The ongoing shortage of registered nurses is a nationwide phenomenon. Many factors contribute to the dissatisfaction and stress of new graduate nurses during the initial transition phase of their career. The lack of peer and leadership support is among the many factors that lead to constant turnover. New nurses entering the workforce are caring for patients with more complex health problems. The Commission on Collegiate Nursing Education (CCNE) has developed standards for accreditation of entry-to-practice nurse residency programs (NRP). The purpose of this DNP project was to propose a formal evidenced-based nurse residency program to the stakeholders of an acute care hospital based on the CCNE standards. The Iowa model of evidenced-based practice was used to outline this formal residency program, and Benner's novice to expert theory guided its development. Eight organizational stakeholders participated in the presentation of the proposal for the evidenced-based nurse residency program. A questionnaire based on the standards for accreditation of entry-to-practice nurse residency programs was used for evaluation. The majority of respondents indicated that the standards presented in the presentation were consistent with the requirements of accredited NRPs. For the three primary categories, program faculty, institutional commitment and resources, and management of patient care delivery, 89% of participants indicated an excellent rating on a four-point scale on the questionnaire. The proposed education, once implemented, could result in social change by ultimately improving work satisfaction, improved retention, improved quality of care, and ultimately improved patient health outcomes.

Self-determination is the ability to control one’s life and to actively participate in the decisions which affect the direction of one’s life. This ability is considered a critical life skill for individuals with developmental disabilities. The ability to make choices, plan, and self-evaluate are among the primary skills included in the development of self-determination. Currently, there is very limited emphasis on the importance of self-determination in the literature of communication disorders. This study was designed to determine if a teaching paradigm which incorporates key elements of self-determination is as or more effective and efficient in teaching syntax than a traditional, clinician-directed teaching paradigm for students with developmental disabilities. Two methods of syntax instruction were compared for 4 students with Down syndrome between the ages of 7 and 13 years using an Adapted Alternating Treatment (AAT) single subject design. In the Clinician Directed (CD) condition, the clinician selected the reinforcing activities, scheduled the order of those activities, and provided the students with feed-back on the accuracy of their productions. In the Self-Determined (SD) condition, the students chose the reinforcing activities from 4 possible choices, scheduled the order of activities, and self-evaluated the accuracy of their productions. Results of the study indicated that both the traditional clinician-directed approach (CD)and the self-determined approach (SD) were effective in teaching syntax targets with all 4 students achieving criterion at an unexpectedly rapid rate and maintaining skills regardless of the teaching condition. The CD condition was slightly more efficient than the SD condition in achieving criterion for 3 of the 4 students in the study; however, for 2 of these 3 students, there was a difference of only 1 session between the 2 conditions. In the SD condition the students were required to self-evaluate responses, a key element in the development of self-determination skills. Interestingly, students appeared to learn to self-correct errors slightly sooner in the SD than the CD condition. Further investigation is needed, but a case might be made that including elements of self-determination in syntax training could justify the slight loss of efficiency, and does so without disrupting teaching effectiveness.

Evidence-based practices in the field of special education within the United States has been well defined in the literature yet challenges persist with the widespread implementation of these practices within school settings. There are many factors that can negatively influence the portability of these practices in classroom settings that remain unaddressed in the literature. The results of a qualitative evaluation aimed at determining teacher’s perspectives on barriers to implementing evidence-based procedures in the area of positive behavioral interventions and supports (PBIS) are described. Data analysis revealed several highly pertinent barriers that teachers face in their attempts to implement evidence-based practices in the classroom. Recommendations for minimizing these implementation barriers are discussed.

The use of data to drive or inform the decision making process is gaining traction in education. In response to the data driven decision making shift, an emerging group of scholars are beginning to discuss how the data movement in education may be viewed using a critical race theory (CRT) framework. With a focus on implications for racial equity, this study explores the ways and to what degree data are valued or practically applied in the decision making process in Manitoba. Participants for this qualitative research study include ten Manitoban school superintendents. Drawing attention to the ways in which data-driven practices like all other practice in education, are not neutral acts, this study looks to contribute to the growing research area on Canadian data-driven decision making and CRT. Findings from this study indicate that school divisions in the province of Manitoba are increasingly driven by data that privileges Western or colonial ways of knowing. Some recommendations for further research include, using achievement data to resist racial oppression, exploring the dangers of Gap Talk, and looking at whether data literacy includes notions of power and privilege. / February 2017

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-12-16T16:28:34Z No. of bitstreams: 1 alessandrapaschoalinomachadodossantos.pdf: 1503475 bytes, checksum: 6bac52c832a479fb1d8eecab7a295a3a (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-12-19T12:40:34Z (GMT) No. of bitstreams: 1 alessandrapaschoalinomachadodossantos.pdf: 1503475 bytes, checksum: 6bac52c832a479fb1d8eecab7a295a3a (MD5) / Made available in DSpace on 2016-12-19T12:40:34Z (GMT). No. of bitstreams: 1 alessandrapaschoalinomachadodossantos.pdf: 1503475 bytes, checksum: 6bac52c832a479fb1d8eecab7a295a3a (MD5) Previous issue date: 2010-08-23 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Neste estudo foi avaliado in vitro o selamento marginal em restaurações classe II com resina composta utilizando-se três sistemas adesivos por meio de comparação da penetração de dois evidenciadores. Sessenta molares humanos hígidos foram utilizados, nos quais foram realizadas cavidades tipo slot vertical com término gengival abaixo da junção esmalte-cemento. Os dentes foram divididos aleatoriamente em três grupos, de acordo com o sistema adesivo a ser empregado (n=20): Grupo A – Sistema adesivo Scotchbond Multi Purpose, Grupo B – Sistema adesivo Adper Easy One e Grupo C – Sistema adesivo Clearfil SE Bond. As cavidades foram restauradas com resina composta nanoparticulada Filtek Z350, sendo a mesma inserida através da técnica incremental. Os corpos de prova foram submetidos à termociclagem de 1500 ciclos a temperaturas de 5ºC + 2ºC e 55ºC+ 2ºC, em banhos alternados de 30 segundos cada. Posteriormente, cada grupo foi subdividido em dois subgrupos, de acordo com o evidenciador a ser utilizado. Os corpos de prova do subgrupo 1 ficaram imersos por 24 horas em solução de nitrato de prata amoniacal, em seguida, imersos em revelador radiográfico por 8 horas sob luz fluorescente. No subgrupo 2, os corpos de prova ficaram imersos em solução de azul de metileno a 2% por 24 horas. Foram seccionados no sentido mesio-distal e a microinfiltração marginal foi avaliada com lupa estereoscópica por dois observadores. Os resultados foram submetidos a análise estatística pelo teste nãoparamétrico de Kruskal Wallis, e análise de Variância de Mann-Whitney (p=0,05). Pode-se concluir que: a) Nenhum sistema adesivo testado foi significativamente eficaz no selamento marginal em restaurações classe II com resina composta; b)Houve maior penetração do evidenciador azul de metileno a 2%, indicando que o 15 tipo de material utilizado pode influenciar nos resultado da pesquisa; c) Outros estudos deverão ser realizados com o intuito se verificar qual a melhor concentração e o melhor tempo de imersão para os evidenciadores utilizados nos testes de microinfiltração marginal. / Here we evaluated in vitro the marginal sealing of class II restoration with composite resin using three different adhesive systems by comparing the penetration of two solutions evidenced. Sixty human molars were used, in which were made cavities as vertical slots with gingival ending below the enamel-cementum junction. The teeth were randomly divided into three groups according to the adhesive system to be used (n=20): Group A: Adhesive System Sctchbond Multi Purpose, Group B: Adhesive System Adper Easy One and Group C: Adhesive System Clearfil SE Bond. The cavities were restored with composite resin Filtek Z350, witch was introduced in the cavity by an incremental technique. The bodies of evidence were submitted to term cycles of 1500 cycles of 5ºC + 2ºC e 55ºC+ 2ºC of temperature in alternated baths of 30 seconds each. After, each group was divided into two subgroups according to the solutions evidenced to be used. The body of evidence from the subgroup 1 was kept immersed in the contrast for 24 hours in a solution of ammoniacal silver nitrate, then immersed in a radiographic disclosing developer for 8 hours and exposed to fluorescent light. The subgroup 2, remained immersed in a solution of methylene blue of 2% for 24 hours. They were cut on the mesial-distal direction and the marginal microleakage was evaluated by two observers using a stereomicroscope. The results were submitted to a statistic analysis using the Kruskal Wallis Test and with the Mann-Whitney (p=0,05). The conclusion is that no adhesive system tested was meaningfully effective on the marginal sealing in restorations class II with composite resin. A bigger penetration of the solution of methylene blue at 2% indicating that the kind of contrast used can interfere with the research results. Other studies must be done in order to verify which is the best 17 concentration and the best time of immersion for the contrast used on the marginal microleakage.

The prevalence of autism spectrum disorder (ASD) has increased two percent from 2012–2014 (Centers for Disease Control and Prevention, 2018) and the Centers of Disease Control and Prevention (CDC) has considered ASD to be a major health concern. The demands of caring for a child with developmental disabilities, including ASD can be overwhelming and the caregivers are experiencing heightened levels of stress in comparison to rearing typically developing children (Argumedes, Lanovaz, & Larivée, 2017; Lindo, Kliemann, Combes, & Frank, 2017). There is a need for more family support to implement more effective coping strategies to deal with the maladaptive functioning of the child with ASD (Hall, & Graff, 2011). The WE C.A.R.E. 2 Program is a nine-week evidence-based community pilot program that will provide an inclusive opportunity with additional family support and effective coping strategies e.g., breathing techniques, yoga postures and positive coping cognitions (e.g., positive self-talk and reappraisals) to decrease the stress levels of caregivers and promote healthy behaviors and healthy child development with the support and training from trained facilitators and a network of caregivers. This individualized plan will tailor to the needs of each dyad to create the necessary mechanisms of change (behavior, cognition, physiological, and sensory modulation) among the children and adults in the yoga group. The professional collaboration of different disciplines (occupational therapy, yoga therapist and teacher) will provide the appropriate modifications to the environment and provide the necessary input for the “just right” experience for a positive outcome.

No description available.

Management of hypertension and its complications requires health care providers to understand the reason for developing the disease. Complications of hypertension (HTN) are more prevalent when patient interventions are not consistently performed by staff. A gap in staff knowledge regarding the management of patients with HTN was noted at an outpatient clinic in the southwestern United States. A staff education project based on the Eighth Joint National Committee (JNC-8) guidelines for HTN management was developed to address the gap in knowledge. This DNP project sought to understand the impact of an evidence-based staff education program in improving the knowledge of nursing staff on HTN management. The health belief model and social cognitive theory guided the project. Three expert panelists evaluated the education program content and agreed that the content was relevant to clinical practice and would improve staff knowledge regarding management of HTN. Eight nurses participated in the education program, first completing a pretest questionnaire followed by educational program content in digital format. Participants reviewed the program for 1 week followed by a PowerPoint presentation at a staff meeting. Posttest questionnaires were completed by 7 participants using a 5-point Likert scale ranging from completely unaware to completely aware. Posttest results indicated that nursing staff knowledge increased to completely aware (100%) of the JNC-8 guidelines for HTN management compared with completely unaware before the program. The project emphasizes the potential for positive social change when translating evidence to practice through staff education to improve patient management and outcomes for the treatment of HTN.

PhD Thesis Abstract: John Michael Quinn V In the 21st century, the prevention of illness, disease and risks to health ushered in public health and medical practice with mixed results. War, hybrid warfare, conflict, complex emergencies and disasters remain significant public health risks and areas of strategic concern; focused epidemiological study in health policy remains elusive. The paradigm shift from major world powers leading global affairs and affecting global health to multiple state and non-state actors vying for power and influence regionally has possibly led to an increase in small scale and low intensity conflict with high morbidity and mortality, including both noncommunicable (NCD) and communicable diseases. The basic research carried out for this PhD project includes: 1) mental health surveys and trauma associated with war; 2) the migration of, and the need for, advanced medical personnel and their services in war and hybrid warfare, including how the negative movement or adverse flow through 'brain drain' of doctors affects disaster; 3) a quantitative study of infectious diseases, health and human security associated with state stability and the mitigation of state failure; 4) a qualitative food security review, the origins of food security and its impact; and 5) the general concepts of...

Le chikungunya, la dengue et la bilharziose urogénitale sont des maladies vectorielles émergentes qui ont récemment trouvé des conditions favorables à leur transmission en France métropolitaine.Santé publique France, l’Agence en charge de la surveillance de l’état de santé de la population française est en première ligne pour détecter et investiguer ces émergences afin d’orienter les mesures de leur prévention et de leur contrôle. Postulant que chaque épidémie constitue une situation d’« expérimentation naturelle », l’objectif de cette thèse était de montrer comment chaque investigation d’épidémie apporte l’opportunité d’acquérir des connaissances scientifiques sur la contribution des cas asymptomatiques à l’introduction, la dissémination et l’endémisation des maladies vectorielles de façon réactive.Notre méta-analyse d’études de séroprévalence per- et post-épidémiques suggère que, contrairement à nos attentes, la lignée de virus chikungunya qui a émergé en 2004 dans l’Océan Indien qui était associée moins d’infections asymptomatiques que les autres. Dans une étude de la séroprévalence de la dengue à Nîmes en 2015, nous avons montré que le potentiel de diffusion de la dengue en France restait actuellement limité. Les données du dépistage des personnes exposées au risque de bilharziose urogénitale en Corse montrant une fréquence élevée d'infections pré-symptomatiques, nous avons évoqué un risque d’endémisation de la maladie qui a justifié son inscription sur la liste des maladies à déclaration obligatoire.Ce travail de thèse démontre qu’une approche pragmatique basée sur une veille sanitaire sensible associée à des investigations épidémiologiques de terrain précoces peut contribuer à aussi bien à la lutte contre les émergences qu’à l’évolution des connaissances. / Conditions recently proved favourable to transmission of emerging vector-borne diseases, chikungunya, dengue and urogenital schistosomiasis in mainland France.Santé publique France, the Agency in charge of public health surveillance in France is at the forefront of detecting and investigating emerging infectious disease in order to guide prevention and control measures. Assuming that each outbreak constitutes a situation of "natural experimentation", the aim of this thesis was to show how outbreak investigations give the opportunity to acquire rapidly scientific knowledge on the contribution of asymptomatic cases to the introduction, dissemination and endemisation of vector-borne diseases.Through a meta-analysis of per and post-epidemic seroprevalence studies,we have shown that the chikungunya virus lineage that emerged in the Indian Ocean in 2004 is associated with a lower frequency of asymptomatic infections. In a dengue serosurvey in Nîmes in 2015, we showed that the diffusion potential of dengue in France is currently limited. Screening data of urogenital bilharziasis in persons exposed in Corsica showed a high frequency of pre-symptomatic infections suggestive of a risk of endemisation of the disease that justified its inclusion on the list of notifiable diseases.This thesis work shows that a pragmatic approach based on sensitive surveillance associated with early field outbreak investigations can significantly contribute to both emerging infections control and the advancement of knowledge.