Distance-based partnerships are being increasingly used in health care and have previously been described to facilitate the training of nurses, researchers, and occupational therapists.1–6 In 2013, the Society of Hospital Medicine’s newly published guidelines for pediatric hospital medicine (PHM) programs indicated that strong leadership is critically important to a program’s success. Many smaller children’s hospitals have very few dedicated pediatric hospitalists, and these hospitalists might not have formal leadership or quality improvement (QI) training, resources, or dedicated time for QI work because of their clinical responsibilities. Similarly, pediatric residency programs at smaller institutions might lack robust inpatient QI experiences for their trainees. Leaders at Cincinnati Children’s Hospital Medical Center (Cincinnati) were approached by leaders at Niswonger Children’s Hospital (Niswonger) to complete a needs assessment of Niswonger’s inpatient program. Niswonger is a 69-bed children’s hospital colocated with Johnson City Medical Center, an adult hospital. These hospitals are located in a suburban area with a large rural catchment area. Both the adult and children’s hospitals are part of a larger health system, Mountain States Health Alliance. Niswonger is affiliated with East Tennessee State University (ETSU) Department of Pediatrics, which provided the majority of physician staffing. The needs assessment, completed in 2012, consisted of several site visits, observation of inpatient rounds, interviews with Niswonger faculty and staff, evaluation of available historical data, and collection of new data. Two main gaps in clinical care and training at Niswonger were identified. The first was the need for a dedicated hospitalist program with providers who did not have competing clinical responsibilities. The general pediatric inpatient unit was historically staffed by several ETSU faculty members, all of whom had primary responsibilities in other areas such as intensive care, outpatient primary care, and infectious disease and none of whom were dedicated pediatric hospitalists. These physicians would typically conduct inpatient teaching rounds in the morning and then resume other clinical responsibilities. The second was the need for QI training for the 19 residents in the ETSU pediatric residency program, an Accreditation Council for Graduate Medical Education requirement.

The goal of diabetes education programs (DEPs) is to improve patients' pattern-management habits for those with type 2 diabetes (T2D), though participation in DEPs is lower than expected due to low physician referral rates. This retrospective study examined secondary data of 162 T2D patients who had been referred to a DEP in a community center in RI to determine whether the source of referral affected patient attendance, participation persistence, and outcomes. Self-referred (n = 62) and physician-referred (n = 100) groups were analyzed for possible associations among the aforementioned variables. Chi-square (p = .04) and logistic regression (p = .04) indicated that the referral source for a DEP does have an effect on participation rates, while logistic regression showed that odds for self-referred patients to participate were 1.97 times higher. Multiple linear regression found no difference between the referral source and the number of sessions patients completed, though covariate analysis showed that age (p = .02) contributes to the model. Multiple linear regression showed no difference between the number of sessions attended and changes in hemoglobin A1c (HbA1c) levels. It is important to note that those who completed the program and reported pre- and post-program HbA1c levels (n = 7) all reported improved outcomes. This highlights the limitation of the small sample size (n = 7), which increased the possibility of a Type II error. This community center DEP model can serve as a blueprint, highlighting the importance of diabetes education and leading to positive social change by improving referral and participation rates and resulting in fewer complications, a decreased disease burden, and an improved quality of life.

This thesis describes a qualitative action research process undertaken ‘in the field’ over approximately eight years of the development of an alternative paradigm for music education. This new paradigm evolved from a simple, practical approach that was not, in the first instance, designed to be transformational, but which quickly showed itself to have potential for providing a different model for conceptualising musical engagement. ¶ It is argued that the standard and widely accepted approach to music education has aspects that does not encourage on-going music making. This study conceptualises that ‘traditional’ Western approach in terms of a ‘virtuosic mountain’ that prioritises and rewards technical achievement. The concept of the virtuosic mountain is developed in terms of three ‘P’s’: Perfection, Practice and Performance. The concept was developed by not just reviewing current literature but also by analysing that literature in light of the developing new paradigm as a means of comparing and contrasting the approaches. ¶ Called ‘The Music Education Program’, this new paradigm is based on a practical approach to the sharing of music making beyond institutional boundaries like the school gate. Children do not ‘perform’ in the community but seek to engage others in making music with them without reference to age, disability or skill level. The focus is on the social outcomes that derive from music making rather than the improvement of skills, which develop as a natural part of community engagement. In this respect, the approach has roots in community enculturation processes that are no longer prominent in Western society. ¶ The new paradigm is presented with a contrasting set of ‘three I’s’: Intent, Identity and Involvement, which are designed to illustrate how the community ‘outreach’ of the Music Education Program provides a model for consciously reconceptualising our approach to music education through re-visiting what might be regarded as ‘old’ practices in a ‘new’ guise. The three ‘I’s’ are illustrated through a series of critical incidents that highlight the necessary change in theoretical underpinnings that the practical application of the Program demands. This includes a particular focus on the Intent behind our music making, rather than the ‘quality’ in terms of technomusical outcomes; stress on the individual and group choices that develop musical Identity; and demonstration of the ways in which this paradigm may contribute to voluntary, rather than enforced, Involvement. ¶ The critical incident data is supplemented by some survey and evaluation data which supports the view that the social component of musical engagement provides an alternate focus to musical development than does an achievement paradigm. The range of data collected shows that classroom teachers can take a significant role in the encouragement of music making in the primary school without relying solely on the expertise of those with specific musical training; and that overcoming negative attitudes and experiences can transform not only the teacher’s relationship with music but produce a positive effect on her students. ¶ The model described here has evolved through a longitudinal process that constantly maintains the centrality of the practical operation of the program. In so doing, it moves away from theoretical constructs that often do not seem to relate directly to practitioners but, at the same time, it avoids prescriptive methodology. Theory is elucidated through practice in a way that encourages teachers to develop their own practices that are consistent with underlying principles. This model is transformative in nature, having first a transformative effect on the principal researcher and thence on those teachers engaging in professional development with the Program. ¶ Since the Music Education Program does not yet have students who have exited the school system, this study does not attempt to claim success in the long-term in terms of promoting ongoing engagement through life. Data suggest, however, that it has had an impact in encouraging teachers to reconnect with music making and enables them to share that music making with their students, thereby helping to develop more school-based musical engagement that is also affecting the broader community in the Australian Capital Territory.

Most couples eagerly anticipate the birth of their first child. However, the transition to parenthood is also associated with significant lifestyle changes and approximately 50% of couples report a moderate to severe decline in relationship satisfaction and quality. Low relationship satisfaction is associated with increased couple conflict, individual psychological distress, negative parent-child relationships and poor child outcomes. Despite our increasing knowledge of the factors that predict enhanced couple adjustment, few evidence-based programs are available to assist couples' adjustment to parenthood. In this first randomized controlled trial evaluating the effectiveness of a flexible delivery psycho-education program, entitled 'Couple CARE for Parents', 71 pregnant couples were assessed on self-report and observational measures of couple relationship and individual functioning and then randomized into either the Couple CARE for Parents program (n = 35) or a comparison program (n = 36). Couple CARE for Parents was a six unit program, comprising of an antenatal workshop, two home visits and three telephone support calls, and included skill-training in key relationship processes that are predictive of couple relationship quality, with the addition of parenting and baby care information. Among intervention couples the typical decline in female relationship satisfaction was prevented, with only 13% of intervention females reporting a decline in relationship satisfaction from pregnancy to 5 months postpartum, compared to 42% of females in the comparison program. Observed couple communication also improved as a result of the intervention, with Couple CARE for Parents couples showing reliably lower rates of negative speaker and listener skills at post-intervention relative to comparison couples. Couples were highly engaged in Couple CARE for Parents and there was a low drop out rate across the 7 month intervention period. These findings are promising and add to the early intervention studies showing positive effects of couple-focused psycho-education during the transition to parenthood by demonstrating that flexible delivery programs are feasible and attractive to couples. Providing cost-effective couple relationship education to expectant and new parent couples opens another window of opportunity for health professionals and governments to minimize the rates of relationship distress and divorce and their associated negative effects on individual, couple and family functioning.

The purpose of this study was to investigate the level of communication-satisfaction within and between institutions that are responsible for the administration of AMEP in the ACT. These institutions are: The TAFE Colleges Office of ACT Further Education and The Department of Immigration and Ethnic Affairs. Data were collected from the educators and administrators. Two questions were addressed and four hypotheses were tested, which addressed themselves to the following aspects of communication: corporate perspective personal feedback organizational integration relation with supervisor communication climate horizontal communication media quality relation with subordinates. The general conclusion drawn from the study was that the institutions that are responsible for the administration of AMEP in the ACT operate at different levels (i.e. policy, implementation and operations) and experience difficulty with communication between institutional boundaries. However, there is little relation between the level of individual perception within and between institutions.

Investigating the teacher education phenomenon of mathematics teacher education through the perspectives of teacher educators was aimed in this study. It was designed to understand the problems and the needs of teacher education in Turkey, to conceive the imperatives of the reforms mathematics teacher education reforms, namely 1982 reform, 1998 reform, and 2006 reform, and to determine whether these reforms satisfy the existing needs in Turkey. Based on the principles of qualitative research methods, documents of mathematics teacher education programs were investigated after the date when teacher education has been replaced under universities. As a second data collection tool, interviews with past and present deans of the education faculties, department chairs of mathematics education departments, and the academic staff were conducted. The data collected were analyzed through qualitative data analysis methods and the meanings and importance of the imperatives, processes, and consequences of the reforms were explored as well as the problems and the needs of teacher education in Turkey and solutions for them were investigated. The findings of this study showed that mathematics teacher education took a great step after establishing education faculties under universities in 1982. However, it has to be improved in order to eliminate the problems and the needs of teacher education in Turkey. It was expected to develop a source for the future teacher education reforms while paying attention to the imperatives and the consequences of educational changes in 1982, 1998 and 2006, and to be beneficial to generate a Turkish teacher education framework.

Concern that youth do not have enough fruit and vegetable intake lead to two strategies implemented to influence intake in the school environment: the Healthy Hunger-Free Kids Act (HHFKA) and Fighting with Food: Battling Chemical Toxicity with Good Nutrition program (FF), which could influence phytochemical content and knowledge regarding phytochemicals, respectively. Individual food logs (n=468) were assessed upon completion of FF curriculum to determine whether students were able to correctly apply their nutrition knowledge regarding FF. Menus from one district were analyzed pre-HHFKA and post-HHFKA in elementary (n=156), middle (n=171), and high schools (n=171), for change in the frequency of fruit and vegetables, and for changes in select phytochemical and vitamin content. In food logs, students correctly identified fighting foods 71% of the time. School menus showed an increase in dark green, red/orange vegetables, with significant increases in carotenoid and flavonol content. Results suggest students are applying their nutrition knowledge. Also, more variety of fruit and vegetables are being offered, despite lack of a robust increase in all phytochemicals, which can help to lower inflammation and oxidative stress. Both strategies have the potential to work together as a multi-level intervention that can encourage more fruit and vegetable consumption among youth.

No description available.

No description available.

No description available.