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Central venous catheters (CVCs) are commonly used as vascular access for patients who require hemodialysis. Infectious complications are a serious clinical problem, and they are associated with high rates of morbidity and mortality, prolonged hospital stay, and increased medical treatment costs. The purpose of theproject was to evaluate the effectiveness of educating registered dialysis nurses regarding CVC maintenance care to reduce catheter-related bloodstream infection (CRBSI) in a hemodialysis unit. The project question focused on the educational program derived from the evidence-based guidelines recommended by the Centers for Disease Control and Prevention (CDC) to improve registered dialysis nurses' knowledge regarding CVC maintenance care. The theoretical foundation of the study was based on Donabedian's structure-process-outcomes model. In this project, nurses considered a structural element and used a self-study module to improve the process of providing CVC maintenance care. A paired-samples ttest was conducted to compare knowledge scores of the participants in the posttest (n = 56) and knowledge scores of participants in the pretest (n = 57). The ttest was significantly higher for the posttest than scores for the pretest. The results suggested a statistically significant improvement in the registered dialysis nurses' knowledge following the educational intervention. This study contributes to social change by identifying an educational intervention that helped improving nurses' knowledge in hemodialysis unit, thus helping hemodialysis patients stay safer and possibly reducing infectious complications.

It is estimated that 9-14% of children from birth to age 5 experience social and emotional problems that may significantly affect their ability to learn later in life and students of any age may experience an array of problems resulting in difficulty learning. Although interventions are available to address these issues within the school context, government funding for programs is often limited to those that are evidence based. Student Assistance Programs (SAPs) address a variety of barriers to learning but many are not supported by empirical evidence. The purpose of the study was to determine if Breakthrough, a specific SAP, had a significant effect on the dependent variables of grade point average, attendance, and behavioral referrals among N = 727 public school students in Grades 9-12. The independent variables were completion or noncompletion of the program, time, and grade level. This quantitative study used a systems perspective, nonequivalent control group design. The statistical analyses performed were a mixed ANOVA and a generalized estimating equation. The interaction of treatment, time, and grade level were found to be significant on attendance, and the interaction between treatment and time on was found to be significant for attendance. The main effect of time was found to be significant on grade point average, attendance, and behavioral referrals. The main effect of treatment was found to be significant on number of behavioral referrals. Increasing the types of supports for school-aged students may bring positive social change by allowing for higher academic achievement and by intervening with issues that may follow students into adulthood such as mental illness and substance abuse.

The overall aim of this thesis was to explore surgical nurses’ experiences of being confronted with patients’ existential issues when caring for patients with cancer, and to examine whether an educational intervention may support nurses in addressing existential needs when caring for patients with cancer. Previously recorded discussions from supervision sessions with eight healthcare professionals were analysed (I), written descriptions of critical incidents were collected from 10 nurses, and interviews with open questions were conducted (II). An educational intervention on existential issues was pilot tested and is presented in Studies III and IV. The intervention was the basis of a pilot study with the purpose of testing whether the whole design of the educational intervention, including measurements instruments, is appropriate. In Study III and IV interviews with 11 nurses were conducted and 42 nurses were included in the quantitative measurements of four questionnaires, which were distributed and collected. Data was analysed using qualitative secondary analysis (I), hermeneutical analysis (II), and mixed methods using qualitative content analysis and statistical analyses (III-IV). Results in all studies show that existential issues are part of caring at surgical wards. However, although the nurses were aware of them, they found it difficult to acknowledge these issues owing to for example insecurity (I-III), a strict medical focus (II) and/or lacking strategies (I-III) for communicating on these issues. Modest results from the pilot study are reported and suggest beneficial influences of a support in communication on existential issues (III). The results indicate that the educational intervention may enhance nurses’ understanding for the patient’s situation (IV), help them deal with own insecurity and powerlessness in communication (III), and increase the value of caring for severely ill and dying patients (III) in addition to reducing work-related stress (IV). An outcome of all the studies in this thesis was that surgical nurses consider it crucial to have time and opportunity to reflect on caring situations together with colleagues. In addition, descriptions in Studies III and IV show the value of relating reflection to a theory or philosophy in order for attitudes to be brought to awareness and for new strategies to be developed.

The overall aim of this thesis was to explore surgical nurses’ experiences of being confronted with patients’ existential issues when caring for patients with cancer, and to examine whether an educational intervention may support nurses in addressing existential needs when caring for patients with cancer. Previously recorded discussions from supervision sessions with eight healthcare professionals were analysed (I), written descriptions of critical incidents were collected from 10 nurses, and interviews with open questions were conducted (II). An educational intervention on existential issues was pilot tested and is presented in Studies III and IV. The intervention was the basis of a pilot study with the purpose of testing whether the whole design of the educational intervention, including measurements instruments, is appropriate. In Study III and IV interviews with 11 nurses were conducted and 42 nurses were included in the quantitative measurements of four questionnaires, which were distributed and collected. Data was analysed using qualitative secondary analysis (I), hermeneutical analysis (II), and mixed methods using qualitative content analysis and statistical analyses (III-IV). Results in all studies show that existential issues are part of caring at surgical wards. However, although the nurses were aware of them, they found it difficult to acknowledge these issues owing to for example insecurity (I-III), a strict medical focus (II) and/or lacking strategies (I-III) for communicating on these issues. Modest results from the pilot study are reported and suggest beneficial influences of a support in communication on existential issues (III). The results indicate that the educational intervention may enhance nurses’ understanding for the patient’s situation (IV), help them deal with own insecurity and powerlessness in communication (III), and increase the value of caring for severely ill and dying patients (III) in addition to reducing work-related stress (IV). An outcome of all the studies in this thesis was that surgical nurses consider it crucial to have time and opportunity to reflect on caring situations together with colleagues. In addition, descriptions in Studies III and IV show the value of relating reflection to a theory or philosophy in order for attitudes to be brought to awareness and for new strategies to be developed.

The purpose of this study was to test the effects of an educational intervention on the aging knowledge of graduate counseling students. Overcoming misconceptions, such as positive and negative stereotypes about older adults, is essential for graduate counseling students to be effectively trained to work with the aging population. Educational interventions have been found to be the most consistently effective way of increasing aging knowledge and helping individuals overcome ageist beliefs rooted in faulty aging knowledge. For this study, it was hypothesized that a comprehensive educational intervention (approximately 2 hours in duration) would increase overall aging knowledge, increase aging and mental health knowledge, and lower levels of negative aging bias; moreover, this study hypothesized that adding a structured discussion (approximately 20 minutes in duration) after the educational intervention would further increase overall aging knowledge and overall aging and mental health knowledge and further reduce levels of negative aging bias. In addition, it was hypothesized that students who received the educational intervention or the educational intervention with structured discussion would be better able to process three exploratory aging related vignettes than the group of students who received no educational intervention. The findings of this study suggest that the use of an educational intervention alone may not be enough to increase overall aging knowledge, increase aging and mental health knowledge, and decrease negative aging bias among graduate counseling students. However, it does appear that adding a structured discussion to an educational intervention is an easy way to produce superior results. In addition, it does not appear that using a short-term educational intervention, with or without structured discussion, is enough to impart the level of aging knowledge to graduate counseling students for them to be able to do more complicated tasks, such as processing an aging related vignette using factual knowledge.

Orientador: Ângela Fátima Soligo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação / Made available in DSpace on 2018-08-18T08:20:19Z (GMT). No. of bitstreams: 1 Gimenez_EloisaHilsdorfRocha_D.pdf: 1807336 bytes, checksum: 8b993f0c4c4d5705145de7b9230f4f20 (MD5) Previous issue date: 2011 / Resumo: Crianças são encaminhadas com queixas escolares constantemente e desnecessariamente para serviços especializados. Estão sendo diagnosticadas erroneamente, o que contribui para estigmatizá-las. Filas de espera para atendê-las são uma realidade e a demanda crescente clama por outras intervenções. Foi por reconhecer tal situação que a coordenadora de um núcleo educacional, que tem como propósito atender queixas escolares, solicitou o trabalho de uma assessoria em Psicologia Escolar, da qual fiz parte junto com outra profissional que também é psicóloga. Realizamos este trabalho durante um ano e três meses e foi por intermédio dele que defini que o núcleo educacional e o trabalho da assessoria fariam parte de minha pesquisa de doutorado. Para tanto, estabeleci os seguintes objetivos: 1) Analisar o funcionamento do núcleo educacional e investigar se ele atende efetivamente a proposta de acolhimento da demanda escolar; 2) Conhecer e analisar as concepções sobre o núcleo dos profissionais que trabalham neste local, bem como de diretores, coordenadores e professores; 3) Compreender as modificações ocorridas no funcionamento de um núcleo educacional a partir das intervenções da assessoria escolar. Participaram desta pesquisa 31 sujeitos, entre funcionários do núcleo, diretores, coordenadores e professores da rede municipal de ensino de uma cidade do interior paulista. Todos responderam a entrevistas semiestruturadas, que foram gravadas e posteriormente transcritas. Além deste instrumento, utilizei-me de registros em diário de campo e de registros ampliados. Os dados foram analisados qualitativamente de acordo com a teoria defendida por González Rey (2002; 2003; 2005) e os resultados mostraram que a as intervenções que o núcleo realizava e a forma como ele estava estruturado contribuíram para perpetuar o processo de estigma e exclusão escolar, embora fora proposto com objetivo contrário a este. Foi possível verificar que ainda é grande a expectativa para que o núcleo educacional intervenha diante das queixas escolares a partir de uma perspectiva médica e clínica. Mediante isto e devido ao fato de vários profissionais que integram o núcleo discordarem que este seja seu propósito, está ocorrendo um movimento em busca de diálogos para que os papéis e funções do núcleo sejam devidamente estabelecidos. Este movimento foi compreendido como favorável, pois anteriormente à assessoria ele não ocorria. Transformações ocorreram e puderam ser compreendidas por intermédios das mudanças nas concepções, nas práticas e no funcionamento do núcleo. Este local passou a direcionar suas intervenções também para o contexto escolar, o que está permitindo maior diálogo e integração com as escolas. Os profissionais, em sua maioria, avaliaram a assessoria como algo positivo, reconheceram sua contribuição e manifestaram necessidade de serem novamente assessorados. Este processo será extremamente válido, pois poderá contribuir para que o núcleo caminhe, cada vez mais, em direção à melhoria do processo de escolarização. Acredito que os resultados apresentados poderão contribuir com isto ao apontarem caminhos mais críticos e menos naturalizantes no trabalho com as queixas escolares. / Abstract: Due to school complaints, children are constantly and unnecessarily sent to specialized treatment centers. They have been wrongly diagnosed with specific disorders, which help their stigmatization. Waiting in line to be attended is part of their routine and reality, and the increasing numbers of such cases demand immediate intervention. Moved by such conditions the coordinator of an Educational Center, who keeps as her main purpose to attend these complaints, asked for the help of an Educational Psychology consultant group, of which I took part, together with another professional psychologist. We carried this consultancy work for one year and three months and it was because of it that I decided that both the Educational Center and the advisory work would be part of my doctoral study. In order to carry out my research, the following objectives have been established: 1) To evaluate the way the Educational Center worked and to analyze whether it effectively attends school demands; 2) To get to know and to evaluate the conceptions about the Educational Center held by the professionals working there, as well by the directors, coordinators and teachers; 3) To understand the changes which took place as far as the way the Educational Center functioned, as a result of the school advisory group interventions. Thirty one subjects participated in this study, among which we can mention Educational Center workers, as well as, some Public Primary School directors, coordinators and teachers of a small city located in the countryside of São Paulo State. All participants answered semi-structures interviews, which were recorded and transcribed afterwards. Besides this research instrument, field diaries were also used. Data was analyzed on qualitative basis, according to the theory supported by González Rey ( 2002; 2003; 2005). Results have shownthat the way the Educational Center was structured and the interventions it made contributed to maintain the stigmatizing process students suffered and to school exclusion, even though its main objectives were originally opposite to these factors. It was also possible to verify that the expectancy is still very high in order for the Educational Center to treat school complaints from a medical and clinical perspective. In face of these excluding processes and due to the fact that many professionals that made part of the Educational Center did not agree with them being its main goals, a movement towards a dialog among participants has been taking place, so that the roles and objectives of the Educational Center can be more appropriately established. Such a movement has been seen as positive, once it did not take place before the consulting work existed. Changes have happened and could be better understood through the changes in the conceptions, the practices and the working structure of the Educational Center. This place has started to also direct its interventions to the school context, which has allowed a bigger dialog and integration among schools. Most of he professionals involved considered the consulting work as something positive, recognized its contribution and showed interest in its future continuation. This process will be of extreme value, because it can help the Educational Center to follow its path, in an ever better and stronger way, towards the improvement of the educational process. I believe that the results shown can contribute to such improvement, as it shows more critical and less naturalizing ways as far as the work with school complaints is concerned. / Doutorado / Psicologia Educacional / Doutor em Educação

abstract: Vehicular automation and autonomy are emerging fields that are growing at an exponential rate, expected to alter the very foundations of our transportation system within the next 10-25 years. A crucial interaction has been born out this new technology: Human and automated drivers operating within the same environment. Despite the well- known dangers of automobiles and driving, autonomous vehicles and their consequences on driving environments are not well understood by the population who will soon be interacting with them every day. Will an improvement in the understanding of autonomous vehicles have an effect on how humans behave when driving around them? And furthermore, will this improvement in the understanding of autonomous vehicles lead to higher levels of trust in them? This study addressed these questions by conducting a survey to measure participant’s driving behavior and trust when in the presence of autonomous vehicles. Participants were given several pre-tests to measure existing knowledge and trust of autonomous vehicles, as well as to see their driving behavior when in close proximity to autonomous vehicles. Then participants were presented with an educational intervention, detailing how autonomous vehicles work, including their decision processes. After examining the intervention, participants were asked to repeat post-tests identical to the ones administered before the intervention. Though a significant difference in self-reported driving behavior was measure between the pre-test and post- test, there was no significant relation found between improvement in scores on the education intervention knowledge check and driving behavior. There was also no significant relation found between improvement in scores on the education intervention knowledge check and the change in trust scores. These findings can be used to inform autonomous vehicle and infrastructure design as well as future studies of the effects of autonomous vehicles on human drivers in experimental settings. / Dissertation/Thesis / Masters Thesis Human Systems Engineering 2019

Palliative care (PC) is the comprehensive management of patients diagnosed with terminal illness. Care for PC patients focuses on relieving symptoms. The purpose of this study was to determine the difference between pretest and posttest scores on the Frommelt Attitude towards the Care of the Dying (FATCOD) and the Palliative Care Quiz for Nurses (PCQN) after an educational intervention to emergency department (ED) nurses. The framework for this project was Bandura's social cognitive theory. The FATCOD was used to assess ED nurses' attitudes toward PC, and the PCQN was used to assess ED nurses' knowledge about PC prior to the educational program. The educational intervention was developed using evidence obtained from the literature review and guided by the PCQN. The program presented to the ED nurses covered the essentials of palliative care and the information and skills needed by the ED nurse caring for the PC patient. The FATCOD and the PCQN were then administered as a posttest. A total of 70 nurses from two ED units volunteered to take part in the project. Results of the PCQN pre- and posttest showed a significant difference (p < .05), and the FATCOD pre- and posttest showed no significant difference (p = .849). The results revealed that education significantly improved knowledge of PC for the ED nurses participating in the project. Attitudes about PC were not significantly changed after the education program. The project promotes positive social change by raising awareness of the need for PC educational opportunities for ED nurses. By improving PC in the ED, patients and their families may experience increased satisfaction with end-of-life care and improved quality of life.

Children with Autism Spectrum Disorders (ASDs) often have difficulty learning to communicate ideas and emotions. Consequently, many new educational theories aimed at improving appropriate socialization and verbal communication skills are emerging for early intervention practices. Because children with ASDs will more willingly make attempts at communication when they are involved in meaningful interactions with caregivers, educational theories include the use of sensory-perceptive, social, and emotion-based language. The Developmental Individual Difference Relationship-Based (DIR) model aids the child in discovering his or her own intentionality and self-purpose, thus creating an intrinsic desire to communicate. The purpose of this study was to increase relevant utterances in an early elementary aged child with autism, using main components of the DIR model. The effects of the model were gauged on frequency and quality of expressive speech used during fifteen-minute sessions. One three-year- old child was selected t6 participate in this study, through the University of Central Florida Center for Autism and Related Disorders, Orlando, FL. Results indicated that the total number of utterances used did not increase with the implementation of the DIR model from Baseline Phase to Intervention Phase. However, the number of relevant utterances used did show a significant increase during Intervention phase, as total number of echolalic utterances decreased.