The objectives of this study were to: 1) create a measure of PBRN clinician member individual performance; 2) produce a rich description of PBRN directors' leadership behaviors and styles; and, 3) identify significant relationships between PBRN director leadership-PBRN clinician member performance. A sequential, exploratory mixed methods design was used to interview and survey PBRN directors and non-director participants. In Phase I, a semi-structured interview guide was used to identify PBRN director leadership behaviors, PBRN non-director performance behaviors and expectations, and decision making activities. A clinician member performance measure was created using a validated behavioral item extraction method. A thematic analysis was conducted on all other data. In Phase II, two quantitative surveys were administered to PBRN directors assessing demographics, membership activity, PBRN productivity, and clinician member performance. One survey was administered to PBRN clinician members assessing their demographics, activity level, and their perceptions of PBRN leadership behaviors. Clinician member performance within PBRNs is a multidimensional construct distinct from participation that is comprised of ownership and engagement aspects, although there is some evidence of a further division into leadership, awareness, follow-through, and communication factors. Collaborative leadership was reported as being distributed to all roles in the PBRN, but is primarily inculcated by a collaborative PBRN director. Time and funding were reported as important resources necessary for the completion of PBRN activities, and are increasingly becoming more limited in their availability. PBRNs engage in a variety of projects and other activities carried out and monitored through ongoing collaborative communication and consensus-based decision making efforts. Top-down decision making patterns by PBRNs have negative relationships with measures of productivity. Directive and participative leadership behaviors do not appear to have direct relationship with clinician member performance, but years of involvement in current PBRN does have a positive association. However, further investigation is necessary to replicate these findings in larger samples. Aiding busy clinicians with engagement through use of central staff may be beneficial. PBRN directors should focus on strengthening collaborative culture of their PBRN and minimizing barriers to effective communication and decision making.

In this study, I aimed to build on a line of research focused on using technology-based, self-management interventions for students experiencing behavioral difficulties in a classroom setting. I analyzed the effects of an iPad application (app) called SCORE IT (Bruhn, Goin, &Hasselbring, 2014) on the behavior of three 5th grade students with, or at risk of an emotional and behavioral disorder (EBD) who were exhibiting low rates of academic engagement in a general education environment. I also aspired to gain an in-depth understanding of a teacher’s perceptions of the feasibility and value of the intervention, SCORE IT. This study was conducted using an embedded, experimental mixed methods design. Quantitative data using direct observation of student behavior was graphed and analyzed to determine if a functional relation existed between SCORE IT and student behavior (academic engagement). Qualitative data, consisting of teacher interviews and electronic journal entries, were merged with quantitative data from the Intervention Rating Profile 15 (IRP-15) and analyzed to assess the extent to which the teacher perceived the intervention to be practical and valuable. Overall, the SCORE IT intervention resulted in significant improvements in academic engagement and teacher perceptions of the feasibility and worth of the intervention were reported as highly favorable. Study limitations and future directions for research are discussed.

In 2012, National Research Council published a new science education framework that explains the science practices and its importance in understanding the process of knowledge development. The students were expected to engage in all the practices by grade 12. All science teachers need some kind of support to improve their understandings of these science practices (NRC, 2012). An important key component of engaging teachers in scientific investigations is to have the teacher participate in a research laboratory experience (NRC, 1996). Research Experiences for Teachers programs (RET) serve as a promising form of professional development to achieve this goal. These programs allow teachers to experience scientific inquiry. The context of the study was a Research Experiences for Teachers (RET) program supported by National Science Foundation It was located in an United States university Environmental Engineering program. There were five preservice and ten inservice teachers in this research. In addition, there were six professors and eight graduate students who served as mentors. Each teacher worked with a specific professor and graduate student mentor in their research projects that are related to the management of the nitrogen cycle, provision of clean water, or urban infrastructure improvement. Also, four professors from engineering and science programs were interviewed to find out what each science practice means to them. The research design of this study was mixed methods that combined quantitative and qualitative research approaches into a single study. In this study, two teachers were selected for the case study based on their experiences and improvements. The study utilized different data sources such as surveys, interviews, observations, and documents. Each research question was addressed based on the results of overall analysis of all the teachers, as well as the results of each case. To find out whether there was a statistically significant difference between the pre-, mid-, and post teacher surveys, repeated measures ANOVA was used for each item. In addition, for the items that showed a statistical difference a Tukey test was conducted to find -which surveys -were significantly different from each other. Also, partial eta squared effect size was calculated for each item. Professor and graduate students' surveys were analyzed by a repeated measures ANOVA and Tukey tests. All interviews were transcribed by the researcher. The data from the interviews were coded and analyzed using a qualitative analysis software. In order to analyze the data in the observations, coding of the qualitative data procedure was employed. The teachers' poster presentations were evaluated by using the researcher-created rubric that has the criteria for each expected part of the poster presentation. The findings of this research suggest that teachers have naive understandings of science practices before they participate in an RET program because they do not have opportunities to learn what those practices mean. The findings also suggest that the teachers still have naive understandings after they participate in an RET program. This is a very important contribution to the literature, in that it is difficult for the teachers to teach those practices in their classrooms if they do not have complete and appropriate understandings of what those practices actually mean. The findings also indicated that teachers' participation in the RET program helped them to improve their abilities to engage in science practices but they need more experience, knowledge, and abilities to engage in the specific practices where they had least improvements. The analysis also indicated that the teachers who actively engaged in the science practices, had productive discussions with the graduate student mentors and participated the quick lessons they gave, read the literature for their research, used new techniques and methods, and participated in the research group meetings improved more on the abilities of engaging in science practices compared to the teachers who did not have the opportunity to participate in the practices because of the structure of their projects, had low interest, and received most of the information directly from the graduate students.

Appropriate education for academically talented students incorporates the use of complex thinking skills, and encourages the development of interpersonal and leadership skills. One potential tool to achieve these goals is the use of instructional technology. Siegle (2004a, 2005) suggests that it is particularly appropriate to utilize technology with the highly-able because they often possess skills that are effective when using today's technology, specifically abstract thinking and rapid processing. This mixed methods multiple case study explored middle school social studies teachers' instructional use of digital technology to teach highly-able students. The participant teachers were from three high-performing schools, as identified by each school's performance on the state standardized test, and in the school's achievement of AYP. The participants at each school were asked to complete the Internet Use Survey, modified from VanFossen's survey (1999, 2005) and participate in a group interview to gather related information not addressed in the survey. From this larger group of teachers, ten teachers were asked to participate in further study. These ten teachers participated in an interview, submitted instructional-related documents for one month, and were observed in a self-identified, typical technology integration lesson. Findings from this study indicate that the participant teachers viewed technology integration as being beneficial to the education of the academically talented student. However, their practice did not reflect this importance. The participant teachers largely used available classroom technology for teacher-centered activities, including information gathering and presentation. Students were rarely engaged in higher-order thinking tasks using the available technology. The participant teachers identified a number of barriers to their technology integration, primarily equipment functionality and availability. Despite the widespread equipment concerns, one teacher utilized the school's available technology to engage academically talented students in student-centered instructional activities. The Technological Pedagogical and Content Knowledge (TPACK) conceptual framework can be used to examine why this one teacher used technology differently than the other participant teachers. Additionally, using this teacher's example and the TPACK framework, suggestions for teacher professional development are provided.

This thesis examines the impact of the engineering culture on women engineering students??? gendered and professional identities. It is simultaneously focused on exploring how identity shapes, and is shaped by, women???s experiences of the engineering culture and, the relationship between gendered and professional identities. The research is set within the context of existing research on women in engineering, much of which has focused either on women???s experiences in industry or experiences of staff in academia, failing to recognise the importance of higher education (HE) as a gatekeeper to the engineering professions. Furthermore, despite numerous initiatives aimed at increasing the percentage of women entering engineering, the proportion of women studying engineering has remained stable, around fifteen percent, for the last few years. The research is grounded in an interpretivist approach, although it adopts a multimethod research design. Specifically it draws upon qualitative interviews with 43 women and 18 men engineering students, a questionnaire with responses from 656 engineering undergraduates and two focus groups with 13 women engineering students from seven departments at one university. These datasets are analysed with the aid of NVivo and SPSS to explore women engineering students??? career choices; women???s experiences of the HE engineering culture; the relationship between engineering education culture and women???s identities; whether there are cultural nuances between engineering disciplines; and, implications for strategies to attract and retain more women in engineering. Key findings from the research are that women and men make career choices based on similar factors, including the influence of socialisers, knowledge of the engineering professions, skills, ability and attributes, and career rewards. However, the extent to which each of this factors are important is gendered. The research also highlights key characteristics of the HE engineering culture, including competition, camaraderie, gendered humour, intensity, more theoretical than practical, help and support for women students and reinforcement of gender binaries. These findings all suggest that women are assimilated into the engineering culture or, at least, develop coping mechanisms for surviving in the existing culture. These strategies reveal a complex and difficult balancing act between being a woman and being an engineer by claiming a rightful place as an engineer, denying gendered experiences and becoming critical of other women. The research also tackles two key issues, rarely discussed in the extant literature. Firstly the help and support women students receive from lecturers and other staff, and the negative impact this has, and may continue to have, on women. Secondly, the analysis of discipline differences shows that design and technology is significantly different from other engineering disciplines in terms of culture(s) and women???s experiences. The thesis concludes that women???s enculturation into engineering results in their ???doing gender??? in a particular way. This means that women???s implicit and explicit devaluing and rejection of femaleness, fails to challenge the gendered cultures of engineering and, in many ways, upholds an environment which is hostile to women.

Master of Philosophy (Medicine) / Health care evaluation serves the purpose of monitoring the quality of health care provided by Health Care Providers (HCP), so that health care services can be provided most effectively and efficiently. Patient satisfaction studies are widely used to assess the quality of outpatient care. A client satisfaction study was conducted at an HIV health care facility in Sydney, Australia during 2007-2008. There were three objectives: 1.) To validate a questionnaire for future determination of client satisfaction in HIV health care facilities. 2.) To identify the levels of satisfaction of clients, and investigate any dissatisfaction and unmet needs towards HIV health care. 3.) To provide recommendations for improving client satisfaction levels in HIV health care. This research used a mixed method approach and consisted of two phases. The first phase was a quantitative survey conducted with 166 clients (both HIV positive and negative) at Albion Street Centre (ASC) using a newly-devised questionnaire. Clients were asked to answer demographic questions, rate their levels of satisfaction with each aspect and each HCP category, and provide suggestions for improvement. Quantitative statistical analysis was conducted to obtain a general view of client satisfaction levels. Dissatisfaction and unmet needs of clients were then investigated in-depth in the second phase of the research through qualitative face-to-face semi-structured interviews. Twenty-two clients (both HIV positive and negative) at ASC were interviewed individually and asked about their attitudes, perceptions, and experiences towards their HCP and the HIV health care services received. Thematic analysis was used to categorise and interpret the qualitative data. More than 90% of the clients were satisfied with most of the aspects covered in the survey, with a mean overall satisfaction score of 84 out of 100. Clients were most iii satisfied with the “technical quality” and “interpersonal manner” of the HCP, and were least satisfied with “waiting time” and “availability of HCP”. The HCP category with which the clients has the highest level of satisfaction was “nurses” (86%), followed by “psychologists” (84%), then “doctors” (83%). Clients who were HIV negative, had a full time job, visited ASC less frequently, or did not possess any type of Health Care Card were more satisfied with the services overall. No common dissatisfaction or unmet needs towards HIV health care service were identified. “Technical quality of HCP” and “the relationship with HCP” were the two most important determinants of client satisfaction, which outweighed the inconvenience contributed by the poor availability of HCP and the location of ASC. The maintenance of “confidentiality/privacy” was shown to be fundamental in HIV health care facilities. The multi-disciplinary nature of ASC increased the degree of convenience and satisfaction level among clients. Suggestions for improvement in client satisfaction levels include increasing the attractiveness of the physical environment and the variety of educational reading materials in the waiting area; introducing beverages, and encouraging clients to be involved in their treatment decisions. Health care administrative staff in particular are reminded not to neglect the importance of the availability of HCP, accessibility, and physical environment when establishing a new HIV health care facility. The mixed method approach (quantitative survey and qualitative interviews) proved beneficial. It increased the validity of the findings by assessing client satisfaction levels using more than one method. This enabled clarification of ambiguities noted in the initial survey through probes used in the interviews, and also allowed investigation of the determinants of client satisfaction through understanding their experiences in HIV health care. Future client satisfaction studies would benefit from using this approach.

Introduction: Ankle injuries are among the most prevalent acute musculoskeletal injuries, and are a significant burden on any health system. The interaction of the physiotherapist with the patient and their mutual understanding of impairments, function and recovery are important to achieving a satisfactory return to work and leisure activities. To date, little attention has focused on this interaction. There is a need for further exploration of differences and associations between outcome questionnaires that investigate similar domains of pain and function, and whether scores from such outcome measures are related to the patient’s perception of function and recovery. Of further interest is whether there are relationships between impairment measures and perceived function, and how actual performance of tasks might influence the patients understanding of their capabilities. To provide a more complete picture of these relationships, a ‘mixed methods’ approach using qualitative research methods within a quantitative study was thought to be most appropriate. The overall aim of this thesis was to utilise this research approach to investigate patients’ perceptions of their recovery and elucidate factors important to both therapists and patients that ultimately might enhance their understanding of recovery from an ankle injury. Literature reviews: Three literature reviews were undertaken. Firstly a review of systematic reviews investigating ankle sprains identified a wide variety of management strategies. There was a lack of strong evidence to support any particular management strategy. Hence clinicians are likely to have difficulty setting appropriate rehabilitation plans. Secondly a critical review identified a number of different outcome questionnaires that were utilised to gauge recovery level; however, justification for their selection was often lacking. This review also identified that little emphasis was placed on understanding the patients’ perception of their injury and the rehabilitation process. A final critical review investigated impairment and performance measures and identified four specific areas that were focused upon by clinicians during the treatment of ankle sprains: joint position sense, postural control, strength and performance during function. However, only weak evidence was found for there being a deficit in joint position sense, postural control and strength in the injured limb following an ankle sprain, and inconclusive evidence of deficits in physical performance of tasks related to function. Methods: Forty participants with an acute sprained ankle were recruited along with their treating physiotherapist. The participants completed a Global questionnaire, the Lower Limb Task Questionnaire (LLTQ) and the Short Form -36 (SF-36) Questionnaire at the initial visit, at discharge and at a six week follow up visit where they also undertook impairment testing involving, joint position sense, postural control and strength along with a functional performance test and selected functional activities. Ten participants were purposefully selected to undertake semi-structured interviews. The treating physiotherapists completed global questionnaires at the initial visit and at time of discharge. An interpretive hermeneutic approach was undertaken to examine the participants’ perceptions. Results: There were equal numbers of males and female participants and the average age of participants was 30.5 years. The relationship between questionnaires for the domains of pain and function varied between low and high degrees of association. The global limitations scores between the participants and physiotherapists were similar at the initial visit, whereas on discharge the participants had a significantly lower score (p<0.05) compared to the physiotherapists. With respect to impairment testing, there was a significant difference (p<0.05) between the uninjured limb compared to the injured limb for the joint position sense and performance agility hop test. All other comparisons of impairments were not significant (p>0.05). There was no association between questionnaire scores and impairment measures (p>0.05). Additionally there were no significant associations between previous injury and questionnaire scores and impairment measures. Finally in relation to the performance of specific functional tests there was a significant difference (p<0.05) between the six week follow up LLTQ score and the score following actual performance of the test. The findings of the participants’ interviews identified three key concerns. Firstly, that participants have a limited understanding of questionnaires, and secondly, that there is a difference in understanding of ‘recovery’ between the therapist and the patient at time of discharge. Thirdly, there was dissociation between outcome measures and the patient’s perception of their own recovery. Conclusions: This study revealed a lack of understanding and effective communication concerning physiotherapy practice in relation to ankle sprains. It was apparent that questionnaires purporting to measure similar constructs are at times dissimilar in scores and are not related strongly. Care needs to be taken in selecting and interpreting outcome measures particularly in relation to questionnaires. It was also apparent that caution should be exercised when considering the influence of impairment measures upon function. Physiotherapists should be aware that patients may perceive a lack of confidence in their level of function at the time of discharge. As a result physiotherapists need to incorporate strategies to improve patient confidence in their management plan.

<p>The purpose of this thesis is to improve our knowledge of substance users in the normal population. The main concern is with how the meaning of drug use is constructed. To answer this, the thesis draws on different theoretical principles and mixed methods design.</p><p>The thesis is made up of four sub-studies, with interconnected foci. The first three papers are based on a qualitative research project in which 44 socially integrated drug users in Stockholm were interviewed. The fourth paper is a cross-national quantitative analysis of nationally representative student samples.</p><p>The first of the three qualitative papers explores the construction of the informant’s self-identity. The second paper analyses the informant’s perceptions of drug-related risk, whilst the third paper analyses the drug users’ perception of differences between men’s and women’s drug use. The fourth paper sets the detailed analyses of the first three papers in a broader comparative frame, exploring differences in the correlates of drug use, in light of the different levels of drug use in Sweden and Switzerland.</p><p>The thesis reveals that the drug users are striving to be understood as normal integrated citizens of Swedish society. They present themselves as inherently different from drug abusers and the informants’ risk perceptions are based on a modified form of core Swedish cultural ideals of conscientiousness. The informants also waver back and forth when called upon to discuss gender and drug-taking. On the one hand they were explicit about existing differences between men’s and women’s drug use; on the other hand they were quite uncomfortable having to explicitly explain them, as this meant that they needed to draw on conservative gender roles, something which in Swedish society is a strong sign of being politically incorrect. Furthermore, the thesis shows that young drug abstainers and cannabis users are quite similar in regards to conventional social bonds.</p>

Fantasy sport participation is an online activity consuming the time, energy, and devotion of many sport followers. This activity provides participants a unique way to experience sport aside from simply viewing, listening, or following a sporting contest. Fantasy sport users present marketers and advertisers with a distinct type of sport fan, segmentation strategy, and target market. These users experience sport beyond wins, losses, and championships. They view statistics as fantasy points, individual players as products, and injury reports as team-altering news. These users see sport through a different lens. The purpose of this research is to gain familiarity with the fantasy sport user by developing an understanding of the motivations behind fantasy sport participation and examining factors associated with participation in fantasy sport; specifically involving media use, message board use, sport participation, overall satisfaction, and future intentions. Data was collected through the use of mixed methods consisting of qualitative online focus groups and quantitative questionnaires. The findings of the focus groups revealed four major themes associated with the participation and experience of fantasy sport. The themes were Competition, Socializing, Surveillance, and Ownership. These findings assisted in (1) validating past and current research, (2) developing and altering scale items for the quantitative questionnaire, and (3) providing deeper understanding of the fantasy sport experience. The major results of the quantitative questionnaire indicated top fantasy sport motivating factors as Fanship, Competition, and Social Sport with the lowest factors as Fan Expression, Ownership, and Escape. The factors with the highest significant relationship with overall satisfaction in the activity were Competition, Achievement, and Surveillance. The factors with the highest significant relationship with future intentions were Competition and Camaraderie. Other findings revealed no significant difference in motivations between different levels of sport participation and message board use. Message board use did, however, produce significant differences favoring higher overall satisfaction and future intentions for those using message boards. Other results examine (1) media use and fantasy sport participation and (2) Mavenism and Schwabism and its relationship to fantasy sport motivations, overall satisfaction, and future intentions.

The purpose of this explanatory, mixed methods case study was to examine instructional leadership within the context of rural secondary schools. This investigation followed an explanatory mixed methods design of sequential quantitative and qualitative phases (QUAL→quan). For the quantitative phase, the Principal Instructional Management Rating Scale (PIMRS) was administered to eight principals and 312 teachers in eight rural secondary schools in the southeastern United States. Descriptive analysis of principal and teacher results found that principals were most engaged in the subscales of framing school goals, coordinating curriculum, and promoting professional development and least engaged in the subscales of maintaining high visibility, protecting instructional time, and providing teaching and learning incentives. Independent t-tests found statistically significant differences in the instructional leadership of principals based on four contextual factors: school size, school SES, principal administrative experience, and district funding (per pupil expenditure). Two principals and their schools were selected for participation in the qualitative phase of the study. Interviews and observations of principals and interviews with teachers added insight to the findings of the quantitative phase. Participants characterized the principalship as a multifaceted job where secondary school principals fulfilled four leadership roles: instructional leader, district/community liaison, organizational manager, and problem solver. Participants also identified important instructional leadership behaviors not measured by the PIMRS, such as hiring effective teachers, providing instructional resources, and sharing leadership responsibilities. The study concludes with suggestions for future instructional leadership research and practical advice for rural secondary school principals.