The study school in Bibb County, Georgia had a passing rate of approximately 60% on 9th grade literature and composition End of Course Tests (EOCT). An instructional paradigm was needed to help provide quality instruction and facilitate students' efforts to meet the mandate for performance. Research supports differentiated instruction (DI), instructional technology (IT), Gardner's multiple intelligences, and Vygotsky's theory of constructivism as the foundation for quality instruction. This ex post facto study used a cluster sample to explore 2 questions. One research questions explored the effect of DI enhanced with IT on students' learning in 9th grade literature and composition class. The other examined the differences in EOCT scores between students receiving 9th grade literature and composition instruction through a traditional approach and those receiving instruction through DI enhanced with IT. One hundred and five 1st time 9th graders in a literature and composition class were divided into 2 groups. One received traditional instruction, and the other received differentiated instruction with technology. Pretests and EOCTs were analyzed using a t test to determine the difference between the 2 instructional practices. Both groups achieved statistically significant growth between the pretest and posttest; however, the treatment group scored a statistically significant 7.4-points higher on the posttest when compared to the controlled group's posttest. It is recommended that stakeholders read this study, revise budgets, and seek out grants to create classrooms addressing the needs of 21st century learners. Significant growth is obtained from instructional practices that include differentiated instruction enhanced with technology, and teachers must be trained in instructional practices that incorporate DI and IT in order to promote positive social change in the educational system.

Quantitative data examined the effectiveness of a Two Way Bilingual Immersion program on the biliteracy and academic achievement of elementary English learners in southern California. Scores from the California Standards Test (CST) for language arts and mathematics were used to compare the effects of a bilingual curriculum on Hispanic English learners and Hispanic English Only Speakers. English learners' average group scores increased significantly; average group scores for English Only Students' decreased. The Standards Test in Spanish (STS) scores indicate English learners' gains in biliteracy development. These notable academic outcomes evidence the importance of Two Way Bilingual Immersion program for English learners.

The iPad and other mobile devices have become so popular over the past few years that many school districts are purchasing these devices and implementing them in the classroom with little to no research. Because there has been no previous research at one rural school district in Michigan, the primary purpose of this quantitative causal-comparative study was to investigate the effects that a 1-to-1 iPad initiative program has had on only 11th grade student achievement and determine if 11th grade students' test scores on the Michigan Merit Exam in the areas of mathematics, science, and social studies for each school year from 2007 to 2016 have improved, declined, or stayed the same. The framework for this study was rooted in Kearsley and Shneiderman's engagement theory, which specifically applies to technology-based learning environments. A repeated measures analysis of variance was used to compare the standardized test scores from 2007 to 2016, with the scores as the dependent variables and the introduction of the iPad technology as the independent variable. Student characteristics of gender, ethnicity, and socioeconomic status were covariates. The findings from this study indicated that the iPad has improved standardized test scores at this local high school and therefore this school district should continue the promotion and investment in mobile learning devices and other technologies. The resulting policy recommendation from this study prompts the local school district to pursue the expansion of a 1-to-1 iPad program or other mobile learning device in the current curriculum to help increase student achievement on standardized tests. The incorporation of Apple's iPad in the classroom has potentially created a solution to help students increase academic performance and achieve higher levels on standardized and state tests.

The problem investigated in this quantitative study was that schools in a small, rural East Texas town were falling below acceptable ratings in reading on the Texas Assessment of Knowledge and Skills (TAKS) and the State of Texas Assessment of Academic Readiness (STAAR). Researchers have found that constructive-based learning environments (CBLEs) can improve student achievement. The purpose of this study was to examine the relationship between length of time enrolled in a CBLE and reading achievement. Based on the framework of constructivism, 2 research questions were examined. To answer Research Question 1, an analysis of covariance (ANCOVA) calculated the difference in reading achievement as measured by the TAKS in 2011 and the STAAR in 2015, between 5th grade students (N = 81) enrolled in a CBLE for more than 2 years (Group 1) and students enrolled in a CBLE for less than 1 year (Group 2) when adjusted for 4th grade scores. Results showed that Group 1 students demonstrated higher adjusted mean reading scores than Group 2 students on TAKS with F(1, 32) = 15.374, p = < .001 and on STAAR with F(2, 42) = 9.427, p < 001. To answer Research Question 2, an independent-samples t test compared the means of the reading scores growth from 4th to 5th grade. The result showed no significant difference in TAKS with t = .607, p = .548 and in STAAR with t = .277, p = .783. America's reliance on standardized tests influences the way in which reading is taught. Examining standardized reading test outcomes may indicate how teaching and learning environments affect student success. This information may lead to positive social change as educators examine teaching and testing goals, ultimately contributing to student success on standardized tests.

L'évaluation d'un objet est intrinsèquement liée à la définition que l'on pose de celui-ci. Si à un certain niveau de généralité, ce qu'est comprendre un texte semble aller de soi, une recension des travaux en psychologie cognitive, du développement, en didactique, en sociolinguistique, montre au contraire le caractère polymorphe de cet objet qu'on peine à définir. Dès lors, comment évaluer ce que l'on peine à circonscrire, même par exclusion ? Toujours dans le but de cerner ce qu'on entend par compréhension, nous avons mené quatre enquêtes. La première repose sur des entretiens avec des enseignants autour d'une épreuve (texte + questions), en vue de décrire leur manière de se représenter la compréhension et ses difficultés. La deuxième, centrée sur l'analyse des questions repose sur la constitution et une première analyse d'un corpus d'environ 200 questions proposées lors d'évaluations nationales sur la compréhension de textes narratifs. Analyser les questions ne pouvant se faire sans prendre en compte l'activité de réponse, nous avons proposé ensuite deux expériences. La première procède d'une sorte de raisonnement par « l'absurde »: peut-on répondre à des questionnaires de compréhension sans le texte y afférant ? La seconde a pour but de cerner les spécificités des épreuves, en proposant aux mêmes élèves quatre tâches (rappel, reconnaissance, jugement d'importance et QCM) sur deux textes différents. Ces analyses convergent pour montrer que chaque tâche donne un portrait différent de la compréhension et que l'on passe parfois rapidement d'une compréhension d'un texte à la compréhension de textes. / The evaluation of an object is intrinsically linked to the way one defines it. In seeking to define narrative texts comprehension, we have educed multiple facets of this process: cognitiv psychology, psychology of development, didactics, sociolinguistics, which each in their way clarifies an aspect of texts comprehension. This being the case, how can an object so polymorphous be evaluated? To properly understand the functioning of MCQs, the most common method for evaluating texts comprehension, we have undertaken four separate investigations. The first was based on interviews with teachers about a given examination (text plus questions), with the aim of being able to formulate how one depicts texts comprehension and its difficulties. The second investigation, centered on the analysis of questions, was based on the constitution of a corpus of about 200 questions used in nationwide tests of narrative texts comprehension , and a first-level analysis. Analyzing questions necessitates taking into consideration the activity of replying to questions, so we developed two further experiments. The first proceeded from a sort of "reasoning by the absurd": can one reply to questions without cognizance of the corresponding text? The second aimed to identify the specificities of tests, by proposing to the same students four tasks (recall, recognition, relative importance judgments and QMCs) for two different texts. These analyses converge to demonstrate that each kind of task generates a specific profile view of texts comprehension, and that sometimes one passes rapidly from the comprehension of a given text to the general texts comprehension reading competencies.

The independent, complex role of a school nurse requires accurate documentation of assessments, interventions, and outcomes. Consistent documentation by all school nurses is crucial to study the impact of nursing interventions on children's health and success in school. While standardized nursing languages are available, the actual use of these languages is in the infancy stages of implementation. This national survey of school nurses reveals diverse practices in school nursing documentation. Using Everett Rogers' (2003) Diffusion of Innovation (DOI) theory, a web-based survey allowed respondents to identify their knowledge and attitude towards the use of standardized languages, including NANDA International (NANDA-I), Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC). Respondents also rated barriers to adopting the use of NANDA-I, NIC, and NOC (NNN). The results of this survey serve as a foundation for moving the practice of school nursing towards consistent documentation. Ultimately, the implementation of NNN will allow school nurses to document more consistently, base practice decisions on evidence, and improve the health and academic success of children in schools.

<p>Volume rendering (VRT) has been used with great success in studies of patients using computed tomography (CT), much because of the possibility of standardizing the rendering protocols. When using magnetic resonance imaging (MRI), this procedure is considerably more difficult, since the signal from a given tissue can vary dramatically, even for the same patient. This thesis work focuses on how to improve the presentation of MRI data by using VRT protocols including standardized transfer functions. The study is limited to exclusively examining data from patients with suspected renal artery stenosis. A total number of 11 patients are examined.</p><p>A statistical approach is used to standardize the volume rendering protocols. The histogram of the image volume is modeled as the sum of two gamma distributions, corresponding to vessel and background voxels. Parameters describing the gamma distributions are estimated with a Maximum-likelihood technique, so that expectation (E1 and E2) and standard deviation of the two voxel distributions can be calculated from the histogram. These values are used to generate the transfer function.</p><p>Different combinations of the values from the expectation and standard deviation were studied in a material of 11 MR angiography datasets, and the visual result was graded by a radiologist. By comparing the grades, it turned out that using only the expectation of the background distribution (E1) and vessel distribution (E2) gave the best result. The opacity is then defined with a value of 0 up to a signal threshold of E1, then increasing linearly up to 50 % at a second threshold E2, and after that a constant opacity of 50 %. The brightness curve follows the opacity curve to E2, after which it continues to increase linearly up to 100%.</p><p>A graphical user interface was created to facilitate the user-control of the volumes and transfer functions. The result from the statistical calculations is displayed in the interface and is used to view and manipulate the transfer function directly in the volume histogram.</p><p>A transfer function generated with the Maximum-likelihood VRT method (ML-VRT) gave a better visual result in 10 of the 11 cases than when using a transfer function not adapting to signal intensity variations.</p>

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To ensure the provision of good and safe nursing care in the ward, the nursing needs of each patient should be established and clearly documented in the form of care plans in his/her medical record. There is a lack of scientific evidence of the benefits of this method of working as well as why this part of the nursing process is not always successful. The main aim of this thesis was to describe the assessment and decision-making process pertaining to nursing needs performed by nurses, to evaluate the consequences of planned, process oriented nursing care and to identify the factors and conditions that have had an impact on the implementation of individual care plans (ICP) and standardized care plans (SCP).   In studies I and III, qualitative methods were used. In study I, data collection and analysis were carried out by means of Grounded theory. Study III was conducted by means of directed content analysis and guided by “The Promoting Action on Research Implementation in Health Services framework”. In studies II and IV, quantitative methods were employed.   The benefits of a planned, process oriented method of working involving documentation of care plans have been investigated from the perspective of both the patient and the nurse. Nurses who applied the process oriented method adopted a nursing perspective in the assessment of and decision making pertaining to the patient’s nursing needs, which was not the case with nurses who did not work in this way and who instead exhibited a more medical approach (I). Patients cared for in wards where care plans were documented reported being more involved and that the care was more tailored to their individual needs compared to those not cared for in this manner (II). Leadership that prioritises the development of nursing care is essential for the implementation and continued use of ICPs and SCPs. Another important factor was the presence of internal facilitators in the ward in the form of nurses with a clear mandate to work with these issues. The nurses reported that they did not discuss scientific evidence as a basis for performing planned process oriented nursing care and that they did not listen to patient experiences to any great extent (III, IV).   The conclusion is that structured, process oriented nursing care based on written care plans probably promotes the nursing perspective and enables patient participation. Leadership as well as facilitators with a clear role and mandate are important factors in the implementation of this method of working and scientific evidence is of less importance.

In 1995 and 2000 a total of 29 886 non surgical ED visits at Uppsala University Hospital were registered. Presenting complaint, admittance to a ward, length of stay, in-hospital mortality, discharge diagnoses, 30-day and long-term mortality were registered. The presenting complaints were sorted into 33 presenting complaint groups (PCGs). For different PCGs there was different in-hospital fatality rate. Compared to the largest PCG, chest pain, the gender and age adjusted OR was 2.12 (95% CI 1.01 – 4.44) for the miscellaneous complaint group and 2.04 (95 % CI 1.35 – 3.08) for the stroke–like symptom group. Within a given PCG the in-hospital mortality could vary depending on discharge diagnoses. By relating PCG and long term mortality to the expected mortality in the population, the Standardized Mortality Ratio (SMR) could be calculated. The SMR was found to be highest in seizure 2.62 (95 % CI 2.13 – 3.22), intoxication 2.51 (95% CI 2.11-2.98) and symptoms of asthma 1.8 (1.65 – 2.06). For the same discharge diagnoses the long term mortality could differ considerably depending on PCG at ED arrival (p&lt;0.001). Between 1995 and 2000 there was a 30 % increase in ED visits at the non surgical ED. PCGs representing lesser severe conditions had increased. Demographic changes could account for 45 % of the increment and the remaining increase could be ascribed to change in visiting pattern. In the 2000 cohort 41.0 % of all visits were performed by re-visitors. The number of revisits and five-year mortality had an inversed u-shaped relationship were patients with three re-visits within the same year had an increased mortality compared to patients with more or less visits. Conclusion: It is possible to define presenting complaint groups (PCGs) that are robust and consistent over time and useful as a tool for epidemiological studies in the ED.