Straddling the Continental Divide, from the Chuska Mountains to the San Juan and Little Colorado rivers, mostly in Arizona, but partly in New Mexico and Utah, lies 23,574 square miles of desert; home to the estimate l75 to 90 thousand Navajo Indians. Unable to more than eke out a bare existence in a barren land where almost 30 acres of range are needed to sustain one sheep, unprepared after generations of isolation and neglect to leave this reservation for areas where a descend standard of living can be had, the Navajos, since 1950, have been the object of a "crash" program of rehabilitation by the United states Government.

This researcher examined an alternative classroom structure for ninth-grade students substantially below grade level (SBGL) in mathematics. This researcher considered whether targeting the academic and social needs of students SBGL in mathematics in a ninth-grade class would increase their self-efficacy and engagement with the mathematics by studying four teaching effects: teacher, teacher-curriculum, peer-curriculum, and peer. The researcher used interviews, observations, and surveys to collect qualitative and quantitative data. The case study (n = 19) employed a QUAL + quan convergent parallel mixed methods case study. Meta-inferences from the analyses of qualitative and quantitative data indicate that the structure of the observed class increased in positive behaviors associated with self-efficacy, cognitive engagement, and behavioral engagement. While the data show an increase in emotional and social engagement, the quantitative data did not show a statistical significance in their increase. These changes illustrated that these ninth-grade students recognized and willingly worked to close the gaps that they acknowledge they had in their mathematics understanding. Findings indicated that the convergent results of self-efficacy, cognitive engagement and behavioral engagement related to all four teaching effects. While qualitative data showed a strong positive change associated with the divergent results of social and emotional engagement, students self-reported little social and emotional peer influence in student interviews and student surveys.

The inclusion of students with special needs in regular education classrooms has been required by federal law for more than three decades. However, much of the responsibility for successful accommodation of students with disabilities rests upon the shoulders of teachers. Previous research has indicated that successful inclusion of students with special needs is strongly influenced by the attitude of teachers involved. In this study, all secondary agriculture teachers in Utah were surveyed to determine their attitudes and perceptions related to their willingness and ability to include students with special needs in their classrooms and laboratories. Selected personal and professional characteristics were correlated with these attitudes and perceptions. A large majority of teachers responded that they understand the concept of inclusion, are in favor of including students with disabilities, and have had a positive experience teaching students with special needs. However, fewer respondents indicated that they had the skill level to successfully include students with disabilities. Overall, while teachers indicated willingness to include the students with most of the specific types of disabilities, they were less positive in their perceived abilities to successfully accommodate students with some specific categories of special needs.

This mixed methods study evaluated clinical and criminal justice outcomes of the Florida Jail Diversion and Trauma Recovery (JDTR) program that utilized compensated veteran peer mentors. Quantitative results showed veteran participation in JDTR improved clinical outcomes, such as PTSD symptoms, function difficulty and depression scores, but not criminal justice outcomes such as re-arrest rates. Study limitations, however, prevent the drawing of conclusions regarding the potential effectiveness of veteran peer interventions improving criminal justice outcomes. Qualitative results showed participants overwhelmingly viewed their assigned veteran peer mentor as a "peer" and rated them as "very important" to their future success. Improvements in avoidance and numbing and depression symptoms also suggest peer interventions may be effective in improving responsivity to evidence-based criminal justice interventions. Overall, findings were consistent with the RNR model that views mental illness as a responsivity factor, not a criminogenic need. They were also consistent with research on "first generation" forensic mental health interventions that shows improvements in clinical outcomes do not result in reductions in recidivism. Social workers as well as other mental health clinicians and policy makers should be familiar with evidenced-based criminal justice strategies, such as RNR, that focus on reducing recidivism and should incorporate these strategies into the development, implementation and evaluation of "second generation" interventions. Future research should evaluate the fidelity of implementation of such interventions as well as the role of peer mentors and importance of the recovery model and therapeutic alliance in improving criminal justice outcomes and responsivity.

Literacy development in Spanish-speaking children is a growing concern in the United States (Invernizzi, 2009). Phonological awareness is a predictor of literacy achievement in most alphabetic languages (Anthony et al., 2011; Davison & Brea-Spahn, 2012; Durgunoğlu, Nagy, & Hancin-Bhatt, 1993; Goikoetxea, 2005). Bilingual children with complex communication needs (CCN) demonstrate increased difficulties in speaking, reading, and writing, making learning two languages a difficult task (Toppelberg, Snow, & Tager-Flusberg, 1999). Literacy attainment in bilingual individuals who have CCN is important to improve their overall language development and communication interaction skills (Harrison-Harris, 2002). A valid and reliable phonological awareness assessment that does not require speech is needed in order to provide appropriate instruction and address desired literacy goals (Barker, Bridges, & Saunders, 2014). The goal of this study is to describe pilot data from the Dynamic Assessment of Phonemic Awareness in Spanish (DAPA-S), a new dynamic phonological awareness assessment that does not require speech responses, with children from Latin American Spanish-speaking backgrounds, in order to determine its construct validity. DAPA-S was administered over the course of one to three sessions to ten participants (six males and four females). Participants also received the Identificación de letras y palabras (Letter-Word Identification; LWID) subscale from the Woodcock-Muñoz Language Survey–Revised (WMLS-R; Woodcock, Muñoz- Sandoval, Ruef, & Alvarado, 2005) as an emergent reading skill task and three subtests from the Test of Phonological Sensitivity in Spanish (TOPSS; Brea, Silliman, Bahr, & Bryant, 2003):letter-name and letter-sound, elision, and rapid automatized naming (RAN) as assessments of phonological awareness. To evaluate concurrent validity, Pearson correlations and bootstrapped 95% confidence intervals were calculated between the DAPA-S total score and the measures of phonological awareness from the TOPSS. The DAPA-S demonstrated strong and significant correlations with elision, RAN, and the letter-sound subtests rs = –.67 to .87, ps = .00 to .03. These results indicated that the DAPA-S likely measured the same construct as the other measures of phonological awareness from the TOPSS. To evaluate convergent validity, Pearson correlations and bootstrapped 95% confidence intervals were calculated between LWID of the WMLS-R and the DAPA-S total score. The DAPA-S demonstrated a strong and significant correlation, r = .75, p < .05. The data suggest a high degree of both concurrent and convergent validity, as many of the conventional measures of phonological awareness and emergent reading were significantly correlated with the DAPA-S, including letter-sound, RAN, and LWID. Overall, the pattern of results suggests that the DAPA-S may be a reliable and valid tool for measurement of phonological awareness in Spanish.

The National Institutes of Health recommends the development of conceptual models to increase rigor and improve evaluation in research. Validated models are essential to guide conceptualizations of phenomena, selection of variables and development of testable hypotheses. Structural equation modeling (SEM) is a methodology useful in model testing due to its ability to account for measurement error and test latent variables. The purpose of this study was to test a model of The Geriatric Cancer Experience in End of Life as adapted from Emanuel and Emanuel's framework for a good death using SEM. It was hypothesized that the model was a five-factor structure composed of clinical status, physical, psychological, spiritual and quality of life domains and that quality of life is dependent on the other factors. The sample was comprised of 403 hospice homecare patients. Fifty six percent were male, 97% were white with a mean age of 77.7. Testing of the model used AMOS statistical software. The initial five-factor model was rejected when fit indices showed mis-specification. A three-factor model with quality of life as an outcome variable showed that 67% of the variability in quality of life is explained by the person's symptom experience and spiritual experience. As the number of symptoms and the associated severity and distress increase, the person's quality of life significantly decreases (ß -0.8). As the spiritual experience increases (the expressed need for inspiration, spiritual activities, and religion) the person's quality of life significantly increases (ß 0.2). This is significant to nursing because the model provides a useful guide for understanding the relationships between symptoms, spiritual needs, and quality of life in end of life geriatric cancer patients and suggests variables and hypotheses for research. This study provides evidence for a strong need for symptom assessment and spiritual assessment, development of plans of care inclusive of symptom control and spiritual care, and implementation and evaluation of those plans utilizing quality of life as an indicator for the outcome of care provided by nurses.

Stigma and discrimination are now recognised as major factors in the spread of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS). To date, research has focused on how to change individual responses to stigma and discrimination without exploring the social and structural dimensions. Complex community and societal dimensions, such as culture, power and difference need to be explored if progress is to be made in coping with stigma and discrimination. India now has HIV/AIDS prevalence figures to rival sub Saharan Africa. The disease has spread from high-risk populations such as intravenous drug users and commercial sex workers into the general population. Married, monogamous, heterosexual women in slum communities are highly vulnerable. Factors such as caste, class, ethnic group, poverty and social expectations present formidable layers of stigma for these women. They have also faced discrimination since before their birth. HIV/AIDS imposes yet another layer of stigma and discrimination upon their shoulders. The aims of the study were firstly to investigate whether stigma and discrimination existed for these women by documenting and analysing literature on the individual, societal and cultural situation of Indian women living with HIV/AIDS (IWLWHAs). Secondly, the study aimed to identify, evaluate and explore the psychosocial needs and coping strategies of IWLWHAs, to determine the barriers to accessing health services, and describe community perceptions as they were experienced by the participants. / This qualitative research study examined the multiple layers of stigma and discrimination experienced by women infected and affected by HIV/AIDS in a low socio-economic area of Mumbai, India. This was achieved by interviewing women who were benefiting from a home-based service - Positive Living - An integrated home-based care programme for people living with HIV/AIDS under the auspices of the KJ Somaiya Hospital in Mumbai. This programme provides a nutrition and home-based service to the nearby community slums. The conceptual framework used for this study was developed to evaluate the effects of natural disasters such as tsunamis, floods and earthquakes. HIV/AIDS is no less of a tragedy for individuals, families and communities. Within this framework, human capacity or the ability of individuals to cope is linked to social ecology - the relationship between individuals and their community. This dimension overlaps with culture and values. Three other dimensions affect humans - economic status, the environment and living conditions, and physical health. I have developed this framework further to examine threats and strengths which arise from these dimensions, and which affect human resilience. An exploratory case study was considered the most suitable approach to explore these areas, as it permits more sensitivity and richer data, and enhances rigour. In-depth interviews of 45 women in three different age groups, home visits and observations, focus group discussion, key informants, narratives, vignettes and photographs were supported by documentary data collection in triangulation of the data. A reflective journal recorded observations and perceptions in the field during three months in India. / Results from the combined data indicated that IWLWHAs experienced discrimination in their families, communities and health care settings. Fear of future discrimination ensured secrecy which, in turn, prevented them accessing community services which would provide emotional and physical support. A range of reactions was demonstrated by the affected women, half of whom were also infected which added to their burden. Women who could not disclose their condition were extremely isolated, lacked family and community support, feared the future and felt hopeless. Despite their appalling living conditions of poverty, overcrowding, prevalence of disease and pollution, the women displayed a sense of pride, dignity and resilience. Culturally appropriate strategies are necessary to address the lack of education and awareness as only two of the 45 women had any knowledge of HIV/AIDS before their own diagnosis which often followed their husbands' positive status. In addition, the social and cultural dimensions which affect these women have to be explored and examined in order to strengthen the 'shock absorbers' of the family. The community health workers and co-ordinator of the home-based service were vital in providing emotional support and health information to the women. Finally, no change is possible unless men take responsibility for their sexual mores. Policy makers and programmes have to look further for strategies which would engage men in the process to change their attitudes and thus protect vulnerable women and children.

This study was designed to identify the spiritual needs of multicultural Australians with a health problem, in order to understand the educational implications for health care professionals. The rationale for the research was supported by the Australian Council for Health Service (1997) requirement that health care professionals meet the spiritual needs of their patients and clients'. At the commencement of this study, no research had been published on what these spiritual needs might be. To discover what health care professionals needed to be taught in order to meet the spiritual needs of their patients, I required a suitable group of patients. Then, after identify their spiritual needs, I wanted to explore ways in which these needs could be met. For this to occur, I also needed to identify factors that would fulfill patients' spiritual needs or prevent them from being met. This research proceeded in two stages. The first involved collecting data from all spiritual groups in Western Australia. The second involved the recruitment and interviewing a small number of ex-patients to gain their perspective of health care related spirituality and needs. To gain data about the various spiritual groups in Western Australia, I wrote to all organisations and associations, asking for information and reference material. This data was analysed using HyperResearch (1995), and themes common to all spiritual groups were developed. The inter-relationship between these themes provided the framework for an emergent model of spirituality. / For the second part of the research which involved a case study of health care patients, a qualitative methodology was used. This approach enabled me to explore the phenomenon of spirituality from the perspective of eight participants, which involved identifying their spiritual needs, the care they desired, and the rite of passage they underwent when receiving health care. The qualitative methodology enabled me to explore the subject from a sensitive holistic perspective, and to protect the integrity of the participants. I wanted to know what patients understood about their spirituality and how spiritual care could be implemented not only in clinical practice but also into health care education programs. The participants' detailed subjective experience was especially important, because I wanted to know how they identified their spiritual needs, how they had requested their needs be met by health care professionals, and the extent to which health care professionals had reacted to those cues. I formulated an 'interpretive phenomenology research' design based on the philosophical writings of Heidegger and Bakhtin. Heidegger argued that people gain knowledge of a subject from their own subjective experience, and of the person being in their world (simultaneous past, present and future thoughts). Bakhtin stated that to bring about social change, the researcher needed to understand the social context of the people's language including their culture, politics, government-provided amenities (such as education and health care), employment and social interaction, both within and outside their communities in which they live. The eight participants were interviewed a number of times in order to explore the phenomenon of spirituality beyond the notions already published in the literature (i.e. from multicultural Australian's perspective). / They told of hospital or health care experiences that included: health care for childbirth, mental and psychiatric illnesses (depression, manic-depression, and anxiety), immunology (lymphoma), stroke, detoxification of alcohol, arthritis, coronary occlusion, hypertension, and peritonitis; surgical procedured/s such as repair of hernia, bowel obstruction, eye surgery, orchiopexy (removal of testes from inguinal canal into the scrotal sac), caesarian birth, appendectomy, and oophorectomy (removal of ovaries); treatments such as radiotherapy, chemotherapy, and physiotherapy; and hospital experiences in both large and small public and private acute hospitals, private and public mental health/psychiatric hospitals, intensive care and coronary care units. These situations demonstrate the diversity of contexts which people want their spiritual needs met. The study revealed that it is not only dying patients who have spiritual need; spiritual needs exist in widespread ordinary conditions and across a wide range of health care services. The eight participants - Ann, Athika, Garry, Red, Rosie, Scarlet, Sophie, and Tom (pseudonyms) - were drawn from many of the multicultural groups resident in Western Australia including Aboriginal, Chinese, English, European, Indian, and Irish peoples. Their spiritualities encompassed Judeo-Christian, Buddhist, Hindu, Pagan Romany, Society of Friends (Quaker), Humanist, Socialist, and Communist values and beliefs. The results of the research give insight into the eight participants' perspectives on being a person, their understanding of spirituality, perceived spiritual needs, their desired levels of spiritual care, and the rite of passage they experienced when undergoing health care treatment in hospital. / The participants' spiritual needs comprised of four categories: 'mutual trust', 'hope', 'peace' and 'love'. The levels of spiritual care spoke of desiring were: 'acknowledgement', 'empathy', and 'valuing'. Recommendations are given for health care professionals to provide spiritual care for the eight participants, and implications are considered for the spiritual education of future health care professionals in order to sensitise them to the wide range of healthcare related spiritual needs they might encounter in local multicultural communities. It is recognised that the scope of the implications is contingent on further research establishing the incidence of health-care related spiritual needs among the broader population of multi-cultural Western Australians. The richness and depth of the data and the very sensitive nature of the material that came from the eight people who shared their experiences with me has rendered this thesis an important document. The nature of the various incidents and situations they shared with me, I believe, demonstrated their preparedness to tell their story so that health care can be improved. On many occasions, I felt honoured that they had sufficient trust in me to enable them to report such deep and personal suffering. For example, Rosie told me of her mental torment and of not knowing if she was alive or dead; of how she burnt her legs to try to feel pain in order to see if she was alive. It was stories such as this that gave me the passion to write this thesis well in order to do justice to all people who want spirituality included in health care treatment.

The experiences of students with special needs attending regular schools, their involvement and achievement within their school setting, and the theoretical underpinnings directing and determining what is best practice and delivery of effective education, have been an area of on-going change and development over the last 30 years. Teaching and learning processes involved in the effective pedagogical practice of special education have been consistently evolving, providing schools with developing options to enhance effective education practice for all students regardless of any academic, social and/or physical differences and subsequent needs. This study researches the experiences of students defined as having an intellectual disability who attend “Aprender”, a special program catering to the students’ special needs within the framework of a regular school setting. These students are eligible to attend a special school due to their individual circumstances, yet they have chosen to attend a regular Catholic school. The study examines the experiences of the students as they participate in the program, by documenting their voice through their school journeys within the social, locational and academic inclusive participation as members of their school community. The research consisted of a longitudinal case study and methods used included interviews, observations, field notes and surveys. The study findings identify the value of relationships as a key element determining the success of inclusive practice within the Aprender program, in particular the peer relations that existed between the participants, their teachers and other students. The study also identified the theme of development, with strong emphasis placed on the examination of academic, social and emotional growth within the experiences of the students. The study illustrates the difficulties that the students with special needs encounter in their educational setting, in particular the social and academic challenges that affects their inclusion. These experiences contributed to determining the success of the approaches structured to support the students’ inclusion in the program. The study found that the program was largely successful in its aims to include SWSN in a regular school setting, though some aspects of a holistic inclusion were less successful, and offers recommendations for further improvement.

Management training has been considered as an important issue attracting the interest of several individuals and organizations in both developed and developing countries. Moreover, empirical evidence shows that there are differences in many aspects of management training that may result from different features of organizations and countries concerned. However, there has been little research on the relationships between organizational characteristics and the need for management training, especially in developing countries. An understanding of these relationships will not only help organizations in developing their human resources but also help training suppliers in their marketing strategies. This research attempts to take a first step towards integrating theories and empirical findings into a conceptual framework that describes the above-mentioned relationship in developing countries. In particular, the research identifies and tests the impact of particular organizational indicators on the needs for training of task-related and people-related skills for both upper and lower managers. The results confirm that types of industry, technological characteristics, ownership, organizational structure, size and business environment, etc., are among variables explaining the training needs of various kinds in a company. The results would also provide regression models as tools in assessing training needs for management skills at various companies. However, it is the perceived needs rather than the real needs that is the concern of trainers, because perceptions lead to action, i.e., their business opportunities. Lastly, the direction for further studies is proposed, including the impact of macro variables, featured for developed and developing countries, and of variables that interfere with the process of transferring from real needs to perceived needs / Master of Commerce (Hons) (Marketing)