and practised in a group setting during an unstructured period of the regular classroom schedule. The training program operated three days in a six-day cycle for approximately twenty minutes a day, from November until mid-March. All children were tested at the outset and conclusion of the study to determine level of functioning in letter identification, word recognition, verbal intelligence, phonological awareness and spelling. Results of the pre-tests and post-tests were compared to determine differences between the experimental and control groups over time. In addition, a systematic analysis of the children's writing looked at the development of the spelling of regular and irregular words. The results of this study provided strong support for the hypothesis that the treatment group would progress through the stages of early writing development more quickly than children without such training. On the basis of differences between the groups over time, it was evident that training in phonological awareness had a direct positive effect on the spelling of regular words for children during the early stages of writing. The training program did not have a significant effect on the spelling of irregular words. Test results evaluating phonological awareness indicated a significant difference within each group over time but no significance between the groups during the experimental period. It would appear that the results of these tests reflect maturational changes in the child rather than causal effects of the training program. Nor did the effects of the training program transfer significantly to other aspects of language. Although some of the hypotheses considered were not supported by the study, the results do indicate that children during the early stages of writing development can benefit from a training program in phonological awareness. The theoretical direction for effective programming as a result of this study is discussed. The educational implications of training phonological awareness concurrent to beginning efforts in writing are considered.

The impact of hospital downsizing on registered nurses displaced from full-time employment

This research identified and explored the various responses often women Registered Nurses displaced from full-time elnployment as staff nurses in general hospitals in southern Ontario. These nurses were among the hundreds in Ontario who were displaced between October 1991 and October 1995 as a result of organizational downsizing and other health care reform initiatives. The purpose ofthis research was to document tIle responses of nurses to job displacement, and how that experience impacted on a nurse's professional identity and her understanding of the nature and utilization of nursing labour. This study incorporated techniques consistent with the principles of naturalistic inquiry and the narrative tradition. A purposive sample was drawn from the Health Sector Training and Adjustment Program database. Data collection and analysis was a three-step process wherein the data collection in each step was informed by the data analysis in the preceding step. The main technique used for qualitative data collection was semistructured, individual and group interviews. Emerging from the data was a rich and textured story ofhow job displacement disrupted the meaningful connections nurses had with their work. In making meaning of this change, displaced nurses journeyed along a three-step path toward labour adjustment. Structural analysis was the interpretive lens used to view the historical, sociopolitical and ideological forces which constrained the choices reasonably available to displaced nurses while Kelly's personal construct theory was the lens used to view the process of making choices and reconstruing their professional identity.

The impact of meaningfulness of and responsibility for work on the relationships among work values, organizational commitment, and job satisfaction for part- time faculty in a community college

One hundred and thirty four subjects participated in this survey. Quantitative data were obtained and correlational analyses were used to test a model to study the relationships among the achievement of work values and organizational commitment and job satisfaction and to identify the moderating effects of the meaningfulness of work and responsibility for work on these relationships. Part-time faculty in the Faculty of Continuing Education of a community college were mailed a questionnaire on all the variables of the model. Several reliable, valid instruments were used to test the variables. Data analysis through Pearson correlation and stepwise multiple regression analyses revealed that the achievement of the work values of recognition and satisfaction with promotions did predict organizational commitment and job satisfaction, although the moderating effects of the meaningfulness of work and responsibility for work was not supported in this study. This study suggests that the revised model may be used for determining the relationships between the achievement of work values and organizational commitment and job satisfaction in a community college setting.