Hearing loss and tinnitus are the two most common service-connected disabilities in Veterans. Patients with a chief complaint of hearing loss and/or tinnitus typically undergo a hearing evaluation to determine the severity and type of hearing loss. The standard treatment for sensorineural hearing loss is the fitting of personal amplification.Up to 95% of tinnitus patients have an underlying hearing loss and could benefit from hearing aids for both improved communication and as an effective treatment to reduce the impact of tinnitus, ((Shargorodsky, Curhan, & Farwell, 2010). It is not uncommon, however, for some of these patients to decline hearing aids although they elect to undergo tinnitus counseling. The observation that some of these patients elected to obtain hearing aids following tinnitus counseling compelled an investigation of tinnitus counseling’s role in the patient’s revised decision to accept hearing aid fitting. An electronic medical records review (2015- 2020) identified Veterans meeting the following criteria: (1) diagnosis of sensorineural hearing loss and tinnitus, (2) declined hearing aids at the time of the hearing evaluation, (3) received tinnitus counseling, (4) elected to obtain hearing aids following tinnitus counseling, and (5) affirmed regular use of the hearing aids for more than one year. 30 qualified veterans provided informed consent to participate. Enrolled participants were interviewed using a brief survey that allowed patients to report a variety of tinnitus and hearing-related challenges. Participants also completed a validated tinnitus intake form, the tinnitus handicap inventory (THI), which reports a patient’s self-assessed tinnitus handicap. A total of six Veterans (white males, average age of 60 years, with bilateral sensorineural hearing loss and bothersome tinnitus) participated. The number of hours of daily hearing aid use was related to the self-perceived benefit of hearing aids for the management of tinnitus, as the 5 participants who wore their hearing aids >5 hours/day reported benefit in contrast to the single participant who wore their hearing aids /day. The reported benefit of tinnitus counseling, however, was not reflected as a significant improvement in the post-counseling THI score. All participants reported the counseling was useful and recommended that other veterans experiencing tinnitus and hearing loss undergo a trial with hearing aids . A narrative analysis of additional information provided by participants was made to identify counseling elements that supported the use of hearing aids for tinnitus management. In general, the analysis indicated that when patients were provided accurate information regarding tinnitus management strategy options, then they might be more likely than uninformed patients to accept and act upon hearing aid recommendations in a timely manner. All participants suggested that the provision of more information regarding tinnitus and management options at the time of the hearing evaluation would have likely expedited hearing aid acceptance. The preliminary findings of this survey suggest that patients with a diagnosis of sensorineural hearing loss and tinnitus might benefit from some form of tinnitus management counseling at the time of the initial hearing evaluation, and that the counseling might facilitate uptake of hearing aids.

What relationship exists between working conditions and teacher turnover in child-care (early care and education) programs? Research has shown high staff turnover is a major factor affecting the quality of care. Using a new survey and data set I designed of union and randomly selected non-union programs in Massachusetts, I examine factors other than compensation that might be related to lower teacher turnover. Focusing on different institutional settings, including unionization and regional unemployment, I use economist Albert Hirschman’s theory of exit, voice and loyalty to see if “voice” alternatives to quitting are an effective method of reducing exits. “Voice” alternatives studied include working relationships and practices between management and labor; identified paths for promotion and compensation; and processes for making decisions and addressing grievances. I discuss three research questions: What working conditions or practices affect teacher turnover in child-care programs in the private market? Results indicate the presence and type of worker voice affects teacher turnover. Programs with collective bargaining agreements have lower rates of turnover than those without. Unionized programs also employ more staff per child, pay higher wages, and serve a higher percentage of state-subsidized children. How does “voice” differ in nature and quantity across different types of workplaces? I find there is more voice in unionized programs. Also different voice practices are used in programs operating in a high-unemployment compared to a lowunemployment environment. What, if any, is the statistical relationship (correlation) between teacher turnover and voice, and how does this relationship vary across workplaces? My results show a consistently negative relationship between teacher turnover and voice in these workplaces even when controlling for wages. Programs with more voice aspects have less teacher turnover.

The purpose of this study was to examine if early childhood teachers can enhance literacy and language development in preschool children and strengthen the literacy with the support of an on-site technical assistant (TA). The present investigation sought to explore two questions: Is there a statistically significant difference between classroom environments for which teaching early literacy skills, as measured by the Early Language and Literacy Classroom Observation Toolkit (ELLCO) Research Edition of three and four-year-olds participating in the on-site technical assistance model when compared to classroom environments in programs where early childhood teachers did not participate? and Is there a statistically significant difference in language scores of children in classrooms whose early childhood teachers participated in the technical assistance model as measured by the Preschool Language Scale-4th edition (PLS-4) as compared to children whose teachers did not participate? ANCOVA was used to assess differences in mean post-test scores (ELLCO and PLS-4) between treatment and comparison groups. Both the treatment and comparison groups’ pre-test scores were used as covariates. There was a statistically significant difference between the treatment and comparison groups of teachers as measured by the ELLCO.

The purpose of this study is to examine the role of center-based care and children's school readiness in predicting their first and third grade reading and mathematics achievement. Predictions derived from an opportunity-propensity theoretical framework applied to data from the Early Childhood Longitudinal Study-Kindergarten Class of 1998-99. The study examined the impact of antecedent factors (e.g., socioeconomic status, parental expectations), opportunities to learn (e.g., center-based care), and children's propensities to learn (emergent reading and mathematics skills, approaches to learning) on first and third grade reading and mathematics assessment scores, and whether center-based care moderates the impact of multiple health and environmental risks for vulnerable children. / Educational Psychology

The purpose of this study was to examine the parent involvement attitudes and practices of early care and education teachers. A sample of 171 early care and education teachers rated the degree to which they agreed or disagreed with 25 statements regarding general attitudes of parent involvement, as well as family and teacher and/or center obligations in creating family-school partnerships. Teachers were also asked to indicate the frequency in which they engaged in 9 specified activities that could be used to engage families in their young child's education. The surveyed teachers were from 31 early care and education centers that were participants in a quality improvement initiative designed to improve the school readiness of the children they serve. Fifteen of the 31 centers received additional services from a family engagement specialist, who worked to increase parent involvement at the centers and to strengthen family-school partnerships. Results indicated that, overall, the teachers reported positive views about parent involvement and the families they served. They recognized the benefits of family-school partnerships for young children. The teachers reported feeling that it was an important part of their job to involve all families and that all families had strengths and abilities that could be used to help their children get ready for kindergarten. Modest differences were found in the responses between teachers who had received assistance from family engagement specialists and those who had not, with teachers who were part of the intervention indicating stronger support from their directors and center and being more likely to talk to families about concerns. All of the teachers surveyed reported using a wide variety of strategies to engage families, with teachers in the intervention group using parent workshops and newsletters more often that the non-intervention group. Slight but significant differences were found on some of the survey questions related to teacher characteristics, such as hours worked at the center per week and age of children taught. With increased emphasis being placed on quality improvement in early care and education, it is important to know how those being asked to implement possibly new and demanding changes in practice feel about and respond to what is being asked of them. Efforts to support them should be effective and responsive to their current views and practices. / School Psychology

Previous research has shown how home and parental characteristics support or hinder the development of children’s self-regulation in the family context. There have only been limited attempts to understand these mechanisms in early childhood education settings. This study used the NICHD Study of Early Child Care (when participating children were 36-months old) to examine the relations among various aspects of the early childhood education setting, the interactions in the setting, and children’s self-regulation in center-based and home-based settings. Structural equation modeling was used to test a model proposing the deconstruction of early childhood education quality into structural (i.e., environmental and caregiver characteristics) and process quality components (i.e., positive and negative interactions) and to examine these as predictors of three-years old children’s self-regulation abilities. A meditational model was tested in which positive and negative interactions in the classroom mediated the relations between the structural characteristics and self-regulation. There were three important findings. First, although there were no consistent patterns of associations between structural features and self-regulation across the two types of care, there were more significant relationships in home-based care compared to center-based care. These findings showed that the home-based caregiver characteristics were more closely tied to the processes in the classroom than those characteristics of caregivers in center care. Second, both positive and negative caregiving were associated with children’s compliance, which suggested that compliance may have been influenced differently by process quality compared to other self-regulation measures, such as self-control and emotion-, behavior-, and attention-regulation. It may be that high rates of compliance may be markers of highly restrictive caregiving rather than the result of good quality caregiving. Third, there were very few significant relationships between process quality measures and children’s self-regulation measures, which suggested that commonly used process quality measures may not be capturing the processes that are most important for the development of self-regulation. / text

The importance of Early Childhood Care and Education (ECCE) as a prerequisite for national development has been emphasized in recent years by developing countries and by donor agencies. Research findings point to the benefits children, as well as nations, derive from ECCE provision. For children, these benefits include school readiness; and for nations, benefits address the reduction of social inequality, possibilities for increased tax revenue through eventual improved employment prospects, and development of societal values. In 1990 at Jomtien in Thailand, 155 nations of the world agreed on a joint plan of action to fulfill six Education For All goals. The first goal required nations to work towards the expansion and improvement of comprehensive ECCE by the year 2015. The responsibility of poor countries was to make necessary budget allocations and policy commitments; rich countries were to provide both intellectual and financial support. Whilst some progress has been made, many developing countries especially in Sub-Saharan Africa are still at risk of not achieving EFA by 2015. Uganda is one country where there are difficulties in attaining EFA and ECCE in particular. This has been exacerbated by the prevailing economic, social, geographical, and cultural differences, as well as general beliefs about ECCE. This study investigates the present quality and accessibility in ECCE provision in Uganda. It explores the extent to which Uganda has expanded and improved ECCE and raises the key question as to why even with international donor support and government commitment to institutional changes, ECCE is an area of education still riven with problems. The study uses participant observation, semi-structured interviews, and photography in six selected schools in three Districts. Research findings reveal that the majority of children are not accessing ECCE provision, while many of those that do are being educated in environments not conducive to their learning and development. Findings show that there are a number of factors both internal and external to Uganda that impact upon efforts to fulfil the commitment made at Jomtien in 1990. This research concludes that first and foremost, there should be a national, ‘Ugandan’ approach to and policies about ECCE. Rather than being led by international pressure and policies, approaches to improving quality and accessibility in ECCE provision should be refocused away from ‘top-heavy’, ‘lop-sided’ approaches to a more pre-school-level focused approach. This will help in establishing and addressing culturally relevant and economically achievable quality targets. Secondly, there is need for public awareness of the importance of ECCE. This will not only give rise to increased community participation in the establishment of community-based ECCE centres, but also the involvement of stakeholders in the identification and implementation of solutions to the problems facing ECCE. And finally, rather than looking to the West for funding, Uganda should develop in-country funding strategies from both public and private sources. This will help to remove the negative impact of ‘modalities’, these often being required by external donor funding. In-country funding sources will as a result give Uganda room to ‘manoeuvre’ when planning for ECCE.

Paper 1 - Integrated Working and the Personal Education Plan: An Exploration of the Transition into Care for Young People in Key Stage 4: The Social Care and Education systems have undergone major reform in recent years, papers such as the Every Child Matters (DfES, 2003) and The Children’s Plan (DCSF, 2007) have acted as political drivers for the identification of children in care as an vulnerable group within education. In addition, the need for effective integrated working has been identified as a key area of development in terms of professional practice. The Personal Education Plan has been identified as a vehicle for raising attainment and promoting integrated working, however, the process of engaging in the Personal Education Plan has remained relatively unexplored. This study reports a qualitative exploration of integrated working in the support of young people entering care in Key Stage 4. The study specifically explored transition, integrated working and the application of psychology within this process. Data was collected using focus groups and interviews to elicit the views of the professionals who engage in supporting young people entering care. Data was analysed using Thematic Analysis (Braun & Clarke, 2006). The findings of the study identify the successive nature of changes experienced by the young person entering care as potentially detrimental to him/her and the supporting professionals. Findings from the study suggest that professionals supporting young people in care experience ambivalence regarding the usefulness of the PEP Personal Education Plan. The competent management of change, acknowledgement of psychosocial implications and effective group working were identified as areas of development for young people entering care and for the professionals supporting them. In addition, the study found that the knowledge and experience of Educational Psychologists’ is an under utilised but potentially valuable resource. Paper 2 - Inclusive Education and the Personal Education Plan: An Exploration of the Support for Young People Entering Care in Key Stage 4 Abstract The education system has undergone major reform in recent years, papers such as the Every Child Matters (DfES, 2003) and The Children’s Plan (DCSF, 2007) have instigated a re-evaluation of the process and context of the education system. One of the major implications of this reform has been the need to identify any groups within the population who underachieve educationally with the intention of providing additional support. The role of designated teacher and use of the Personal Education Plan has been established within school settings, however, the process of supporting young people entering care within college settings has remained relatively unexplored. This study reports a qualitative exploration of core subject teachers in the support of young people entering care in Key Stage 4. The study specifically explored professional engagement in the Personal Education Plan, classroom practice and support of young people entering care. Data was collected using focus groups to elicit the views of the professionals who teach young people entering care. Data was analysed using Thematic Analysis (Braun & Clarke, 2006). The findings of the study suggest that teaching staff identify individual need in response to conflict (in the form of response to presenting behaviour within school). The nature of additional need identified within the study was predominantly psychosocial. Additional support is therefore reactive. The dichotomy between inclusive legislation and practice is explored Teachers identified the need for a proactive response to supporting young people in care as an area for development at both the individual and systemic level. Future considerations for the application of psychology and research are identified.

This thesis deals with the development of education in anesthesiology and intensive care in the Czech Republic. The operational objective of the historical-theoretical thesis is to explore specialized education in the field of intensive care from its roots to the present. At the beginning of the thesis describes the development of the field of Anesthesiology and Intensive Care, also are given information about the work of nurses, including their competencies in this field before the official introduction of specialized study. The following chapters are devoted specialized education from 1971 to 2013. Each of these chapters ends with a list of competencies of nurses, which are then compared. The thesis is the comparison of specialized study from 1971 to 2013. The thesis also deals with the development of the field paramedic and informs about current possibilities of specialization in intensive care and specialization at universities with their comparison.

The promotion of male educators in the early childhood care and education (ECCE) workforce has been pursued as a social policy in various countries around the world, yet this issue is virtually absent in ECCE literature and policy in South Africa. From certain child development, education and gender perspectives, more men in ECCE is seen as good for children, good for men, challenges gender stereotypes and enhances gender equity as well as the quality of ECCE. We know very little about male ECCE educators in South Africa. This study aims to shed light on their experiences and explore whether there is a need to promote gender inclusivity in ECCE in South Africa. Due to the virtual absence of this minority, a small sample of six male ECCE educators were purposively sampled in an in-depth, qualitative case study, using semi-structured interview schedule and face-to-face interviews. The study also explored the views of two key informants - academics working in early childhood and gender studies. Thematic content analysis of the data revealed some commonalities with previous studies. While some generalisations can be drawn the aim of the study was to gather contextualised accounts of these experiences and views on the broader social issues pertaining to the lack of men in the sector. The overall findings suggest that there is a need for existing and potential male educators to be encouraged, supported and made more visible. This requires network building by male educators themselves and support from the ECCE sector, Government and other stakeholders for programmes that promote attitude and institutional change.