Since its conception in 1987, much money and effort have been expended establishing the National Board for Professional Teaching Standards. Although 16,038 educators in 45 states and the District of Columbia have obtained National Board Certification, there are over 1,200 teachers in the East Tennessee counties of Cocke and Sevier who are eligible for National Board Certification, but have not obtained this certification. This study sought to identify the barriers that discouraged this population from attempting to gain National Board Certification. The research design was inferential and utilized data from a survey instrument constructed by the researcher. A pilot test of the instrument was conducted, reliability coefficients calculated, and survey items retained, modified, or deleted based on the results. The final survey contained 38 statements (grouped into five subscales) and a demographic section. A total of 700 surveys were sent to eligible educators in the public schools of Cocke and Sevier counties; of those, 459 were returned and 448 responses were usable. Other variables studied were age, gender, teaching assignment, years of teaching experience, education level attained, future plans to attempt, not attempt, or unsure about attempting National Board Certification, informational sources, and overall opinions of the National Board for Professional Teaching Standards. In addition, a space was provided for comments. Findings included: The most problematic barriers from greatest to least were personal obstacles, teaching professionalism, teacher morale, evaluation process, and financial considerations. Significant differences regarding the barriers existed in all demographic areas included in the study except for educational levels, and the majority of respondents had a negative overall opinion of National Board Certification. However, the opinion varied with the source of information about the process. Educators who received their information from local administrators and published materials had a more positive opinion than those that received their information from peers. This study indicates that the barriers identified are factors in keeping eligible East Tennessee educators from attempting National Board Certification.

Integration in rural primary care has well-delineated advantages, but there are barriers to developing a workforce in these areas. In this presentation, representatives from three novel rural service delivery programs will discuss specific strategies for overcoming these barriers. Attendees will learn how a rural Federally Qualified Health Center grew from 0 to 6 full-time psychologists in two years, how a graduate training program uses telehealth to provide services at rural primary care clinics, and how integrated clinics in the Frontier counties of Nebraska ensure a future workforce starting by targeting high school students.

No description available.

Abstract available in the Journal of the American Psychiatric Nurses Association.

Recent research has shown that traditional safety evaluation methods have been inadequate in accurately determining the effectiveness of roadway safety measures. In recent years, advanced statistical methods have been utilized in traffic safety studies to more accurately determine the effectiveness of roadway safety measures. These methods, particularly hierarchical Bayesian statistical techniques, have the capabilities to account for the shortcomings of traditional methods. Hierarchical Bayesian modeling is a powerful tool for expressing rich statistical models that more fully reflect a given problem than a simpler model could. This paper uses a hierarchical Bayesian model to analyze the effectiveness of two types of road safety measures: raised medians and cable barriers. Several sites where these safety measures have been implemented in the last 10 years were evaluated using available crash data. This study analyzes the effectiveness of raised medians and cable barriers of roadway safety by determining the effect each has on crash frequency and severity at selected locations. The results of this study show that the installation of a raised median is an effective technique to reduce the overall crash frequency and severity on Utah roadways. The analysis of cable barriers showed that cable barriers were effective in decreasing cross-median crashes and crash severity.

Each year approximately 1,000,000 child become the victims of abuse or neglect. The detrimental effects of child maltreatment (CM) have been well documented and create significant problems for the survivors and for society as well. All fifty states have enacted mandatory reporting laws to combat the CM epidemic. As mandated reporters, nurse practitioners and nurse midwives (APRNs) have the opportunity and responsibilities to identify and refer potential victims of CM, in this study a significant percentage choose not to report their suspicions. Respondents to the study survey identified several potential barriers to APRN reporting such as lack of education and training about CM, negative perceptions of child protective services and lack of physical evidence indicating CM occurred.

Here explored is a method by which designers can use the tool of topology optimization to numerically improve barriers to reverse engineering. Recently developed metrics, which characterize the time (T) to reverse engineer a product, enable this optimization. A key parameter use din the calculation of T is information content (K). The method presented in this thesis pursues traditional topology optimization objectives while simultaneously maximizing K, and thus T, in the resulting topology. This thesis presents new algorithms to 1) evaluate K for any topology, 2)increase K for a topology by manipulating macro-scale geometry and micro-scale crystallographic information for each element, and 3) simultaneously maximize K and minimize structural compliance(a traditional topology optimization objective). These algorithms lead designers to desirable topologies with increased barriers to reverse engineering. It is concluded that barriers to reverse engineering can indeed be increased without sacrificing the desirable structural characteristic of compliance. This has been shown through the example of a novel electrical contact for a consumer electronics product.

Breastfeeding (BF) reduces maternal and infant risk for the development of a variety of short and long-term health outcomes. Appalachia faces several health disparities, with infants at increased risk for poor birth outcomes. The purpose of this study was to explore postpartum patients’ (PP) infant feeding experiences (IFE) and examine perceived barriers to BF among PPs and international board-certified lactation consultants (IBCLC) in Northeast Tennessee, located in Appalachia. PPs and IBCLCS were recruited using convenience and snowball sampling, respectively. Fourteen semi-structured interviews were conducted, 7 PPs and 7 IBCLCs. Interviews were conducted in-person or via Zoom and were recorded, transcribed, and de-identified. PPs were asked about their IFEs and barriers to BF, while IBCLCs were asked about perceived barriers to BF for their patient population. Rapid qualitative analysis was conducted with two coders, both summarizing the first interview for each participant type. Summaries were compared to ensure consistency and subsequent interviews were coded by a single coder. Summaries were used to identify high-level themes related to barriers to BF for each participant type. All analysis was conducted in Microsoft Excel, and the study was approved by the ETSU Institutional Review Board. High-level themes for PP IFEs included stressful experiences and the positive impacts of IBCLCs. Stressful experience sub-themes included latch and supply issues, pump and syringe feeding, PP and infant health complications, lack of hospital support, and expectations for supplementing. Barriers to BF for PPs incorporated physiological (latch and milk supply sub-themes) and environmental barriers (employment and family support sub-themes). High-level themes for IBCLCs perceived barriers to BF included PPs having access to too much information, perceptions and expectations of BF, cultural barriers, lack of support and prenatal education, physiological barriers, and maternal comorbidities. Overlap between PPs stressful IFEs and IBCLCs perceived barriers to BF included themes related to BF expectations, lack of support, physiological barriers, and comorbidities. Similarly, overlap between PPs and IBCLCs perceived barriers to BF included physiological and environmental factors. IBCLCs mentioned additional barriers such as access to too much information and lack of prenatal BF education, while these themes were not identified in PP interviews. A future focus for BF support includes discussions with clinicians after delivery about any physiologic barriers that PPs may face and informing providers on how to both avoid and treat these barriers as they arise to alleviate stress. Connection to BF support in the community before and after delivery could improve the chances that mothers receive help in addressing these issues as they arise. Furthermore, including family members in these discussions may help build family and overall social support.

Farmaceutens roll har utvecklats med tiden numera har apotekspersonalen en mer aktiv roll i läkemedelsdialog med patienten. En god kommunikation mellan farmaceuter och patienter spelar en viktig roll för förbättring av läkemedelsanvändning, minskning av osäkerhet samt oro hos patienterna. Men inom interpersonell kommunikation förekommer det olika barriärer som kan påverka effekten av kommunikationen. Den största barriären som möter invandrare är språkbarriären. För att uppnå det bästa resultatet för patientens hälsa är det viktigt att det finns olika resurser som kan hjälpa farmaceuter med att övervinna barriärer på apoteket. Syfte: Syftet med detta examensarbete var att studera  kommunikationen mellan farmaceuten och patienten på apoteket och hur språkbarriären påverkar den, samt att undersöka de tillgängliga resurserna för att kunna övervinna språkbarriärerna. Metod: Insamling av data från olika studier gjordes genom sökning i pubmed, OneSearch och Oxford Academic. Resultat: Resultaten för samtliga studier visade att många farmaceuter bemöter svårigheter vid kommunikation med patienter som har ett annat språk. Dessutom visade studierna att anställa tvåspråkig personal var mest användbart kommunikationshjälpmedel. Slutsatser: Många apotek försöker använda olika resurser för att förhindra problem som kan uppstå på grund av brist i kommunikationen.

Sleep is an important and necessary part of life. While the biological need for sleep among school-aged individuals has not changed over the years, the quality and quantity of their sleep has. School-aged children reporting sleep deficits in the United States is on the rise and a significant body of research establishes associations between a lack of sleep and lower cognition as well as psychological and behavioral problems. These associations can heavily influence the academic progress and success of students. School psychologists are in a unique position to identify and provide support to individuals with sleep issues. Unfortunately, there is little evidence in the literature to suggest that school psychologists are regularly accounting for sleep. Additionally, no studies have attempted to explore the barriers and facilitating factors for regular sleep screening/assessment among school psychologists. The present study surveyed 105 school psychologists to ascertain the proportion of practitioners who report assessing or screening for sleep issues. School psychologists were also asked to identify potential barriers and facilitating factors related to treating sleep challenges. The results indicated that many school psychologists are not assessing, screening, or treating students for sleep issues or disorders. Many school psychologists report minimal exposure to sleep training within their graduate programs and practitioners cite a lack of training and awareness to sleep-related resources as both major barriers and facilitating factors to implementing sleep related practices. The results highlight the continued lack of emphasis on sleep training within the profession of school psychology. Practitioner's responses indicated a need for better sleep training and education within professional training programs, including equipping such programs with faculty possessing expertise and experience with sleep training/treatment. Results also indicated a need for professional school psychology associations and organizations, such as the National Association of School Psychologists, to provide better awareness, training, professional development opportunities, along with increased visibility to resources on sleep for practitioners to utilize. Furthermore, this article provides practitioners a variety of sleep-related resources to better prepare and educate themselves to provide the best possible services to students and families.