Class of 2006 Abstract / Objectives: To evaluate the group clinic patients’ visit satisfaction and self-efficacy assessments at baseline and six months after the implementation of the heart failure group clinic. Additional outcomes of interest included health service utilization and medication management. Methods: This study utilized a pre-experimental design to compare patients’ clinic visit satisfaction and self-efficacy assessments at baseline and six months. Demographic variables, diagnoses, vitals, health service utilization and medication management data were obtained retrospectively from the computerized patient record system (CPRS). Results: Eleven patients met the inclusion criteria, agreed to participate and completed the informed consent. Mean age was 64.1 years (± 11.28); 100% were male; 45.5% were white, not of Hispanic origin. Health service utilization could not be compared using the planned analysis because of the limited data available for this outcome. Medication management trends included titrating angiotensin-converting enzyme inhibitors (n=1), titrating beta-blockers (n=6), and converting from non-preferred HF medications to ACC/AHA guideline recommended agents (n=3). The mean self-efficacy score increased at follow-up when compared to baseline data (7.4 ± 1.7 versus 6.4 ± 2.7, respectively) with no statistical significance shown between the two groups (p=0.12). Additionally, the mean patient satisfaction score increased at follow-up when compared to the baseline scores (74.5 ± 12.3 versus 71.0 ± 15.1 respectively); however, data analysis revealed no statistical significance (p=0.50). Conclusions: Our study demonstrated trends suggesting improved patient satisfaction and improved self-efficacy with a group clinic model in veteran patients with heart failure. Group clinic settings have the potential to optimize HF medication management in the setting of enormous demand for VA healthcare services and limited financial resources.

This study was designed to evaluate the perceptions of novice and veteran teachers’ level of stress and their attitudes toward their profession. Stress may be caused by many different factors. Work related stress is common amongst many people in the work force. In education stress is endured, in some cases on a daily basis. There are many demands put on teachers to ensure student learning. These demands can cause an overwhelming amount of stress for teachers. This stress can have a positive or negative impact on teachers’ attitude toward their profession. The qualitative research method is the method that was used in this study. Qualitative research provides an opportunity for the researcher to have an individual interaction with participants. Interviews and focus groups were used to collect data. Twelve elementary teachers in Northeast Tennessee were interviewed. Of the 12 teachers who were interviewed, novice and veteran elementary teachers in Kindergarten through fourth grades participated in this study. During data analysis, 9 themes were identified. These themes were (a) resources, (b) testing, (c) lack of time, (d) changes in curriculum, (e) relationships with coworkers, (f) internet sources and technology, (g) school community and culture, (h) personal life, and (i) job satisfaction. Based on the research the following conclusions were presented. Some of the most common stressors among teachers are evaluations, paperwork, testing, and students’ academic and behavioral needs. Positive relationships with other teachers and staff members within a school are important throughout the school year. Support from school and district administrators is very much needed and appreciated in order to retain teachers. Providing support and encouragement for teachers could be beneficial to schools and school districts. Recommendations from this study’s findings may assist school districts and administrators in retaining teachers and supporting them in their profession.

The purpose of this study is to identify the perceptions of novice and veteran teachers regarding the role of the principal in retaining teachers in the profession. Also, the research investigated whether and to what extent there are differences in the perceptions of novice and veteran teachers on the role of the principal in teacher retention. Participants for the study were selected from 15 elementary schools in an urban school district in the Southwestern part of the United States. The study included 270 novice and veteran elementary teachers who completed a Likert Scale questionnaire consisting of 23 questions. The study revealed that novice and veteran teachers believe principals play a key role in the retention of novice teachers. Specifically, the study revealed that teachers want to know the expectation of principals and their evaluation of them as a novice. In addition, they expect principals to play a major role in providing professional development support for teaching strategies, classroom management, and they expect continuous collaboration and encouragement. The results of the study revealed that there was not a statistically significant difference in the perceptions of the novice and veteran teachers in regards to the role of the principal and teacher retention.

This project examined the life narratives of four veteran teachers, each of whom began their careers before the onset of the Standards Era and were still teaching in 2013. Seeking to surface both their ways of resilience and negotiations of their identities as teachers through their decades-long careers, the question is positioned in the neoliberal turmoil of high-stakes accountability, national curriculum standards, and widespread, large-N assessment, to determine if resilient, long-career teachers exhibit particular characteristics and support systems that enable their accomplished status. Using the postmodern, interpretivist methodologies of portraiture and oral history, richly contextualized narratives for each teacher were crafted as an initial analysis. A secondary analysis revealed three manifestations of identity: the socially constructed identity, the bureaucratically informed identity, and the emotionally shaped identity. Findings suggest that having a fully developed and robust set of identities might encourage teacher resilience and longevity, supporting existing bodies of research, and that storytelling is an important aspect of identity development and maintenance. An additional finding was the absence of adversity through veteran teachers’ careers, which pushes against current research on resilience, as it positions resilience against adversity. An interesting question remains, which is in what ways might these veterans have renamed themselves—through the development of multiple and fluid identities—and renamed the challenges and disruptions of their world of work so that they might continue in the classroom. As school leaders typically rely on the knowledge base of seasoned veterans—to inform curriculum development, novice teacher support, and professional learning communities—it seems important to consider the power of storytelling in those venues. In conclusion, the author suggests that the addition of research from the field of knowledge creation, usage, and stewardship could be useful to future research of veteran teachers and the ways their professional knowledge might be better leveraged for improved educational outcomes. / text

Background and Rationale: Rural Hispanic Veterans in the Southern Arizona region with type 2 diabetes mellitus (T2DM) are at risk for diabetes related complications. The Southern Arizona Veterans Administration Health Care System (SAVAHCS) care coordination home tele-health (CCHT) program serves as a useful tool in T2DM management in addition to services through primary care. CCHT has not been evaluated to determine effectiveness in this uniquely vulnerable demographic - rural Hispanic Veterans with T2DM in the Southern Arizona region. Purpose: The purpose of this DNP project was to evaluate the effectiveness of a nurse managed and nurse ran program known as the SAVAHCS CCHT T2DM program in achieving successful diabetes self-management and related biological measures among male and female Hispanic veterans who reside in rural Arizona counties and receive their health care through SAVAHCS. Project Aims: Aim I: Evaluate the effects of the SAVAHCS CCHT T2DM program among rural Hispanic veterans on the biological measure of glycosylated hemoglobin A1C (HbA1C) at three different time periods, initially at admission, three months after admission, and six months after admission. Aim II: Evaluate the effects of the SAVAHCS CCHT T2DM program among rural Hispanic veterans on the other quality measures of diabetes management including Body Mass Index (BMI), blood pressure (BP) and low density lipoprotein (LDL) cholesterol at three different time periods (see Aim I). Methods: A descriptive study design was used to evaluate the SAVAHCS CCHT program. The Centers for Disease Control and Prevention (CDC) Framework for Program Evaluation in Public Health was used to examine the effectiveness of the tele-health program. Data were collected from the Veterans Health Administration data warehouse. Biological measures were collected and analyzed at three different time points. Results: Descriptive data analysis of the veterans (n=12) demonstrated minimal intervention improvement of 0.1 units on A1C (8.3% of veterans), BP (16.7%) and BMI (16.7%). Due to missing data the results may not be due to the CCHT program but to structure and process issues related to collection of reliable data. A more robust program evaluation is recommended.

This research study documents the perceptions of Manitoba teachers working with educational assistants as schools comply with the Appropriate Educational Programming Amendment to the Public Schools Act (Manitoba Education, Citizenship and Youth, 2005). Eight teachers who work with educational assistants in rural and urban Manitoba were asked about four aspects of this emerging role: (i) What are their experiences working with educational assistants in the classroom (what roles do they perceive educational assistants to perform), (ii) the competencies they think they need for their work, (iii) how they have been prepared for this responsibility, and (iv) how they think teachers should or could be (better) prepared for their work with educational assistants. The study invited four novice teachers (less than two years of teaching experience) and four veteran teachers (more than 10 years of teaching experience) to participate in one-on-one face-to-face interviews. Open-ended questions based in current research prompted the participants to reflect on their own practice. The study reveals some of the perceived issues teachers report as challenges in their changing role to meet new legislative mandates. It examines the need to introduce collaboration with educational assistants during pre-service training and access to professional in-service learning opportunities to facilitate teachers understanding of the role of educational assistants in Manitoba schools. The study also reveals some of the competencies required for managing the activities of educational assistants.

A persistent difficulty in the field of psychology is identifying which individuals are at the greatest risk for suicide. Veterans of the US Military are at elevated risk for suicide as compared to the general population. One approach for designating tiers of risk is applying the “Suicide Index Score” to discriminate individuals based upon their reported wish to live (WTL) and wish to die (WTD; Kovacs & Beck, 1977). Brown, Steer, Henriques, and Beck (2005) demonstrated those who indicated a complete WTD and no WTL were at greatest risk to die. The current study expanded on previous research by using this approach with a highly elevated at-risk population of suicidal veterans. Participants for this study included 93 suicidal veterans hospitalized at the Robley Rex Veteran Affairs Medical Center in Louisville, Kentucky. The WTL and WTD items from the Scale for Suicidal Ideation-Current were used to create two quasi-independent groups: WTL/Ambivalent and WTD. The following outcome measures were included as dependent variables: Acquired Capability for Suicide Scale, Interpersonal Needs Questionnaire, Outcome Questionnaire-45.2, Suicide Attempt and Self-Injury Count, Alcohol Use Disorders Identification Test, Drug Abuse Screening Test, and the Stages of Change Questionnaire, as well as the Suicidal Ideation, Posttraumatic Stress Disorder and Insomnia items on the Common Data Elements. T-tests were used to examine patient characteristics for continuous outcomes and chi-square analyses were used for nominal outcomes; however, no group differences were found. T-tests were then used to measure between-group differences on the dependent variables. Individuals classified in the WTD group reported significantly higher levels of thwarted belongingness t(91) = 2.89, p = .00, acquired capability t(91) = 2.64, p = .01, suicidal ideation, t(91) = 3.51, p < .001, and posttraumatic stress t(91) = 2.53, p = .01. Furthermore, a negative binomial regression was used for count outcomes and results revealed that those in the WTD group also reported significantly greater accounts of suicide attempts (incidence rate ratio [IRR] = 2.08; standard error [SE] = 0.63; 95% confidence interval [CI] 1.14-3.77; p = .02) and non-suicidal self-injury (IRR = 3.49; SE = 0.69; 95% CI 2.36-5.16; p < .001).

Det finns relativt omfattande internationell (främst amerikansk) litteratur som visat att militär internationell insats påverkar den anställde och dennes familj/nätverk, men få svenska studier. Syftet med denna studie var att fördjupa kunskapen om psykologiska belastningsfaktorer och stödbehov i samband med militär insats i utlandet med fokus på familjesituationen. Aktuella frågeställningar var: Hur upplevde veteranen/partnern ökad belastning, stressreaktioner eller annan påverkan på måendet? Hur upplevde veteranen/partnern/paret behov av stöd? Hur upplevde veteranen/partnern att PREP, ett pedagogiskt förebyggande program för par, varit till hjälp vid insats? Undersökningsgruppen bestod av fyra par som genomgått PREP där en i paret deltagit i en militär internationell insats i Afghanistan. Inför intervjuerna gjordes en intervjuguide på basis av inläst material. Det insamlade intervjumaterialet bearbetades utifrån tematisk analys. Resultat som framkom var ökad belastning på hemmavarande, (övergående) påverkan på måendet hos paret, betydelsen av mentala och praktiska förberedelse och en fungerande kommunikation liksom svårigheter att ta varandras perspektiv. Positiva effekter framkom som yrkesmässig utveckling, kamratskap under missionen och att paret klarat utmaningen. Specifika förutsättningar för anhörig till civilrekryterad personal beskrevs. Behov av stöd i olika former framkom liksom att PREP varit till hjälp. Slutsatser som drogs var betydelsen av delaktighet, vikten av att följa upp mental hälsa, att ett ”nätverkstänk” bör genomsyra hela (utbildnings)insatsen samt att bygga upp ”förstärkt PREP” eller andra anpassade former för par i behov av professionell behandling.

This research study documents the perceptions of Manitoba teachers working with educational assistants as schools comply with the Appropriate Educational Programming Amendment to the Public Schools Act (Manitoba Education, Citizenship and Youth, 2005). Eight teachers who work with educational assistants in rural and urban Manitoba were asked about four aspects of this emerging role: (i) What are their experiences working with educational assistants in the classroom (what roles do they perceive educational assistants to perform), (ii) the competencies they think they need for their work, (iii) how they have been prepared for this responsibility, and (iv) how they think teachers should or could be (better) prepared for their work with educational assistants. The study invited four novice teachers (less than two years of teaching experience) and four veteran teachers (more than 10 years of teaching experience) to participate in one-on-one face-to-face interviews. Open-ended questions based in current research prompted the participants to reflect on their own practice. The study reveals some of the perceived issues teachers report as challenges in their changing role to meet new legislative mandates. It examines the need to introduce collaboration with educational assistants during pre-service training and access to professional in-service learning opportunities to facilitate teachers understanding of the role of educational assistants in Manitoba schools. The study also reveals some of the competencies required for managing the activities of educational assistants.

Please note: creative writing theses are permanently embargoed in OpenBU. No public access is forecasted for these. To request private access, please click on the locked Download file link and fill out the appropriate web form. / Anyone who tries to tell a conventional story about an unconventional war is a damned liar. Shrapnel is an experimental novel structurally designed to reflect the distance, despair, and rage felt by a veteran of the wars in Iraq and Afghanistan. The author of this work, Andrew M. Swanson, is a veteran of Kosovo, Afghanistan, and Iraq, and has served in the prestigious 173rd and 82nd Airborne as an infantry paratrooper between 2000 and 2006.