Dental discoloration from fluorosis is a global public health problem. In Nigeria, 11.4% of the population is impacted by this disorder. Dental discoloration is caused by successive exposures to high fluoride concentrations during tooth development in utero and it is linked to the development of a variety of psychological and physiological problems, from dental aesthetics to a reduction in intelligence and skeletal changes. The purpose of this quantitative, cross-sectional study was to examine the cultural and environmental determinants of dental fluorosis in children in a rural community in Nigeria. A multilevel theoretical model was used to develop possible fluoride exposure pathways, such as good social services and dental care, as well as factors in the environment. The study was guided by 2 main research questions: What is the prevalence of fluorosis among Nigerian school-aged children? What is the severity of this fluorosis, and is it associated with the fluoride content of the soil, the water or the food? Data was collected by administering three surveys, on children aged 5 to15 years, their parent/guardian, and on community leaders. Chi-square and regression analysis tests were used to test for possible associations. The study findings showed a fluorosis prevalence rate of 86.6% in the 269 school children surveyed, with majority of these children between the ages of 8 to 13 years. The severity of children fluorosis was associated with the length of stay in the study area and the fluoride content in water, soil, and food. This study's possible impact on social change include raising awareness to the problem and the possible ways to resolve it, such as through, improved dental care services and a supportive social environment like flocculation of community water sources.

For the first time in history, 5 generations are working side by side, creating a challenge concerning training, developing, and managing a multigenerational workforce. More people are working into their later years, and the U.S. labor force participation rate of individuals age 55 and older is projected to increase from 22.4% to 24.8% by 2026. The purpose of this single case study was to explore training strategies managers used to improve multigenerational employee productivity. The sample population included 6 managers of an automotive company in the Great Lakes area of the United States who had knowledge and experience supervising multigenerational workers. Human capital theory was the conceptual framework used to ground the study. Data were collected from semistructured face-to-face interviews, company documents, and website pages. Data analysis included coding to identify themes and member checking to ensure validity. The 2 main themes were collaborative training methods and mentoring programs; the 2 subthemes were advancement and promotion, and retention of employees. Findings of this study may be used to support older employees working longer than traditional retirement age, which might benefit society with increased economic productivity through decreased costs of retirement benefits, healthier living, and greater longevity.

acase@tulane.edu / In the nearly 30 years since the Convention on the Rights of Child (UN, 1989) first called for the inclusion of children in research, evidence has demonstrated the many benefits of engaging children as active participants in research. There exists a gap in qualitative research examining the psychological well-being of elementary-aged African American children. This study used child-friendly qualitative methodology to understand the psychological well-being of elementary-aged African American children living in New Orleans, Louisiana. The study explored children’s stressors, supports, and reactions to stressors and supports from the perspectives of multiple stakeholders: elementary-aged children, parents of elementary-aged children, and school teachers and administrators. The purpose of the study was to gain understanding of children’s unique perspectives and to inform culturally-appropriate school-based supports. To understand the unique and shared perspectives of the stakeholders regarding the constructs of children’s psychological well-being, the research used children’s ecomap drawings, focus group narratives, and interview data. Through the use of a deductive-inductive coding process, Support, Reaction to Support, Stressor, and Reaction to Stressor themes and codes were identified and defined. The findings revealed overlap and unique perceptions regarding children’s psychological well-being. Further findings, implications, future research directions, and limitations are discussed. / 1 / Emiliya Adelson

Many older adults develop restrictions in the performance of activities that are essential to daily living, referred to as functional limitations. Functional limitations can lead to disability, the inability to complete tasks necessary to function in society. A better understanding of how impairments in body systems affect functional limitations and disability in older adults could lead to improved medical management of older adults. The purpose of this study was to examine how impairments in lower extremity muscle performance (strength, power, and endurance) are related to functional limitations and disability in community dwelling older adults. Thirty-four subjects were recruited to participate in this cross-sectional analysis study with 30 individuals completing the study. The Keiser 420 Leg Press was used to measure impairments in lower extremity muscle performance. Functional limitations were classified through the Short Physical Performance Battery, the Six-Minute Walk Test, the Late Life Function and Disability Index (LLFDI) Functional Limitation Component, and average walking speed, average walking distance and average number of steps per day over a six-day period obtained from the AMP 331 physical activity monitor. Disability was measured through the LLFDI Disability Component Limitation Category. Regression analysis was used to examine the direct effect between impairments in muscle performance and functional limitations. Mediation analysis was used to examine the indirect effect of impairments on disability. The results of this study support a relationship between impairments in lower extremity strength and power to functional limitations and disability in community dwelling older adults. Impairments in lower extremity power consistently demonstrated a stronger relationship than strength to all measures of functional limitations and disability. The results of this study did not support a relationship of impairments in endurance to functional limitations or disability. The overall findings of this study would indicate that community dwelling older adults should focus on maintaining and improving lower extremity strength and power across a range of relative intensities in order to decrease functional limitations and disability.

This grounded theory study investigated how registered nurses (RNs) managed problem-solving and decision-making in residential aged care facilities (nursing homes) in Western Australia. The outcome of the study was the substantive theory of situational positioning, the process used by the RN participants when they were trying to get things right .In-depth interviews were conducted with 25 purposefully selected registered nurses and nursing home management staff. The interviews were transcribed verbatim, and analysed using the constant comparative method. Other sources of data. guided by theoretical sampling. were selected documents such as government reports regarding aged care, and some field observations. Situational positioning was a process that involved physical. cognitive, emotional, and moral dimensions, and reflected how the RN participants acted and responded when dealing with situations at work. Situational positioning was conceptualised as occurring along two intersecting continua of behaviours, and these behaviours emerged from the data as four interrelated categories. Yielding and confronting represented the poles on a continuum of action-oriented behaviour, with being flexible and being rigid on a continuum that reflected more affective or attitudinal responses. The four categories that made up the positioning continua had both positive and negative meanings in relation to the actions and responses of the participants, depending on the particular situation. Yielding was a conceptual category that reflected participants' comments about stopping a particular action and trying something else or giving up completely and even leaving the situation. f he term confronting was used to describe participants' actions that were based on assertiveness that was seen as a constructive behaviour, or anger that tended to be non-productive. / Being flexible meant that the participants were responsive to changing situational variables, and this was usually seen as a desirable attribute of effective nursing practice in aged care. However, it could also mean being pliant and ready to compromise in order to get through situations when the participants realised that they would be unable to get things right. At the other end of the response axis, the term being rigid was defined as the opposite of being flexible, that is, having firmly fixed or set ways of responding. or a tendency to respond to situations in the same way in all circumstances. The basic psychosocial problem, being unable to get things right, had two properties. One property was temporal, in that the problem occurred when the participants were getting behind or running late because of having insufficient time. usually due to interruptions. The second property of the problem was more qualitative in that contextual and intervening conditions led the participants to feel that they were not doing things properly because of adverse conditions. Conditions that varied .situational positioning were those that led to the participants being unable to get things right, such as having insufficient time. working with unqualified carers. and trying to meet the differing expectations of various stakeholders. Situations that were easy for the participants to manage involved known routines and few, if any. interruptions. In those circumstances, si uational positioning was intuitive and the phases of recognising, prioritizing, and moving on were negotiated quickly. In more complex situations, or when significant interruptions occurred, the participants followed an alternative pathway, which involved recognising that something in the situation changed. then compromising. that is. choosing a new course of action. / Compromising required tolerance, as the participants adjusted their expectations of what could be achieved in the circumstances. Repositioning then occurred belore they moved on to the next task or to the end of their shifts. Moving on. the third phase in the process, involved persevering as they continued trying to get things right. The adverse conditions that prevailed in nursing homes during the time of this study impeded nursing practice and the delivery of consistently good standards of care for all residents. Situational positioning enabled the participants to persevere in their efforts to try to get things right, but their capacity to maintain the effort was eroded by the apparently unrelenting nature of the adverse conditions that existed in nursing homes. The main conclusion of this study was that the RN role in nursing homes in Western Australia was ill-defined, and inefficient in terms of best utilisation of nursing time. Recommendations included a review of the RN role in aged care and implementation of strategies that would enable aged care RNs to focus on their clinical roles.

This thesis provides a situated understanding of the ways in which the reality of a new technology is socially constructed. In particular, it examines how members of the aged interpretive community made sense of the computer as an interruption event, a technology not yet routinised as part of their everyday taken-for-granted reality, and needing to be consciously considered and evaluated to make it understandable. Members' sensemaking is studied as a narrative process in which meaning is produced by drawing on a repertoire of narratives, evaluating and developing localised responses to those narratives for the purpose of action taking. Two hundred and four participants over the age of 55 years, recruited predominantly from senior citizens' and SeniorNet organisations in the North Island of New Zealand, were interviewed in 28 focus groups over an eighteen month period between September 2001 and May 2003. Participants were categorised according to their self-identified membership of one of three groups: computer users affiliated to SeniorNet member organisations; computer users without SeniorNet organisational affiliation; and non-computer-users. Their computer-related stories were analysed using narrative analysis to identify and map the similar and different ways in which they constructed computers and themselves in relation to computers, in the stories they told. The research findings from this interpretive study augment the largely functionalist literature on older people and computers and provide insights not identified in previous studies. In particular, the findings indicate that participants identified a common meaning for the computer as actually or potentially useful for older people, but their meanings also varied according to their membership of one of the three participant groups, with SeniorNet members tending to identify the computer as an opportunity; Users, as a tool; and Nonusers, as a threat. Participants' meanings were traced through a storying process that identified three narrative elements as key: the settings in which accounts of the principal protagonists older people and computers were produced; the strength of the narrator's identification with old stories and values; and the ways in which the narrators oriented to the computer in the context of other technologies and events, or in isolation from them. The study makes a contribution to knowledge by enhancing understanding of older people's relationships with computers, through a micro level investigation of their experiences with, and meanings for, the technology. In addition, by identifying and explicating the processes through which the ongoing reality of a new technology is constructed and negotiated, and compared and contrasted in relation to three separate sub-groups of the one demographic population, the study contributes to social construction of technology theory. The study also makes a contribution to practice by showing how the alignment of old stories and new stories is a crucial component in the process for enabling those new to a technology to negotiate an appropriate placement for it, and how such alignment can be influenced by age-peer groups and the imperatives of inter-generational family communication.

This postmodern feminist ethnographies research aimed to explore the everyday meanings of primary health care (PHC) held by rural community nurses. Secondly, the research aimed to explore the everyday meanings of care held by the clients of the rural community nurses who participated in the study. The representation of this research is written in four voices which converse with each other to varying degrees in each chapter. This writing strategy is a deliberate one aimed at destabilising the usual approach to representation of research. It is also a strategy which seeks methodological coherence. The third aim therefore is to deliberately trouble the acceptable grounds concerning how nursing research is represented. The research utilised dialogical (conversational)and participant observation methods concerning the everyday meanings of nurses and their clients.The meanings I made of the information were created from a deconstruction of the texts. These texts included fieldnotes of participant observations and transcripts of conversations with nurses and their clients. The form of deconstruction utilised was informed from multiple sources and involved three levels of analysis. A realist interpretation was followed by an oppositional interpretation and then a reconstructive movement. The results revealed that rural community nurses practice is both spatio-temporally contextualised and metaphorically situated in an in-between space. This in-between space is situated between margin and the centre. Rural community nurses working on the margins traverse this space in order to overcome further marginalisation whilst working with Indigenous Australians and the aged. Moreover, the in-between space encompasses and creates opportunities to mutually exchange the gift of desire that being - empowering and compassionate relationships with clients and colleagues. Futhermore, whilst rural community nurses are strongly committed to the philosophy of PHC, their evryday working life is discursively constructed by powerful discourses which result in oppositional tensions. The tensions and the 'in-between' space allow the rhetoric of PHC to be resisted and reframed. Consequently, the oppositional constructs of their practice were displaced. Moreover, this necessitated the negotiation of space and place, and required the reconstruction of subjectivity, intersubjectivity and becoming / Doctor of Philosophy (PhD)

This mailed survey of nurses in all (111) New South Wales aged care facilities with Huntingdon Disease affected residents, used a custom designed questionnaire in a triangulated exploratory design. It was undertaken by an HD specialist nurse into the previously un-researched field of the nursing challenges in that setting. Knowledge was sought, through descriptive and correlational analysis of fixed choice and open-ended questions, of the facts of the affected resident profile (N=63). Similarly, nursing opinions were obtained on the following unsatisfactory aspects of care provision, the impact of internal resources and the HD nursing role and its support. Results are discussed in some detail. Overt evidence of stigmatisation was not evident. Approximately 32 additional long stay HD beds are needed plus more equipment and education for the aged care facilities. The outreach model of support was strongly endorsed. / Master of Nursing (Hons)

Ethical decision-making is an integral aspect of gerontic nurses' experiences of caring for nursing home residents and their families. This thesis examines the author's journey into the life-worlds of nine registered nurses working in an Australian nursing home to explore how they manage the ethical problems they encounter in their everyday experience of nursing home life. As a result of interviews, the study revealed that nurses utilized an approach to ethical decision-making not previously described.This approach was identified as being professional, familial, collegial and reciprocal in nature. As an approach to ethical decision-making, respectful relationships is a potential tool for nurses coping with the ethical problems that are an every-day aspect of their professional lives in a nursing home. Respectful relationships can guide nurses' ethical decision-making as they strive to do the right thing / Doctor of Philosophy (PhD)

Job-seeking research has been implicitly an examination of the job-seeking activities of youth. Even at the broader level of the labour market there continues an underlying association of youth with employment while the experiences of mature workers have been largely minimised, especially in New Zealand. This study examines the job-seeking activities and experiences of mature job-seekers in the New Zealand labour market from a political economy perspective.Issues surrounding mature workers have lacked a theoretical and disciplinary "base" with the issues of retirement and health consistently overwhelming any discussion about mature people and employment. The political economy theory of aging does provide a useful explanatory framework given the struggle for recognition and resources of mature workers. The persistent exclusion of mature workers from any discussion about the labour market in New Zealand is a common theme throughout the present study.As mature workers become increasingly "problematised" by economists as a threat to future economic productivity; issues surrounding mature employment need to be better understood because there will be greater proportions of mature workers and mature job-seekers. Through a sample of 947 mature jobs-seekers collected by MESA offices throughout New Zealand, issues surrounding mature job-seekers in particular were examined.The results highlight both the different and similar experiences of men and women in the New Zealand labour market. Women respondents were more likely to present themselves as younger than men, and to be returning to the labour market after family responsibilities with lesser confidence in their job-seeking skills and occupational abilities. Men by contrast presented themselves at MESA as older and more likely to have been made redundant; they also appeared to have more confidence in their job-seeking and occupational skills. Gender, however, did little to explain the primarily formal job-seeking methods used and the effort expended job-seeking. There is little to suggest that job-seeking efforts diminish significantly with age. Only with the final cohort of age 61 years and over, was mean job-search effort significantly less than for other age-cohorts. By contrast the variable time out of work explained much of the variance with job-search peaking at six months out of work. Subsequent analysis strongly supports the suggestion that any policy intervention will have the greatest impact within the first four to six months of unemployment.There is also some evidence to suggest that the reason for becoming a mature job-seeker and the attributions these mature job-seekers make for their unemployment is associated with their job-search efforts. In the present study those mature job-seekers made compulsorily redundant, regardless of age or gender, clearly tried harder than other job-seekers. By contrast those job-seekers who indicated they had been dismissed gave less effort to their job-search.The primary barrier identified by mature job-seekers is silence, silence from employers or employment agencies about why they have not been considered or rejected for work. As a consequence many mature job-seekers interpreted this silence as age discrimination. Understandably mature job-seekers are reluctant to see their lack of skills or experience as contributing to their circumstance and feel disappointed that their skills are not appreciated: a point well highlighted by the qualitative analysis "Trajectory of emotion" that captures the voice of participants in the present study. Finally, paid employment does matter to mature people and future research and policy would do well to examine the full picture of the labour market and give attention to where real needs exist. Mature job-seekers in the present study did not necessarily seek "special" treatment but rather the same opportunities as their chronologically younger colleagues to make a contribution to New Zealand society through paid work.