Since the inception of the 1974 Education for all Handicapped Children legislation, the number of students referred and placed in special education has been steadily rising. The largest increase is in the learning disabilities category. With the reauthorization of the Individuals with Disabilities Education Improvement Act of 2004 and the federal requirements for schools under the No Child Left Behind law, schools are required to take a closer look at their rising special education numbers and identify alternative solutions for children's needs other than a certain placement in special education. There are different levels of variables that influence a teacher's decision to refer a student to special education. This study aimed to understand the mesosystem school variables that influence this process. Using two scales, the Organizational Health Inventory for Elementary Schools (OHI-E) and the Collective Efficacy Scale (CE-Scale) this study used purposive sampling to survey ten elementary school faculties in a large suburban district in Virginia. LD prevalence rates were collected for all elementary schools in the district. Data was analyzed to answer the following questions: (a) How does school organizational health correlate with the number of students referred to special education in a given school? (b) How does collective teacher efficacy correlate to the number of students referred for special education services? The overall return rate for the survey was 87% with 490 teacher surveys completed. Teachers did not have many teaching years in their buildings. Teachers with twelve or more teaching years experience were more likely to refer students to special education. Collective teacher efficacy scores were correlated to school health scores but not to LD prevalence rates. Higher institutional integrity was seen in smaller schools. Title I schools did not correlate with higher LD prevalence rates. Two variables predicted referrals to special education; years teaching in combination with teacher efficacy resulted in greater referrals to special education. The findings of this study may aid educational leaders in making sound changes within school environments to affect the school's LD prevalence rate, addressing particularly teacher efficacy and referral habits of more experienced teachers. / Ed. D.

<p>Information overload förekommer på alla arbetsplatser där informationsbearbetning är viktigt för arbetsprocesserna. I vissa fall kan information overload medföra allvarliga konsekvenser både för den enskilda medarbetaren och för verksamheten i stort. På akutmottagningen på Centrallasarettet i Växjö har sjuksköterskorna en viktig roll som samordnare av den information som används i patientarbetet. Syftet med denna undersökning är att undersöka vilka faktorer som främst orsakar information overload hos sjuksköterskorna på akutmottagningen CLV, samt att undersöka hur fenomenet IO påverkar vårdkvaliteten.</p><p>Under mars och april 2007 genomfördes intervjuer med sju sjuksköterskor på den aktuella akutmottagningen utifrån en frågemall som utformats med hjälp av aktuell forskning på information overload. Resultatanalysen skedde utifrån en specifik orsakstabell som tagits från en litteratursammanställning av Eppler och Mengis (2004). Orsakstabellen utgår ifrån fem specifika områden - personliga faktorer, informationens karaktär, arbetsuppgifter och processparametrar, organisatorisk design samt informationsteknologi. Studien har genomförts utifrån en kvalitativ ansats.</p><p>Undersökningen visar att sjuksköterskorna på akutmottagningen ofta drabbas av information overload, och att riskfaktorer finns i samtliga fem ovanstående kategorier. Flera av deltagarna upplever regelbundet information overload-relaterade symtom och detta riskerar att hota patientsäkerheten på mottagningen. Dessutom leder det till minskad arbetstillfredsställelse hos sjuksköterskorna. Slutligen konstateras att en ordentlig informationsplan behöver upprättas för att rätta till de missförhållanden som orsakar information overload. Det är framför allt viktigt att informationen är relevant och hanterbar för att höja patientsäkerheten och vårdkvaliteten.</p> / <p>Information overload exists in all organisations where information processing is important for the work process. In some cases information overload is a serious threat to both the individual who suffers from it and to the organisation at large. At the emergency department at the Central Hospital in Växjö the nurses have an important function as coordinators of the information used in the patient treatments. The purpose of this study is to find out which factors primarily cause information overload in the emergency department and what implication this has on the quality of care given there.</p><p>In March and April of 2007 seven nurses were interviewed on the subject of information overload. Through a literary review relevant questions were formed for the interviews. The analysis of the answers were conducted from a table by Eppler and Mengis (2004) illustrating the causes of information overload. The table has five sub categories, personal factors, information characteristics, task and process parameters, organizational design and information technology. The study has a qualitative approach.</p><p>The result shows that the nurses at the ED are often affected by information overload, and that risk factors exist in all five sub categories mentioned above. Several nurses regularly experience symptoms caused by information overload, and this is a threat to patient safety at the ED. It also causes dissatisfaction in the daily work. Finally we conclude that a proper information plan is needed in order to find solutions to the problem. The information needs to be relevant and manageable to increase patient safety and the quality of care.</p>

Syftet var att undersöka om det fanns någon skillnad mellan de växelvisboende barnen och de barn som bor hos en förälder i fråga om sociala relationer. Under de senaste åren har hälften av   föräldrar som skiljer sig ordnat växelvisboende för sina barn. Totalt är det 35 procent av barnen med skilda föräldrar som har växelvisboende. En orsak till ökningen kan vara de lagändringar som skett under de senaste decennierna, angående gemensam vårdnad som är idag är den vanligaste  vårdnadsformen. Det är fortfarande vanligast att barn bor enbart eller mest hos mamma efter en skilsmässa. Social nätverksteori används för att förklara varför de sociala relationerna är viktiga för ett barns utveckling. Begreppen mikrosystem beskriver relationerna till föräldrar och nära vänner och mesosystem används för att beskriva det som händer när barnen interagerar med varandras familjer vid besök hos en kompis. Materialet analyseras genom multivariat logistisk regressionalalys där modellen har växelvisboende som oberoende variabel mot undersökningsvariablerna. Undersökningsvariablerna beskriver de sociala relationerna i variablerna antal nära vänner i klassen, besök hemma hos kompisar, kompisar hemma på besök och hur intervjupersonerna kommer överens med mamma och pappa. Resultatet visade inga skillnader på vänskaps-och besöksvariablerna mellan de växelvisboende barnen och de som bor med en förälder. Däremot fanns det en skillnad mellan de växelvisboende i hur de kom överens med sina föräldrar, där de flesta hade svarat mycket bra eller ganska bra. Studiens brister betår bl.a. i kausalitets problem, det var omöjligt att säga om vänskapsrelationerna skapades innan eller efter barnet blev växelvisboende. Fördelen med studien är att det är barnen själva som svarat på enkäten.

Information overload förekommer på alla arbetsplatser där informationsbearbetning är viktigt för arbetsprocesserna. I vissa fall kan information overload medföra allvarliga konsekvenser både för den enskilda medarbetaren och för verksamheten i stort. På akutmottagningen på Centrallasarettet i Växjö har sjuksköterskorna en viktig roll som samordnare av den information som används i patientarbetet. Syftet med denna undersökning är att undersöka vilka faktorer som främst orsakar information overload hos sjuksköterskorna på akutmottagningen CLV, samt att undersöka hur fenomenet IO påverkar vårdkvaliteten. Under mars och april 2007 genomfördes intervjuer med sju sjuksköterskor på den aktuella akutmottagningen utifrån en frågemall som utformats med hjälp av aktuell forskning på information overload. Resultatanalysen skedde utifrån en specifik orsakstabell som tagits från en litteratursammanställning av Eppler och Mengis (2004). Orsakstabellen utgår ifrån fem specifika områden - personliga faktorer, informationens karaktär, arbetsuppgifter och processparametrar, organisatorisk design samt informationsteknologi. Studien har genomförts utifrån en kvalitativ ansats. Undersökningen visar att sjuksköterskorna på akutmottagningen ofta drabbas av information overload, och att riskfaktorer finns i samtliga fem ovanstående kategorier. Flera av deltagarna upplever regelbundet information overload-relaterade symtom och detta riskerar att hota patientsäkerheten på mottagningen. Dessutom leder det till minskad arbetstillfredsställelse hos sjuksköterskorna. Slutligen konstateras att en ordentlig informationsplan behöver upprättas för att rätta till de missförhållanden som orsakar information overload. Det är framför allt viktigt att informationen är relevant och hanterbar för att höja patientsäkerheten och vårdkvaliteten. / Information overload exists in all organisations where information processing is important for the work process. In some cases information overload is a serious threat to both the individual who suffers from it and to the organisation at large. At the emergency department at the Central Hospital in Växjö the nurses have an important function as coordinators of the information used in the patient treatments. The purpose of this study is to find out which factors primarily cause information overload in the emergency department and what implication this has on the quality of care given there. In March and April of 2007 seven nurses were interviewed on the subject of information overload. Through a literary review relevant questions were formed for the interviews. The analysis of the answers were conducted from a table by Eppler and Mengis (2004) illustrating the causes of information overload. The table has five sub categories, personal factors, information characteristics, task and process parameters, organizational design and information technology. The study has a qualitative approach. The result shows that the nurses at the ED are often affected by information overload, and that risk factors exist in all five sub categories mentioned above. Several nurses regularly experience symptoms caused by information overload, and this is a threat to patient safety at the ED. It also causes dissatisfaction in the daily work. Finally we conclude that a proper information plan is needed in order to find solutions to the problem. The information needs to be relevant and manageable to increase patient safety and the quality of care.

Divorce is a potentially destructive reality in society. According to the bio-ecological model of Bronfenbrenner, the development of the child takes place within two micro family systems when a family is reconstituted following divorce: the primary micro family system, where the child resides permanently with his/her biological parent who has parental rights and responsibilities, as well as the secondary micro family system of the other biological parent who also has parental rights and responsibilities, where the child visits periodically. Challenges that the child faces in the context of the reconstituted family thus include shared membership of the two micro family systems and the complexity of the mesosystem. Resilience can be defined as a process of the inborn ability to achieve positive outcomes and to adjust successfully despite challenges and adverse living conditions. The purpose of the study was twofold: firstly, to achieve understanding of the way in which middle-adolescents of divorced parents, in moving between the two micro family systems of their reconstituted families, utilise their resilience to develop optimally in spite of a probably dysfunctional relationship between their biological parents at the mesosystemic level and secondly, to contribute to the fields of knowledge on resilience and bio-ecological theory in order to enhance educational psychology praxis with regard to the adaptation of adolescents of divorced parents in reconstituted families. The study was qualitative, and conducted in the interpretive paradigm. A multiple case study with a purposeful sampling of four participants was used. Unstructured narrative conversations were conducted, which included a resilience-based therapeutic intervention to facilitate sensitisation regarding personal strengths and assets in accordance with the assetbased approach. The format of the data description and analysis was defined by the narrative way of working. The participants’ utilisation of resilience qualities was evaluated in accordance with a definition of resilience which had been newly constructed by means of a synthesis of the bio-ecological model, positive psychology and the focuses of the first three waves of resilience research. The findings of the study indicated that the way in which middle-adolescents utilise their resilience depends on a therapeutic process (a personal, controlled process) as well as the nature of the mesosystem in their developmental context (a factor that can only be controlled by the divorced biological parents). In respect of a therapeutic process, the utilisation of the middle-adolescents’ resilience depends on their emotional security to make conscious choices to mobilise their resilience and consequently change their behaviour in order to cope effectively with difficult family circumstances in both their micro-family systems. In respect of the nature of the mesosystem, the utilisation of the middle-adolescents’ resilience depends on the effectiveness of the relationship between their divorced biological parents at the mesosystemic level. The utilisation of resilience per se is apparently dependent on some consistent systemic foundation in the developmental context of the child, which is, in the case of divorce, the mesosystem. / Thesis (PhD)--University of Pretoria, 2011. / Educational Psychology / unrestricted

Although there has been increasing research on HIV/AIDS and children, albeit mostly outside the school environment, most research in the area tends to view 'children as objects' (Christensen and James, 1999) in the research process whereby the change in the child is what is being observed. This view lessens the role of the child and as such means that the results are inadequate - mostly the researcher's perspective is represented. In Zimbabwe, with an estimated 1.1 million AIDS orphans and 115,000 children under 14 living with HIV/AIDS, not much empirical research has been conducted in school settings where they spend most of their time; the complexities of infected and affected students' experiences within the school-home-community spheres are mostly inferred due to lack of empirical research. Using Bronfenbrenner's Ecological System's Theory and the Capability Approach to adopt a holistic psychosocio-cultural lens, the research aims to understand the experiences of infected and affected students from their perspectives within their school, home and community environments. Added to observations, in-depth interviews based on data collected using photography, drawings, timelines, sociograms and student diaries were conducted with 65 boys and 27 girls aged 10 -13 years from a rural primary school during the months of August to December 2011. In-depth interviews were also conducted with 161 parents and caregivers. Also interviewed were 13 stakeholders comprising of a Senior Research Officer within the Ministry of Education, District Education Officer, 5 Teachers and their Principal, a District Councilor, the Chief, a village head, a local Baptist Minister and a research staff person from, FACT, a local NGO that works with AIDS orphans. Among children, findings point to dilapidating issues of stigma, abandonment, unaddressed emotional and physical needs; children relied on each other's advice more than that of teachers and caregivers. Among the adult community, the education authorities and community leaders who are custodians of their education, ignorance about infected and affected children is astounding. An ageing population of caregivers is barely able to deal with the complexities of infected children. Religion has a powerful negative influence on addressing HIV/AIDS issues. Teachers, citing taboo issues about sex and the fact that HIV/AIDS is not an exam at the school, refused to broach the subject. Education Officials at the time clearly pointed out that there has been no research nor any plans yet to address this population and their needs. Further research will need to be conducted for educational planning that will be most effective in implementing meaningful changes for this group and other rural primary school children.

Sveriges landsting har börjat införa nya kliniska informationssystem som komplement till sina elektroniska patientjournaler. Målet är att kunna förnya och effektivisera existerande system och processer, sänka sjukvårdkostnader samt öka patientsäkerhet och kvalité i vården. Trots betydande investeringar i nya kliniska informationssystem har inga övertygande bevis kunnat presenteras för systemens övergripande effekter i organisationen. Ny forskning anser att detta huvudsakligen beror på en trög användning av nya informationssystem som varken är kompatibla eller lätt att använda, samt att verksamhetsområdena inte har lyckats återanpassa sina kliniska processer till det nya systemet.  Denna fallstudie har genomförts hos verksamhetsområdet för Thoraxkirurgi och Anestesi vid Akademiska sjukhuset i Uppsala. Studien redogör för den medvetenhet projektledning och organisation har kring riskindikatorer och dess effekter vid införseln av ett kliniskt informationssystem. Aktuella risksamband visar att implementationen kommer leda till en trög användning av systemet på grund av att man inte lyckats återanpassa verksamhetens kliniska processer till det nya systemet. Studiens slutsats är att förberedelse och planering inför implementation av ett kliniskt informationssystem bör ses från ett helhetsperspektiv. En medicinsk verksamhet behöver komma underfund med hur deras egna strategier, operativa funktioner och processer fungerar. En omfattande förberedelse med iterativa planeringsprocesser och analys innan implementation är nödvändigt för att bedöma om organisationens strategiska mål kan tillgodoses. Å andra sidan, att allt för ensidigt fokusera på tekniken skapar risker i organisationen. Implementation inom sjukvården är en komplex process. Oförutsedda problem kan hända under ett projekts faser, vilka behöver hanteras rätt för att undvika risker som fortplantar sig nedströms. / Sweden’s County Councils have begun to introduce new integrated health information system modules to complement their integrated computer-based patient records (ICPR). The goal is to innovate and streamline existing systems and processes, reduce healthcare costs and improve patient safety and quality of healthcare. However, in spite of enormous investments in new health information systems, no convincing evidence of the overall benefits has been given. Recent results in research establishes that the disappointing performance of health IT to date can be largely attributed to several factors: sluggish use of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and the failure of health care providers and institutions to reengineer clinical care processes to reap the full benefits of health IT. This case study has been conducted at the department of Thoracic Surgery and Anesthesiology at Uppsala University Hospital. The study analyzes the awareness of risks associated with implementing a health information system. Current risks with the implementation will lead to a sluggish use of the system due to failure reengineering and adapting clinical care processes. The study concludes that preparation and planning for implementation of a clinical information system should be viewed from a holistic perspective. A healthcare organization needs to figure out how their strategies, operational functions and processes work. An extensive preparation with iterative planning processes and analysis before implementation is then necessary in order to evaluate if the organization's strategic objectives can be met. On the other hand, a too strong focus on technology creates risks in the organization. Implementation of a clinical information system is a complex process. Unforeseen problems can happen during a project's phases, which need to be managed correctly in order to avoid risks that propagate downstream.