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

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.

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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.

The purpose of this phenomenological qualitative study was to explore the lived experiences of school counselors who address the mental health needs of students through at least one of the following educational evidenced-based programs: Positive Behavior Intervention and Supports, Response to Intervention, Restorative Practices, and Student Assistance Program. EBPs have evolved as a staple of quality educational programming with a focus on best practices, data, and accountability. Over the past several decades, school counselors have struggled to demonstrate efficiency, accountability, and transparency consistently in counseling outcomes (Generali, Foss-Kelly, & McNamara, 2013). Recent literature in school counseling embraces the movement toward evidenced based practices to urge counselors to demonstrate their capacity for leadership, advocacy, and accountability (Cressey, Whitcomb, McGilvray-Rivet, Morrison, & Shander-Reynolds, 2014; Goodman-Scott, Betters-Bubon, & Donohue, 2015). Six significant themes emerged through data analysis: 1) Cultivating advocacy and leadership skills; 2) Recognizing benefits of EBP integration; 3) Being frontline in mental health as personal-social domain dominates school counselor role; 4) Collaborating and consulting with school and community stakeholders; 5) Needing supportive environment to promote mental wellness; and 6) Navigating EBP implementation challenges. Findings from this study suggest that promoting mental wellness using EBPs is conducive to address the personal social needs of students. Moreover, the school counselor participants indicated that the EBPs reviewed were valuable school reform models as the EBPs address students’ mental health needs. The findings also suggest that school counselors, as key educational stakeholders, should be included in the discourse of EBP advancement, execution, and assessment.