<p> Although Filipino and Filipino American nurses represent an impressive share of the nursing workforce, they are not well represented in advanced practice, faculty, and executive leadership positions. Obtaining a graduate degree in nursing has the potential to open a wider range of opportunities to meet the healthcare demands of a population that is growing older, and increasingly becoming more diverse. The purpose of this study was to examine the factors affecting graduate degree pursuit for BSN-prepared Filipino and Filipino American nurses working in the United States. This study provides an in-depth examination into intergenerational perspectives from 33 Filipino and Filipino American nurses from 14 states. Ricoeur&rsquo;s hermeneutical phenomenology was utilized as an interpretive approach and the theoretical underpinnings of career construction theory served as a framework. This study revealed that the determination to provide a better life for their family and a commitment to advancing the profession were incentives to pursuing a graduate degree. In addition, having a reliable network of colleagues and peer mentors was essential to persisting in their programs. Across all generations, finances were a major barrier to educational attainment, specifically for first-generation participants who prioritized sending money back to their family in the Philippines. Other factors were related to English as a second language, communication styles, experiencing discrimination, lack of knowledge of available graduate programs, approaching the age of retirement, friction between generations, and perceived discrimination. Exposure to advanced practice registered nurses in the workforce was a disincentive for some participants and was inspiring to others. These factors were not independent of each other and their impact fluctuated over time. The decision to pursue an advanced nursing degree depended upon the individual&rsquo;s determination that the return on investment of a graduate degree outweighed the sum of all their responsibilities and obligations. Findings from this research can help the Filipino community and professional nursing organizations, higher education faculty and staff, and healthcare system leaders in developing strategic plans to help Filipino and Filipino American nurses overcome barriers and to facilitate robust pathways for those who intend to advance their educational goals and professional nursing careers.</p><p>

<p> Accurate temperature assessment is essential in neonatal patients and allows for prompt recognition of illness. Temperature can be measured by rectum, which is subject to injury, axillary, which is time-consuming, and temporal artery, which is safe and fast. The purpose of this evidence-based practice quality improvement project was to create an educational toolkit for nurses teaching temporal artery thermometers for routine temperature measurement on neonates, to establish the content validity of the toolkit, and to make recommendations for implementation of the toolkit. The format applied was the Kellogg Logic Model that proceeded from the assumption, to planned work, and results. The theoretical framework was Roger&rsquo;s Diffusion of Innovations, which identifies champions as the initial change agents, helps engage the staff, and facilitates the change. The project consisted of a two-phase process. Phase 1 was the development of the toolkit contents by integrating the evidence and applying the framework in the context of working nurses. Phase 2 was the validation of the toolkit by expert nurses and educators with Item-CVI ranging from 0.80 to 1.00 and the scale-CVI at 0.98. The Toolkit for Implementation of Temporal Artery Thermometers for Neonates with three short video presentations was validated. The toolkit is shared on multiple webpages and is available to the public. Adopting the temporal artery thermometer for routine temperature measurement could be a new standard for temperature monitoring that is accurate and fast. Improved family satisfaction would result from a quicker temperature process and a less invasive method resulting in a more comfortable experience for their infant.</p><p>

<p> Despite the growth in the US population of persons of color and the need for allied health professionals to improve healthcare disparity, people of color make up only 20% of the total enrollment in professional occupational therapy education programs (American Occupational Therapy Association [AOTA], 2016a). Inequalities in the participation of people of color can lead to diminished educational experiences for all students, isolation for occupational therapy students and professionals of color, and decreased healthcare quality for minority clients. This five phase, qualitative interpretive/constructivist study explored the academic experiences of occupational therapists of color, guided by the following research questions: </p><p> 1. How do occupational therapy practitioners of color ascribe meaning to their educational experiences in their OT program? </p><p> 2. How do occupational therapy practitioners of color describe their perceived facilitators and barriers to educational success? </p><p> 3. In what ways do occupational therapy students/practitioners of color navigate their culture of origin and the majority White culture in order to succeed in occupational therapy educational programs and in professional practice? </p><p> AOTA (2016b) professionals (<i>N</i>=14) were solicited by email through their Multicultural, Diversity and Inclusion Network and participated in Phases I, II, and III. Participants completed demographic and interest questionnaires in Phase I; a reflective questionnaire regarding educational facilitators and barriers in Phase II; and depth interviews in Phase III. Using Colaizzi&rsquo;s data analysis strategy (Colaizzi,1978), the results of the Phase III interviews were used to complete the Phase IV elite informant interviews with OT leaders (<i>N</i>=4). Phase V consisted of a document analysis of historical and current policy documents. </p><p> Six themes emerged from this study: 1) Decision to Enroll in an OT program, 2) Educational Program Culture, 3) Faculty Relationships, 4) Peer Relationships, 5) Student Resilience, and 6) Working Professionals.These results reveal participant persistence towards professional OT goals; however, academic and leadership success did not shield participants from marginalization or racism. These results may inform OT professionals regarding enrollment strategies for students of color and the imperative for student-centered program standards and zero- tolerance policies regarding discrimination within OT educational programs. </p><p>

<p> Caregivers&rsquo; compliance with polio vaccine regimens and timely receipt of the recommended 4 doses of polio vaccine are pivotal to eliminating polio. This cross sectional study, conducted in Lagos State, Nigeria, examined polio vaccine compliance and demographic attributes of caregivers&rsquo; for statistically significant associations. Using an adapted health belief model theoretical framework, 1,200 participants were recruited from well-baby clinics in 8 local government areas in Lagos State. Participants completed a brief demographic survey providing data on caregivers&rsquo; age, gender, residence (rural or urban), and their level of education as well as records from their children&rsquo;s immunization cards. Data obtained were tested for associations between caregiver&rsquo;s demographic information and their children&rsquo;s receipt of polio doses within specified timelines using chi-square and logistic regression analysis. Fisher&rsquo;s exact analysis were conducted for variables with frequencies less than 5. The only significant association recorded was between the receipt of Polio Dose A and location of caregivers&rsquo; residence: Rural dwelling caregivers were less likely to receive the first dose of polio. Results showed Polio Dose D to be the dose most likely received in an untimely manner as well as most likely missed of the 4 doses. Logistic regression analysis did not show any variable to be of greater odds in predicting completion of the 4 doses or compliance with timelines of their receipt. Study&rsquo;s results may inspire polio program planners to develop interventions that broaden the immunization coverage for rural dwellers to include nontraditional maternity locations. Positive social change will ensue by the improvement caregivers&rsquo; compliance with full polio dose receipts with timelines, maximizing immunity. </p><p>

<p> The Human Papillomavirus (HPV) is a common sexually transmitted infection (STI) and etiological agent of cervical cancer. It has been suggested that religiosity may promote a generalized disassociation between all STIs/STDs, including HPV, and personal relevance thus contributing to lower levels of HPV awareness and knowledge among certain groups. This study sought to identify the role of religiosity as a predictor of HPV awareness and knowledge among women in a Christian university. Religiosity was defined and measured using the Duke University Religion Index (DUREL). The schemata and social identity theories provided the theoretical framework for this study. A total of 173 women completed the modified survey instrument to assess level of HPV awareness and knowledge, attitudes toward premarital sex, and level of religiosity. Multiple linear regression analysis was used to test the hypotheses. Religiosity, as defined by the intrinsic religiosity subscale of the DUREL significantly contributed to HPV awareness (<i>p</i> = .002) and HPV knowledge (<i>p</i> = .036). The positive social change implications of this study include a better understanding of the role of religiosity in HPV awareness and knowledge; consideration of religiosity in dissemination of health information by informing public health policies and programs to ensure adequate and culturally relevant education and awareness about HPV transmission, HPV-related cancers, and HPV vaccination.</p><p>

<p> Public health leaders lead a diverse workforce and organizations that are comprehensive in their breadth and scope of services. The purpose of this descriptive quantitative study was to describe the transformational and transactional leadership behaviors of federal public health leaders, their coaching practices, and the relationship between those leadership and coaching behaviors. Researcher recruited a convenience sample of 91 U.S. Public Health Service (USPHS) officers from training events between March-July 2014. Participants self-selected to voluntarily complete an internet-based survey comprising a researcher-designed questionnaire, the Multifactor Leadership Questionnaire 5X Form, and Get Fit for Coaching self-assessment. The first two research questions related to leadership and coaching behaviors were analyzed in SPSS 22 using Kruskal-Wallis H, Yates&rsquo; correction, and Monte Carlo significance tests. The Pearson&rsquo;s product-moment correlation analyzed the third research question examining the relationship between leadership and coaching behaviors. No difference was found in the leadership or coaching behaviors of junior and senior officers when examined by actual rank or seniority. The data revealed several relationships between leadership and coaching behaviors, with significant correlations found for 24 dichotomous pairs, indicating transformational and constructive transactional leadership and coaching behaviors as similar, complementary, and interrelated. The findings showed the act of providing feedback improved performance, while failure to take action or implement change stifles learning and growth. Recommendations for future research included: examining these behaviors among non-uniformed and non-federal public health leaders; exploring their leadership outcomes; and the inclusion of the 360-assessment to validate the self-reported leader data.</p><p>

<p> Women face great risks in pregnancy and childbirth, especially in developing countries where there are very few skilled birth attendants and negligible government investments in maternal health programs. As a result, obstetric fistula (OF), a potentially fatal but preventable and treatable condition, affects some 3 million women and girls globally. In Sierra Leone, the prevalence of OF is extremely high, but the absence of quality data to inform decision-making, both on prevalence and risk factors, is a barrier to creating an environment for OF prevention and care. The purpose of this phenomenological study was to explore and document the barriers to medical care, and the perceptions of patients and medical personnel concerning the complexities of OF. In-depth interviews were performed over a 2-month period with 12 patients and 8 medical personnel at the Aberdeen Women's Center in Freetown, Sierra Leone. Results showed that patients face multiple medical barriers including high costs, fear of hospital treatment, severely inadequate treatment, and severe physical sequelae including paralysis and foot dragging. Multiple emotional, social, and financial harms related to OF were also reported, including stigmatization, abandonment by family, embitterment, depression, and job loss. Most patients expressed a preference for traditional birth assistants over medical personnel. However, many also benefitted from the intervention of friends or other good Samaritans. The results and recommendations from this study should be helpful in informing the general public and policy-makers about OF as a major public health problem, and in the design and delivery of programs to eradicate or alleviate the problem of OF in Sierra Leone.</p><p>

In Massachusetts and around the country, public secondary schools have designed support groups and other programs to improve gay, lesbian, bisexual, and questioning (GLBQ) students' sense of safety at school. There is a tacit understanding that public middle and high schools are homophobic, unsafe places for students based on a belief that the majority is homophobic or un-accepting of their GLBQ peers. This study investigated the criteria GLBQ high school students use to define their sense of safety at school, surveyed five student bodies about their attitudes toward GLBQ students and explored correlations between students' personal feelings of comfort and their perceptions of others' comfort. Generally speaking, students were, "Sort of comfortable" to "Very comfortable" with sexual minorities and would support a friend who came out as GLB. All students, regardless of self-identified sexual orientation, underestimated peer support for gays, lesbians and bisexuals. The most supportive students tended to be older, female, have higher grade point averages, value education beyond high school and experience support from an adult in their school, community or both.

This research demonstrates that people's ways of dealing with matters of life and daily occurrences are not the result of standard common sense deductions from learned facts. It has consistently shown that any presented information gets framed by the respondents in a multitude of ways depending on their habitual ways of dealing, viewing, judging, and challenging messages in their environment. Such ways of interacting with one's direct environment are shaped by the most common means of communication or the media that are being used. The literature that has inspired and guided this research is that of scholars like Ong, Havelock, McLuhan, and Burke who had great contributions to the Communication discipline. Consequently, this research challenges the existing public health literature, which, in its largest majority, is informed by the theoretical understanding of beliefs, attitudes, and behaviors within the sociological and psychological disciplines. It is a step away from the practice of crafting messages that are conducive to behavioral change and a step forward toward dealing with any health endeavor as something to be created, negotiated, and recreated within its environment. Among the research's most significant findings is that the respondents' assessment of the health risks of some of their behaviors had little to do with their knowledge of such risk, and more with their education level and the amount of time they spent watching television. Depending on whether the respondents were defined as “oral”, “literate”, “television viewer”, or “light-to-non viewer”, their responses to identical health information took different turns which reflected various ways of dealing with the issue at hand. The research also showed that the link between the educational level of the mothers and her position on some life threatening health risks weakened significantly when they had already undertaken such health risk, like in the case of smoking. Instead, a strong positive link proved to exist between television viewing and the inclination to admit to the presence of a personal risk due to smoking. The research proved however that underneath such positive health responses among the television viewers, was a reactive language that intended to conform yet remained optimistic about any personal repercussions.

This study describes and analyses a collaborative research process used to initiate inquiry and change in a health system in a First Nation, Aboriginal community in Canada. As background, the author reviews issues in transferring government health programs to local control, describes traditional and government health systems in the Split Lake Cree First Nation community and grounds the rationale for the research approach in the traditions of action research and participatory research. The case presentation covers the first year and a half of participatory education and collaborative research activities. Initially it deals with the formation and development of a community research group, with the author serving as co-operating external researcher and training resource. This represents the first instance in Canada of an Aboriginal group doing its own study in preparation for taking over and transforming its health system rather than employing an external consultant to do the study. Specific activities include the preparation of a proposal for funding a study to help with the transfer and the initial design and field work on a study of traditional health practices and resources in the community. The account is based on audio recordings and transcriptions of fourteen meetings, each two to three days in length. In the meetings, the efforts, constraints, interactions, training and skill development of the research group as well as its analysis of systems and reflections on its own process are documented. The author intersperses his own observations in italics. In conclusion, the author reflects on issues arising out of this innovative experiment and on insights it offers for specific problems in collaborative research. Finally, there are recommendations for the use of such an approach as a means for community empowerment and control over change in local health systems.