Many lesbian, gay, bisexual, and transgender (LGBT) individuals report experiencing discrimination in their health care that leads to avoidance of regular appointments with providers. Lack of regular primary care can delay diagnoses of preventable conditions and increase patient risks for chronic disease complications. A systematic review of the literature was conducted to understand LGBT cultural competencies for nursing and other health care providers. The Cochrane Handbook for Systematic Reviews and Melnyk's levels of evidence framed this systematic literature review. Articles for inclusion were limited to those published in English between 2008 and 2018. Keywords used in the literature search included LGBT health disparity, LGBT cultural competency orientation, and nursing LGBT education. The search yielded 70 article results, which were further reduced to 12 articles by critically analyzing the applicability of the literature to the practice-related questions and removing duplicate articles. Five articles met the criteria for Levels III-IV (case-control or cohort), 6 met the criteria for Level II (randomized control trials), and 1 was Level 1 (systematic review). The analysis of evidence demonstrated the importance of providing education to nurses and other health care providers regarding LGBT cultural competency. Recommendations are offered for best practice strategies regarding the inclusion of LGBT cultural competencies in nursing orientation modules. Application of the findings may lead to positive social change if knowledgeable health care providers engage the LGBT population in primary care leading to improved health care outcomes.

Immunologic competence is correlated with resistance to infectious disease which may be affected by exposure to certain compounds. Methyl parathion (MP) and carbofuran (CF) have been reported to affect the development of active immunity in the rabbit and the present research was conducted to quantify the dosage relationships of these two pesticides to both host resistance and acquired resistance in the mouse. Preliminary study was made on the virulence of Salmonella typhimurium in mice. Mortality rates among infected animals fed Purina Laboratory Chow diet providing 0.08, 0.7 3.0 mg MP/kg/day or 0.1, 0.6, 1.0 mg CF/kg/day along with untreated controls were determined and protection afforded the animals by vaccination under the influence of chemical treatment was examined. The nature of dose response was further investigated with the study of various parameters of host defense against microbial infection. Measurements were made of the bacterial population in tissues of mice during and after the course of infection, differential leukocyte counts, in vivo and in vitro opsonic effect of serum, clearance of the reticulo-endothelial system, agglutination titers of serum, total serum gamma-globulin levels, serum immunoglobulin levels with classes and subclasses, and lymphocyte response to mitogen stimulation. Dosage-related increases in mortality were seen in unvaccinated mice under both chemical treatments, and protection by immunization was decreased. Pesticide treatment extending beyond two weeks was required to obtain significant increases in mortality. Increased mortality was associated with increased numbers of viable bacteria in blood, decreased total gamma-globulins and specific immunoglobulins in serum, and reduced splenic blast transformation in response to mitogens. Serum opsonic activity of CF-treated animals was slightly reduced. These results support those of other investigations indicating effects of environmental toxicants upon the resistance and immune competency of experimental animals.

Research has clearly demonstrated that variables associated with the family, child, and utilization of social supports relate to parent perceived competency. However, the research has failed to demonstrate which variable best predicts parent perceived competency. The primary goals of this study were to identify those variables that account for the most variability in parent perceived competency, to examine the relative effects of child characteristics on parental psychopathology, and to evaluate the moderating effects of social support on parent perceived competency based upon various parental characteristics. Participants for this survey study consisted of a convenience sample of 91 female primary caregivers of children (aged birth to three years) who received their initial evaluation at the University of South Florida Early Steps Program (ESP) clinic during a twelve-month data collection period. Inclusion criteria for this study required that participants were the female primary caregiver of the infant or toddler, all participants were primarily English speaking, and the infant or toddler had to be diagnosed with a medical and/or developmental diagnosis by an evaluator at the ESP clinic during the initial visit. Participants completed several questionnaires including assessments of female primary caregiver stress, depression, perceived sense of competency, utilization of social support, perception of child functioning, and perception of child behavior. Results of this study suggest that parent-reported stress and depression symptoms are significantly related to parent-perceived competency. Further, female primary caregivers whose child has medical and developmental disabilities report higher levels of stress and depressive symptoms compared to those whose child have developmental disabilities only. Similarly, female primary caregivers whose child has significant behavioral problems report higher stress and depression symptoms than those whose child does not have behavioral problems. Implications of these results as they relate to intervention development, limitations of this study, as well as future directions for research are also discussed.

This thesis describes an internship for the Department of Anthropology that was part of the Florida Health Literacy Study (FHLS) conducted at the University of South Florida College of Public Health, Department of Community and Family Health in the spring and summer of 2003. The FHLS implemented Pfizer Inc.'s For Your Health program, a type 2 diabetes and hypertension education programs, at 14 community health clinics across the state of Florida. The internship was designed to elicit the experiences of 10 bilingual health educators about their experiences and their perceptions of the experiences of their Latino patients with type 2 diabetes with the Spanish version of Pfizer'ts For Your Health or Para Su Salud type 2 diabetes education program. This internship examined the Para Su Salud program for its cultural appropriateness for the diverse Latino population in the community health clinics in Florida. This internship combined the fields of anthropology and public health to provide a holistic analysis of the issues important to the Latino Health Educators participating in Pfizer's Para Su Salud type 2 diabetes education program. Through anthropological methods including in-depth interviews, class and clinic observations and patient satisfaction surveys, this internship found that the program was well-liked in the community health clinics and it could provide more culturally appropriate themes and food options for type 2 diabetic Latinos in Florida. This thesis makes nine specific recommendations for improving the appropriateness and ultimate success of the Para Su Salud educational program.

This study assessed the dilemmas associated with apprentice assessment systems in the New Apprenticeship Training and Assessment System (NATAS), (State based system), and the Modular system (National system) in Western Australia. Although both were described as competency-based systems these different schemes showed the variations that existed under this general description of training and assessment. The Modular system was a competency-based system which emphasised outcomes rather than the process of training.The emphasis on the process of training was what sustained decades of traditional apprenticeship training. The competency-based approach, discussed in detail later, was a performance-based methodology. Conceptually the apprentice either could perform a given task or task element as set by a specific performance criterion, or s/he could not. The person was judged, based upon the performance outcome to be either competent or incompetent. The basic assumption was that the person could not be partially competent.The competencies approach was a cornerstone of the Australian National training provision. It was administered by the National Training Board through an Australian Standards Framework. The key target group in this assessment of the competency area and the focus of this study was the young apprentice who would become a skilled tradesperson in a relatively short period of four years.Supporting the apprentices in the NATAS system were monitors, lecturers, and employer's members of these groups, who together with apprentices were used to gain insights into the new training initiatives.A previous study Williamson, Lowe and Boyd (1990) had looked at the Western Australian New Apprenticeship and Training System (NATAS). The intention was to develop ideas further and in greater depth using qualitative methodology in the area of effectiveness of the training and ++ / assessment system. The research also had critically assessed the Modular system (National) which in most cases progressively replaced NATAS during the period of the research.

Historically, vocational subjects have been a part of the Australian school curricula for 200 years. In early school curriculum the vocational aspect was considered to be related to the acquisition of manual skills such as domestic science or woodwork, rather than careers. From the 1950s to mid 1980s, vocational education, focused specifically on career and job training, was the responsibility of the technical colleges, which had been established to develop these skills. The concept of high schools targeting identified skills for the future work force, and hence becoming involved in the vocational skill development of youth, developed in the mid 1980s in Australia. Industry influence on governments to make educational decisions based on economic initiatives has increased over this time.Major growth has occurred in Vocational Education and Training (VET) in schools, with student participation rates in vocational education trebling in the past six (6) years (House of Representatives Standing Committee on Education and Training, 2004). This increase is predicted to continue as VET qualifications and the process of accreditation is improved and becomes increasingly user-friendly (Polesel, 2004). The focus on vocational education and industry needs is recognised as an economic necessity for Australia. Schools and teachers, however, need to balance the demands of industry and government with the holistic educational needs of the youth they are entrusted to teach.The school curriculum currently offers a broad range of subject choices that provide for diverse student needs. However the rapid growth of vocational education in schools has impeded effective reflective practices of current vocational programs. Vocational education is experiencing a boom due to the increasing popularity of vocational subjects. The planning and implementation of the diverse subject offerings at school level is often a response to immediate needs rather than in-depth analysis and evaluation. For this reason, it is timely for a critical analysis of the current Hospitality programs in schools to ensure currency and relevancy of content and implementation.The project was localised to one school to enable an extensive and thorough analysis of the Hospitality program. Marymount College is a co-educational Catholic College of approximately 1050 students. Located in the Gold Coast suburb of Burleigh, Marymount College offers a wide range of VET subjects ranging across the five (5) industry areas of Information Technology, Business, Marine Science, Industrial Skills and Hospitality & Tourism.The aim of the analysis will be to suggest what measures need to be implemented in the programs at Marymount College, Gold Coast, Burleigh, Australia, to ensure best practice in Hospitality vocational education. These measures can be constructively applied to other Queensland schools currently delivering vocational education and Hospitality, or to those schools considering introducing subjects associated with Hospitality.

This thesis emerged from the author’s quest to increase her personal and professional effectiveness, to become more congruent, and to be a better person in the world. The thesis discusses how to move from Argyris and Schon’s behavioural model 1 (seeking answers externally, blaming others, avoiding responsibility, controlling behaviour and the belief that there is one right way) to model 2 (seeking answers from within, accepting responsibility, living in a state of flow, surprise and emergent possibilities, looking at the world in multiple ways and collaborating with others). Drawing from her own experiences and interactions with others, the author explores issues such as how people learn the qualities that enable them to be better people; what experiences have enabled people to move toward model 2; what happens when a group, especially within an organisation, moves toward model 2 and how does this happen; and how can conditions be created to enable individuals or groups to move toward model 2. / Master of Science (Hons)

Public health nutrition workforce development is a capacity building strategy identified as a priority in the Australian National Public Health Nutrition Strategy (Eat Well Australia). Systematic and scholarly approaches to workforce development that enhance the capacity of the health system and the broader community to effectively address public health nutrition issues, are limited in Australia. The associated lack of intelligence and a range of methodological difficulties similar to those encountered in broader public health workforce research, provide the need for, and motivation for, this study. The specific objectives of this study relate to the development of workforce development intelligence that: Fills gaps in the knowledge base to inform effective workforce development ; Provides baseline data (benchmarks) for ongoing workforce development planning, evaluation, monitoring and surveillance ; and, Contributes to international scholarship regarding public health nutrition workforce development ; and, Enables the development of a strategic framework for workforce development planning in the national context. The case study research strategy used in this study involved an emergent, multi-method design involving methodological triangulation of data and consensus development. The focus of inquiry was based on a problem-based conceptual framework developed to identify intelligence needs for workforce development strategy planning. Quantitative and qualitative data were collected using five different methods including literature review, interviews with advanced-level public health nutritionists in Australia, a national public health nutrition workforce survey, an analysis of position descriptions and consensus assessment and development via a Delphi survey of an international expert panel. The collection, analysis and interpretation of data in this study focused on developing an intelligence base on six main issues pertinent to public health nutrition workforce development, including: Definitions of public health nutrition; Workforce size and composition; Workforce practices; Core workforce functions needed; Competencies required for effective public health nutrition practice; and, Continuing competency development needs. Data from these multiple methods were used to describe and interpret the determinants of workforce capacity, assisted by triangular analysis. This analysis identified a range of determinants limiting the capacity of the Australian public health nutrition workforce including; A small designated specialist public health nutrition workforce; Workforce instability associated with unsecured funding and staff turnover; Limited collaboration and partnership building practices by the existing workforce; Disorganisation of the workforce in terms of location, accountability, service mandates and support; Workforce practices are not consistent with the required work; Limited access to, and use of, public health nutrition intelligence; A workforce practice culture that does not promote research and dissemination; A lack of practice improvement and learning systems; Limited access to public health nutrition mentors; Limited incentives for practice excellence; An absence of consensus about the required work and competencies required for effective public health nutrition practice; Barriers to continuing competency development; and, Inadequate workforce preparation. This interpretive analysis provided the basis for developing a strategic framework that addresses workforce quantity, quality and performance concerns, based on workforce development strategy categories including: Building human resource infrastructure (quantity); Organisational systems and policy (performance); Intelligence support (performance); Learning systems (quality) and; Workforce preparation. This research has also provided data that can for the basis of tools such as definitions, core function statements, position descriptions and competency standards to assist public health nutrition workforce development in Australia and internationally.

This study investigates the nature of the mathematical understanding possessed by preservice teachers as they enter Early Childhood and Primary Teacher Education Programmes. The subjects comprised thirty students divided into groups of ten to represent three levels of mathematics competency as measured on a mathematics competency test. Evidence of mathematical understanding was gathered from videotaped interviews in which students were required to provide solutions for a set of six tasks. The analysis of student performance included monitoring students' ability to provide multiple representations for tasks as well as the students' demonstration of connections between mathematical ideas. The results show that preservice teachers entering the Early Childhood and Primary Teacher Education Programmes at the University of Canberra do so with weak understanding of many of the mathematical concepts that are fundamental to primary level mathematics curricula. The type of understanding demonstrated by these students was predominantly instrumental in nature. Differences between groups were found with reference to the amount of confidence and interest displayed during tasks. The implications of these results on mathematics teacher education are discussed. The study identifies the need for alternative assessment protocol for mathematics screening of preservice teachers. Discussion of appropriate techniques for the reconstruction of mathematical understanding is also considered.

This study originated from a professional interest of the researcher in competency standards and their implementation in the professions. The study was conducted with the aim of informing policy development and implementation in Namibia in this area by drawing lessons from the Australian experience. It set out to identify the factors that influenced the implementation of this policy in Australia, the importance of these factors and the strategies employed by implementors to enhance successful implementation. The study is grounded in policy implementation theory. Twenty professions have been involved in developing and implementing competency standards in Australia under the guidance and with the support of a national government organisation called the National Office of Overseas Skills Recognition (NOOSR). The main objectives of the Australian government in implementing this policy were the improvement of migrant skills recognition and the achievement of recognition for professional qualifications across state and territory borders. Time and budgetary constraints would not allow the involvement of all the professional groups in this study, so four groups were selected based on their size and progress made in developing and implementing the standards. The groups ranged from a very large professional group (more than 250 000 members) to a very small professional group (approximately 3 500 members). Eleven respondents from NOOSR and the professional groups participated in the study. Data was gathered by structured interview, a rating schedule and document analysis. The study found that there were seventeen factors that influenced this process as perceived by the respondents. These factors were classified into five categories: technical, political, economic, administrative and political, and then placed on a matrix with the levels at which they exerted their greatest pressure: external, internal to the professional body, and on the steering group. This classification of factors gave indications of the types of strategies and the level of intervention which may address implementation problems best. The study compiled a list of the factors in order of importance as rated by the respondents. This ranking showed that leadership was the most important factor, followed by experience and expertise of the steering group and the need for and appropriateness of the standards for the professions. The study also found that the Australian government employed inducement, capacity building and facilitation strategies to enhance the successful vii implementation of the standards, while the professional bodies employed mainly staff development and training as strategies. The study concluded that Namibian policy makers and implementors can draw the following lessons from the Australian experience: 1. there is a need for a balance between pressure and support from government; 2. there is a role for a national implementation plan; 3. the main attraction of national competency standards is still the many uses it can be put to and the many purposes it serves for different organisations; 4. assessment strategies need to be considered from the beginning; 5. the methodology of using a representative steering group to lead standards development is one of the best features of the Australian approach; 6. Over time, the original objectives of the policy became low priority for NOOSR and the government; 7. the classification matrix can be used as a planning tool; and 8. the ranking of the factors indicates the importance of organisational, technical and economic factors.