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This study examined the morale of fifteen teachers in a Mid Atlantic State Public School System after the implementation of restructuring per the corrective action continuum mandated by the No Child Left Behind federal legislation. Per the legislation, schools which fail to meet Adequate Yearly Progress (AYP) for six consecutive years were required to select one of the suggested school restructuring options. These options were: replace most of the school personnel, including the principal; convert the school in to a charter school; release the control of the school to the state department of education; or contract the services of an outside agency to operate the school. The participants in this case study consisted of fifteen faculty members; five faculty members who remained at the study school, five faculty members who were displaced from the study school and five turnaround teachers who were newly assigned to the study school. As qualitative studies focus on `How' and `Why' questions, it was appropriate to utilize this type of framework as the researcher identified and explored how the morale of the faculty changed after the implementation of the restructuring process. The results of this study show only one of 15 of the study participants expressed that the implementation of the restructuring at the two study schools yielded a positive change in faculty morale. On the contrary, 14 of 15 study participants felt the restructuring process, as carried out in both study schools, had a negative impact on employee morale. Additionally, study participants indicted both study schools as having more of a positive climate prior to the implementation of restructuring as all of the interviewed subjects reported the restructuring process negatively impacted the student body, their parents and the entire school community. / Educational Administration

Few studies explore the phenomenon of unintended pregnancy among women living with the Human Immunodeficiency Virus (HIV). To decrease mother-to-child transmission and transmission to a sexual partner, contraceptive methods, cultural beliefs, in addition to protocols pertaining to preconception, pregnancy, labor, delivery and the postpartum period among persons living with HIV must be considered. Half of the pregnancies that occur among HIV-positive women are unintended and requires monitoring and additional prenatal care to reduce adverse health outcomes. This qualitative study sought to increase knowledge of the meaning and understanding of unintended pregnancy among a sample of twelve urban HIV-seropositive African American women. Women shared their experiences related to pregnancy, risk and living with HIV. The majority of participants reported they experienced an unintended pregnancy, discussed lapses in contraception use, knowledge of pregnancy and antiretrovirals, vertical transmission of the virus, sexual risk, and differences in adherence to antiretrovirals during and after pregnancy. Guided by grounded theory the major themes that emerged were used to develop a model that explained unintended pregnancy among the participants. The major themes included resilience, disclosure, and an instinct to protect. Additionally, culture, stigma, social support, contraception, and partner safety were secondary themes. Our review suggests that a model of unintended pregnancy containing social-ecological aspects can describe predictors of pregnancy and potential prevention strategies. Furthermore, the future exploration of the challenges that African American women living with HIV experience with unintended pregnancies, efforts to manage their condition and prepare for a pregnancy are needed. / Public Health

In order to meet the instructional, accountability, and staffing requirements of No Child Left Behind legislation (NCLB, 2001) and the Individuals with Disabilities Education Improvement Act (IDEA) of 2004, elementary school principals are being challenged to include all students with disabilities into general education settings. The purpose of this study was to describe and analyze a sample of elementary school principals'experiences and views of the unintended consequences of implementing inclusion of students with disabilities in the Commonwealth of Virginia. Data were collected through a qualitative design, using focus group methodology and document analysis. Three focus groups were conducted consisting of elementary school principals from Virginia. Participants were asked to provide school and/or division level documents stating the philosophy or procedures regarding the inclusion of students with disabilities. The researcher also reviewed information and documents on the school and division websites of participants prior to focus group sessions. These documents were analyzed in regards to the role of the principal in relation to the inclusion of students with disabilities. Research questions and data collected were framed and analyzed using an educational system capacity framework developed by Florian, Hange, and Copeland (2000). The researcher interpreted and described how elementary school principals experience inclusion as affecting the role of the principal through the lens of human, organizational, structural, and resource capacities. Major findings that emerged included the following challenges that elementary school principals experience: (a) the inclusion/LRE debate; (b) their own lack of knowledge of special education and inclusion as well as the lack of knowledge of other key players; (c) limited staffing and scheduling options that offer the continuum of special education services in order to meet the unique needs of students with disabilities; (d) co-teaching conflicts; and (e) discipline concerns related to including students with disabilities in the general education setting. / Ed. D.

Innovation is often related to positive outcomes for the majority to enjoy that enhances welfare and facilitates everyday activities. In different fields of study (economics, management, sociology, history and science and technology) it is becoming a field of magnitude (Malerba and Brusoni, 2007). Fagerberg and Verspagen (2009) discuss the emerging interest of innovation in the field of social science. Although the interest within the subject of innovation is high, very little research has been done regarding the aim to contribute to the design innovation policy, developed by scholars studying the field of innovation. One often so neglected study within innovation is in the field of negative unintended consequences of innovation (NUCoI) (Sveiby et al, 2012). One main contributor of innovative activities is organizational operations leading to value for end customers. While firms often have the aim to create value with innovation for the greater benefit in society, sometimes these value-creating mechanisms may create unintended negative consequences in addition to the positive effects. While innovations are increasing in rapidness and numbers of output produced, the effects on society and the natural environment needs to be highlighted. With assumptions regarding vague CSR implementation in corporations (Newell, 2005), this research tries to grasp understanding on how NUCoI is perceived from the managerial perspective in organizations regarding their stakeholder viewpoint. As a starting point, the authors use Charlie Chaplin’s famous quote “More than machinery, we need humanity” from the movie “The Great Dictator” indicating the importance of caring for various stakes. Purpose: The aim of this research is to highlight the new field of study in social science; Negative unintended consequences of innovation (NUCoI) in relation to the societal natural environment (society and the natural environment). The research contributes to the existing frameworks on organizational value creation mechanisms in innovation policy to incorporate the aspect of negative consequences of innovation (NCoI), in terms of sustainability to highlight the importance of secondary stakeholders. Results: The new Extended Value Creation Mechanism for Global Sustainability, the Societal-Natural-Environment Stakeholder Framework of Innovation and Global Sustainability framework (SNE SFI GS-framework), aims to contribute in the long-term perspective for research in innovation policy by highlighting one aspect of a field of the often so neglected societal natural environment perspective, when competing rivalry becomes too fierce. The framework highlights the importance of secondary stakeholders, where primary stakeholders may act as a “link” between the organization and secondary stakeholders. Additionally, the authors suggest going to basic practices regarding sustainability with valuating the natural resources for a prospering sustainable society. The aspects in the research include stakeholder-theory, value-creation in terms of the societal natural environment, and innovation as a field of social science, negative consequences and organizational sense-making.

Background: Over one half of all pregnancies in the United States are unintended. Nurses are on the frontlines of the health care work force and often encounter women with unintended pregnancies in the clinical setting. They may find themselves responsible for options counseling and helping these women to explore their options of pregnancy, adoption and abortion. Discussing these three options in a non-judgmental, well-informed manner allows the woman to consider all possibilities. Leading this type of conversation requires specific skills and knowledge as well as the ability to deliver this information in a therapeutic, nonbiased manner. Purpose: The intent of this study was to analyze data regarding the inclusion of options counseling and abortion education in undergraduate nursing programs in New England. Identification of gaps can provide opportunities for curriculum reform. Due to the enormous impact that nurses have with patients, institutions have a responsibility to provide their students with accurate, honest, factual, current knowledge about options counseling including abortion. Doing so is a public health issue with the incentive of not only providing women with optimal health care and better maternal-fetal outcomes, but also to reduce spending nationwide. This study can support efforts to accomplish these goals. Methods: A cross-sectional survey was sent out via email to the faculty members of accredited undergraduate nursing programs throughout New England. It was active for approximately three months between June 2015 and September 2015 with intermittent reminders sent during that time frame. The survey inquired about personal attitudes, inclusion/exclusion of options counseling and abortion education as well as methods used to include this material in the curricula. Results: All states in New England were included in this study. Fifty percent of responding institutions reported that they include options counseling and abortion education in the curricula, while the remaining 50% reportedly do not. When asked to identify reasons that this content is not included in the current curricula, 80% of respondents indicated that it is not a curriculum priority due to time constraints. The main identified methods that support inclusion of options counseling and abortion in the curricula include classroom sessions focused on technical/evidence-based instruction, classroom sessions focused on ethical issues and assigned readings. Conclusions: Options counseling and abortion education is not adequately covered in undergraduate nursing curricula across New England. This data set is remarkably similar to a study done in 1997, showing that in the course of nearly 20 years, there has been little advance in the inclusion of options counseling and abortion education. In many instances, this material is given equal or more attention in ethical discussions rather than focusing on technical evidence-based instruction. Personal attitudes about abortion have been correlated with the inclusions of options counseling and abortion education and likely affect the content that is incorporated in the curricula.

Health care providers’ (N = 421) implicit perceptions of pregnant women based on age, race or ethnicity, marital status, and socioeconomic status are assessed through a true-experiment design. Ordinal and binary regression analyses revealed that respondents felt more pity for an unmarried than married pregnant woman and more anger toward an unemployed pregnant woman without health insurance compared to a pregnant woman who was employed with health insurance. Male, Asian, and Hispanic respondents were less likely to help the pregnant woman, Black and protestant respondents were more likely to express some degree of anger toward the pregnant woman, and male and protestant respondents assigned more responsibility to the woman for her pregnancy. Additionally, respondents’ open-ended suggestions varied based on the pregnant woman’s characteristics. Implications and future directions are discussed.

Background: Approximately 70% of US adults currently receiving opioid agonist treatment (OAT) for opioid use disorder are of reproductive age. Among women receiving OAT at risk of having an unintended pregnancy, typically less than half report any current contraceptive use compared to 90% in the general population. In addition, the rate of unintended pregnancy among women receiving OAT is disproportionately higher than the general population (~80% vs. 45%, respectively). Lack of knowledge about family planning may be contributing to decreased rates of contraceptive use and increased rates of unintended pregnancy among women receiving OAT. Method: Participants were a convenience sample of women and men receiving OAT or a comparison group receiving primary care (PC) services. Family planning knowledge was assessed with the recently validated Contraceptive Knowledge Assessment (CKA), a self-administered 25-question multiple-choice survey. A two-way ANOVA, with fixed factors (i.e. patient sample and sex), compared the total number of correct responses for all questions and five more specific content areas (p<.05). Results: Overall, 332 participants completed this survey. The mean percent of total correct responses was significantly lower in the OAT sample (n=167) compared to the PC sample (n=165), 47% vs. 53% correct, respectively (p<.001) or approximately 1.5 questions less. The mean percent of correct responses in four of the five content areas was also lower among the OAT sample compared to the PC sample (ps<.01). The mean percent of total correct responses was significantly higher among women (n=169) than men (n=163), 56% vs. 44% correct, respectively (p<.0001) or approximately 3 questions more. The percent of correct responses in four of the five content areas was also higher among women than men (ps<.01). Conclusion: Given the substantial discrepancy in rates of contraceptive use and unintended pregnancy between individuals receiving OAT and the general population, it is somewhat unexpected that individuals receiving OAT did not have lower levels of family planning knowledge, although patients in both samples only answered approximately 50% of the questions correctly. Results from the present study suggest deficits in family planning knowledge, while statistically significant, may be less clinically so. Overall, lack of family planning knowledge is likely only playing a small role in population differences in contraceptive use and unintended pregnancy and interventions aimed at decreasing these differences will need to address other barriers to accessing family planning services and utilizing contraception in this population.

Pregnancy intention is extensively examined in the literature and the concept of "unintended" pregnancy is considered a significant health problem. Large efforts have been made to reduce negative health consequences presumably associated with pregnancies that are unexpected, unwanted, or mistimed but have had limited impact. A study was conducted to examine contextual issues surrounding women's experiences with pregnancy intention its intersection with knowledge, perceptions, and use of emergency contraception in a population of female university students. The project was a mixed method study including a survey examining demographic characteristics, sexual history, and knowledge and use characteristics in addition to interviews exploring prospective perceptions of pregnancy intention. An integrative review informed the background of the study demonstrating the need for expansion of current concepts of pregnancy intention that inform measurement and subsequent interventions. Quantitative survey results provide new information including higher rates of use in comparison to previous studies but persistence of misinformation. Qualitative interview findings illustrate a process by which individual agency in terms of sexual and pregnancy decision making is influenced by a precursor of the embodiment of convictions and empowerment. Combined conclusions confirm the need of exploring the role of the social context on pregnancy intention, suggest ways in which nurses can empower women to be their own agents of health, and start discussions of how intervention approaches to pregnancy intention can be improved.

The Title X Family Planning Program (Public Law 91-572), enacted by President Richard Nixon in 1970, provides federal funds for voluntary, confidential family planning services to all women, regardless of their age or economic status. This federal legislation aspired to prevent unintended pregnancies and poor birth outcomes to those in most need. However, over the past three decades, Title X has faced political, financial and social challenges. Despite its enormous success in improving the health and well-being of women and children by decreasing unintended pregnancies, the need for abortions and providing key comprehensive preventive services, without a newfound political will similar to that during which it was conceived, the future of Title X may be in jeopardy. This study grounded theoretically and methodologically in a feminist policy analysis approach, critically examined the maturation of Title X by employing a mixed methodology design that consisted of a thematic analysis on Title X's legislative history and the conduction and analysis of oral histories. In Phase I, themes were extracted from the federal bills included in Title X's legislative history, which assisted in the identification of the issues that this policy has endured. In Phase II, a semi-structured interview guide was developed based upon the themes and findings from the thematic analysis as well as from pre-determined constructs from McPhail's Feminist Policy Analysis Framework, to explore key informants' perceptions, recollections and experiences regarding the Title X program. By examining Title X through a feminist lens, various issues were exposed and critically examined, including issues that are typically ignored by traditional policy analyses. Moreover, understanding the historical underpinnings and evolutions of a policy and recognizing past failures and achievements are necessary in order to make informed future decisions. Implications for research, practice and policy are discussed.