A study conducted on patients who underwent total knee arthroplasty indicated that participants who were offered preadmission education for their procedure had statistically better outcomes than patients who had not attended an educational class. The study further focused on patients’ confidence in their ability to take control of their health situations as well as the effect of encouragement and motivation to provide active involvement. Two surveys, the Krantz Health Opinion Survey and the Multi Dimensional Health Locus of Control, were used to assess patients’ innate desires to be involved in their care and if they felt they could render any control themselves on their health. The study showed a statistically significant better outcome when patients received education prior to their procedure. When patients were encouraged and motivated to participate and take control of their rehabilitation after knee surgery, the outcomes were better than with education alone. It is a worthy endeavor therefore for education to be provided before total knee arthroplasty and to identify those patients who need additional encouragement to gain confidence in their abilities in order to positively affect their outcomes. Providing healthcare professionals information about patients’ innate traits regarding their desire or self-confidence to engage in their care could also be useful to allow caretakers to work with patients in the most advantageous manner to achieve better outcomes.

This historical study examines the desegregation of a historically African- American high school during the period between 1965-1975. The Mims v. The Duval County School Board (1971) decision brought about radical changes in the operation of the Duval County Public Schools. The mass transfer of teachers and reassignment of students as a result of the federal judge's order in this case resulted in a school system that was dramatically different from the one that previously existed. The author seeks to determine why the desegregation of William Raines High School was short-lived and questions the continued effort of the school system to desegregate this school. The author conducted a multi-faceted investigation to answer the research questions. Following a case study approach, both archival and oral data were collected and examined. Focused interviews were conducted with former William Raines High School students, faculty and parents. In addition, written documents and local newspaper accounts were studied. The oral interviews support and expand the findings of the archival documents. The findings of the study indicate that the history and traditions at William Raines High School are founded on a strong sense of pride and identity. However, changes in the school over time have resulted in a school that has lost its focus on academic excellence. In order for lasting desegregation to take place, substantive changes will be required. The pride that was the school's legacy must be restored. Excellence in all aspects of school life should be the overarching goal. PALMM.

The leadership of American not-for-profit hospitals is one context in which servant-leadership finds appropriate expression. However, little research exists that explores the sources of servant-leadership within the leader, what processes leaders use to engage in servantleadership, or what impact servant-leadership has on organizations and communities. This research presents a new perspective offering insight into those questions. The Dimensions of Servant-Leadership in American Not-for-Profit Hospitals is a qualitative study of the lives and works of four chief executive officers of successful not-for-profit health systems identified as exemplars of servant-leadership. The researcher further examined perceptions of servant-leadership among colleagues of each of the four CEOs and their health systems. The findings of the study indicated that the common denominators of servant-leadership, as perceived by those served by these four CEOs and their organizations, are that the people grew as individuals; the people felt that they were healthier, wiser, freer, more autonomous, and more likely themselves to become servants. The servant-leader CEOs gave strong evidence of a group-oriented approach to decision making. They fostered strong organizational involvement in programs of community betterment, they each had a strong commitment to continuing education for their associates, and they demonstrated in all their activities a great love and compassion in caring for the health of their communities. Finally, the study offers valuable insights into servant-leadership which might be useful in the postsecondary education of future healthcare leaders.

This dissertation is a cross-case study and analysis of four teachers in a school involved in two reform initiatives which promote constructivist approaches to teaching and learning. The study describes the teachers' understandings of the learning theory and their interpretations of it in their classroom practice. The study found that three of the four teachers were practicing in ways consistent with constructivism while one was not because her need for control took precedence. The study found that although teachers are very aware of their students as individuals with different ways of learning and constructing an understanding, they are not much interested in learning theory. Teachers are, therefore, more likely to practice in ways consistent with constructivist learning theory if they see that such practice can help them meet the diverse learning needs of the individuals in their classes and if they are shown the "how-to's" in their professional development. The study also found that classroom management needs and the need for control of student behavior inhibit practice consistent with constructivism and concluded that teachers are more likely to practice in ways consistent with constructivism if complimentary classroom management techniques can be found and if teachers are comfortable giving students choice and control. The study uncovered the four C's of impediments to constructivist practice: classroom management, control, "coverage," and custodial care.

The purpose of this study was to identify and describe the possible components of structural autonomy that influence Nurse Practitioners' (NPs) perceptions of independence in practice. The components identified were NP state regulatory practices, educational background, and managed care environment. The study explored the relationship between NP structural autonomy as it relates to the above components and attitudinal autonomy as it relates to perceptions of independence in practice. A conceptual framework derived from a review of the literature demonstrated the possible relationships. The investigator employed a mail survey to collect data from certified NPs in six eastern and mid-eastern states. Current state regulations regarding advanced nursing practice were used to establish current state practice scores. The Nursing Autonomy Scale (Pankratz & Pankratz, 1974), the Index of Work Satisfaction (Stamps & Piedmonte, 1986), and the Professional Inventory (Hall, 1974) measured perceptions of autonomy. Additional information was collected to determine the NP demographic background, educational background, practice setting and managed care circumstances. Of 300 surveys mailed, 227 participants responded. Data analysis included correlation analysis, t-tests, analysis of variance, and multiple regression procedures. Demographic information was summarized with descriptive statistics. The major findings of the study were: (1) State regulatory guidelines do not affect perceptions of autonomy as measured on the scales used. (2) Preceptor experience during NP education does not affect perceptions of autonomy as measured on the scales used. (3) Pharmacology preparedness does not affect perceptions of autonomy as measured on the scales used. (4) Managed care circumstances do not affect autonomy as measured on the scales used. It was concluded that structural autonomy is a more complex and multi-dimensional experience than originally hypothesized. Many additional factors must be taken into consideration when exploring NPs' perceptions of autonomy. It may be that most NPs are practicing in an independent, yet collaborative role, which provides opportunity for autonomy. The investigator also concluded that NP educational programs do not adequately prepare NPs for independent prescriptive authority. Variables related to NP autonomy were not determined in the study, yet it is evident that NPs' perceptions of autonomy are affected by many variables. Further study is needed to ascertain these variables.

A model of managerial control and an instrument-The School Managerial Control Questionnaire was developed by Bogotch (1989). These were tested using a sample of elementary, middle, and high school teachers in the nation's fourth largest school district. A study by Williams (1990) used the same model and instrument with a sample of elementary school teachers from the same school district. This study used the same model and instrument to measure control processes exercised by principals in small, rural school districts in North Florida. The model reflects two managerial behavior styles: Discretionary and ministerial; four managerial control processes: Standards, information, assessment, and incentives; and four selected tasks of curriculum and instruction: Teacher evaluation, staff development, curriculum development, and selection of texts and instructional materials. In addition to the dependent variables studied, five independent variables related to the demographical responses from the high school teachers were measured along the managerial behaviors, control processes and the selected curriculum and instructional tasks. This study validated Bogotch's model and his instrument as they relate to rural high school principals.

This case study was a qualitative investigation to describe the nature of teachers' involvement in school based management (SBM), and to describe how this involvement affected teachers' worklives. The review of related literature provided the historical background that led to SBM restructuring, examined what the literature has revealed on SBM, and investigated organizational commitment in the context of SBM. A semi-structured interview was the instrument used to gather the data. The participants of this case study were a random sample of teachers, a sample of teachers selected by their principals, and the principals currently employed at each of the three elementary schools in a single county school district in Florida. A total of 33 educators were interviewed and their responses were tape recorded to assist in the authentication of the transcribed data. The data were then compiled and analyzed. Themes and patterns were identified and placed into a matrix for purposes of assessing the interrelationships of responses offered in the context of the three elementary schools. The analysis and interpretation of data revealed that restructuring with SBM was implemented to a minimal degree at the elementary schools of Florida County. The results showed that the effects of restructuring were varied and included both positive and negative findings. For some teachers, involvement enhanced commitment to the organization and spurred them on to further efforts, while for most respondents restructuring activities were perceived as impositions that made it difficult to balance classroom and SBM responsibilities. Respondents also revealed that they doubted the potential of SBM as a means to improve the quality of education at Florida County Schools or as a process for producing significant academic achievements. Recommendations were made for practical application and for future research.

This study was designed to compare midlife male graduate students with midlife female, early adulthood male, and early adulthood female graduate students in terms of their motivations for returning to higher education and their academic self-concept as returning students. Data were gathered, using Boshiers's Education Participation Scale (1995) and Drummond's Academic Self-Concept Scale (1984), from graduate students at a comprehensive, urban, southeastern, public university of approximately 10,000 students. The 426 graduate student participants were enrolled in three colleges (Business, Education, and Health) at the university. Multivariate analysis of variance (MAN"OVA), univariate analysis of variance, and multiple comparison tests results indicate significant motivational and academic selfconcept differences. Midlife males' mean scores were significantly lower in the motivation category of Professional Advancement than the other three age/gender groups. Midlife males' and females' academic self-concept mean scores were significantly higher than early adulthood females in the category of Extraversion, and higher than early adulthood males in the category of Academic Skills. These findings may be useful in educational recruitment and curriculum programming. Implications for practice and recommendations for research are provided.

The purpose of this study was to examine the effects of the use of a school-wide token economy program on middle school students' achievement, behavior, and attitudes toward school. This involved the comparison of two similar suburban middle schools, one of which used a school-wide token economy program. A nonequivalent control-group design was used to examine: (1) the effects on achievement as measured by grades and honor roll status; (2) the effects on behavior as measured by numbers of students attaining perfect attendance, numbers of punches earned, and numbers of detentions and suspensions; and (3) the effects on attitude as measured by the School Attitude Measure (SAM). Data were gathered from school guidance and disciplinary records. The results indicated that there was a statistically significant relationship between the token economy program and student achievement as measured by grades and honor roll status in the A/B honor roll (p Implications and limitations of the study are discussed. Suggestions for further research are presented.

This study examined the relationship between first grade teachers' theoretical orientations toward reading and their classroom instructional practices. The study, which was conducted in Duval County Florida, used the Theoretical Orientation to Reading Profile (DeFord, 1985) and the Luciano Reading Instruction Practices Survey to gather self-reported data from the 102 study participants. The sample teachers reported the frequency with which they used 25 specific instructional practices to assist students in learning to read. Ten percent of the sample teachers were observed by the researcher for thirty minutes and their instructional practices were documented on a checklist which corresponded to the Luciano survey. These observations found that 48% of the reported practices were present. Raw scores on the TORP instrument indicated that 22.5% of the sample teachers held a phonics orientation towards reading, while 77.5% scored in the mid-range indicating an orientation which supported a mixed theoretical orientation of decoding skills and whole language approaches. No significant mean difference was found when teachers' survey scores were used to categorize them as supporters of either phonics, whole language, or a combination approach to reading instruction. However, a correlation of r = .46 (p < .0005) was found between raw scores on the two instruments indicating a moderate relationship among teachers' theoretical beliefs and instructional practices. Descriptive statistics of instructional practices obtained from the Luciano Reading Instruction Practices Survey (RIPS) indicated that 72% of all the sample teachers allowed students time for freereading on a daily basis, 66% reported emphasizing letter sounds, 59% reported using consumable skills workbooks every day, and 56% of the study teachers activated student interest prior to each reading experience. RIPS scores also indicated that sample teachers who used a combination of phonics and whole language practices comprised the largest group (46%) in the study. Nearly 1 0% of the sample used a majority of phonics-based practices and 44% reported utilizing mostly whole language-type activities. The results of this study provided insights as to the current methods being used to teach reading at the first grade level in a large urban school district and indicated moderate support as to a relationship between teachers' theoretical orientations and classroom practices.