MEDEM / Department of Curriculum Studies and Education Management

My thesis consists of a novel in stories, each taking place in or around the Brooklyn Art Institute. My characters fall along a spectrum of artistic failure, whether because they have lost touch with both their former successes and their former selves, or because they are unable to reach the upper echelons of the artistic community. The stories themselves are a testament both to failure and to the dreams and desires that lead to it, and ultimately ask the reader whether it is better to lead a life of comfortable contentment or to fail gloriously.

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É sabido que o paciente com doença renal crônica que tem um acompanhamento nefrológico precoce apresenta melhores condições clínicas e melhor prognóstico ao entrar em diálise. Porém o acompanhamento precoce pelo nefrologista melhora também o enfrentamento psíquico da doença e do tratamento? Foram estudados 39 pacientes com insuficiência renal estágio 5 no momento em que entravam em hemodiálise: 19 pacientes com acompanhamento por nefrologista 6 meses (Grupo 1) e 20 pacientes sem qualquer acompanhamento nefrológico prévio (Grupo 2). Todos os pacientes participaram de entrevista semiestruturada, composta por 17 questões abordando informações, crenças, expectativas e fantasias relacionadas à doença e ao tratamento. As respostas foram decompostas em categorias através da técnica da Análise de Conteúdo. Os dados demográficos e laboratoriais também foram coletados. A classe socioeconômica foi avaliada e classificada como baixa, média ou alta. Na análise estatística foram utilizados o teste de Fisher, do Quiquadrado, t de Student ou de Wilcoxon como apropriado e os resultados apresentados como média ± DP. O grupo 1 foi seguido por 26 ± 20 meses. Em ambos os grupos a maioria dos pacientes pertencia à classe baixa e era do sexo masculino. Os pacientes do grupo 2 eram mais jovens e apresentavam piores parâmetros laboratoriais (p <0,05). Também os aspectos psicológicos foram semelhantes nos 2 grupos: 63% dos pacientes do grupo 1 e 55% do grupo 2, disseram que tinham informações anteriores sobre a diálise; 42% no grupo 1 e 40% no grupo 2, disseram pouco entender o que o médico falava; 74% no grupo 1 e 85% no grupo 2 acreditam que seus rins voltariam a funcionar. Em ambos os grupos, 25% tinham expectativas ruins sobre voltar a trabalhar, e 60% sentiam atitudes negativas da família. O acompanhamento com o nefrologista minimiza as complicações clínicas e laboratoriais dos pacientes com insuficiência renal estágio 5, porém não é suficiente para minorar o impacto psicológico da entrada em hemodiálise. A atenção do nefrologista deve ir além dos aspectos clínicos. É necessário que o paciente seja adequadamente informado sobre sua doença e tratamento. Principalmente os pertencentes a uma classe social baixa como os estudados o apoio de uma equipe interdisciplinar pode ser de grande valia. / It is well known that patients with chronic renal failure (CRF) who are early on referred to a nephrologist have less clinical complications of the disease and a better outcome on chronic dialysis. But can early referral also improve the psychological burden of starting chronic dialysis? Thirty-nine ESRD patients initiating dialysis were studied: 19 patients had a Nephrology followup 6 months and 20 patients had no referral to nephrologist, starting dialysis on emergency situation. All patients participated in a semi-structured interview with 17 questions covering the perceived knowledge, beliefs, expectations and fantasies related to the disease and dialysis. The answers were decomposed in categories through the technique of content analysis. Demographic and laboratorial data at dialysis initiation were also collected. The socioeconomic position was evaluated and the patient was classified in one of 3 categories: low, middle or high. Categorical data were analyzed by Fishers or Chisquare statistical tests and continuous data by t or Wilcoxon tests as appropriate. The results are presented as mean ± SD. Group1 had been followed for 26 ± 20 months. In both groups the majority of patients were classified as low socioeconomic position and were males. Group 2 was younger and had worse laboratorial parameters (p<0.05). Also regarding the psychological aspects both groups were similar: 63% patients of group 1 and 55% of group 2 said they had no previous information about dialysis, and 42% in group 1 and 40% in group 2 said they didn\'t completely understand what the doctor said; 74% in group 1 and 85% in group 2 believed that their kidneys would work again; 25% in both groups had bad expectations about being able to work again , and 60% in both groups felt there was a negative attitude of the family toward them. Nephrology care of CRF patients mitigates clinical complications. However, on its own, it is not enough to minimize the psychological impact of the entering dialysis. Nephrology care must go beyond clinical care. The patients need to be well informed about the disease and treatment, especially patients like ours who came from low socioeconomic position. This kind of patients should be supported by an interdisciplinary team.

Yu Sau Fung. / "October 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 389-460) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

É sabido que o paciente com doença renal crônica que tem um acompanhamento nefrológico precoce apresenta melhores condições clínicas e melhor prognóstico ao entrar em diálise. Porém o acompanhamento precoce pelo nefrologista melhora também o enfrentamento psíquico da doença e do tratamento? Foram estudados 39 pacientes com insuficiência renal estágio 5 no momento em que entravam em hemodiálise: 19 pacientes com acompanhamento por nefrologista 6 meses (Grupo 1) e 20 pacientes sem qualquer acompanhamento nefrológico prévio (Grupo 2). Todos os pacientes participaram de entrevista semiestruturada, composta por 17 questões abordando informações, crenças, expectativas e fantasias relacionadas à doença e ao tratamento. As respostas foram decompostas em categorias através da técnica da Análise de Conteúdo. Os dados demográficos e laboratoriais também foram coletados. A classe socioeconômica foi avaliada e classificada como baixa, média ou alta. Na análise estatística foram utilizados o teste de Fisher, do Quiquadrado, t de Student ou de Wilcoxon como apropriado e os resultados apresentados como média ± DP. O grupo 1 foi seguido por 26 ± 20 meses. Em ambos os grupos a maioria dos pacientes pertencia à classe baixa e era do sexo masculino. Os pacientes do grupo 2 eram mais jovens e apresentavam piores parâmetros laboratoriais (p <0,05). Também os aspectos psicológicos foram semelhantes nos 2 grupos: 63% dos pacientes do grupo 1 e 55% do grupo 2, disseram que tinham informações anteriores sobre a diálise; 42% no grupo 1 e 40% no grupo 2, disseram pouco entender o que o médico falava; 74% no grupo 1 e 85% no grupo 2 acreditam que seus rins voltariam a funcionar. Em ambos os grupos, 25% tinham expectativas ruins sobre voltar a trabalhar, e 60% sentiam atitudes negativas da família. O acompanhamento com o nefrologista minimiza as complicações clínicas e laboratoriais dos pacientes com insuficiência renal estágio 5, porém não é suficiente para minorar o impacto psicológico da entrada em hemodiálise. A atenção do nefrologista deve ir além dos aspectos clínicos. É necessário que o paciente seja adequadamente informado sobre sua doença e tratamento. Principalmente os pertencentes a uma classe social baixa como os estudados o apoio de uma equipe interdisciplinar pode ser de grande valia. / It is well known that patients with chronic renal failure (CRF) who are early on referred to a nephrologist have less clinical complications of the disease and a better outcome on chronic dialysis. But can early referral also improve the psychological burden of starting chronic dialysis? Thirty-nine ESRD patients initiating dialysis were studied: 19 patients had a Nephrology followup 6 months and 20 patients had no referral to nephrologist, starting dialysis on emergency situation. All patients participated in a semi-structured interview with 17 questions covering the perceived knowledge, beliefs, expectations and fantasies related to the disease and dialysis. The answers were decomposed in categories through the technique of content analysis. Demographic and laboratorial data at dialysis initiation were also collected. The socioeconomic position was evaluated and the patient was classified in one of 3 categories: low, middle or high. Categorical data were analyzed by Fishers or Chisquare statistical tests and continuous data by t or Wilcoxon tests as appropriate. The results are presented as mean ± SD. Group1 had been followed for 26 ± 20 months. In both groups the majority of patients were classified as low socioeconomic position and were males. Group 2 was younger and had worse laboratorial parameters (p<0.05). Also regarding the psychological aspects both groups were similar: 63% patients of group 1 and 55% of group 2 said they had no previous information about dialysis, and 42% in group 1 and 40% in group 2 said they didn\'t completely understand what the doctor said; 74% in group 1 and 85% in group 2 believed that their kidneys would work again; 25% in both groups had bad expectations about being able to work again , and 60% in both groups felt there was a negative attitude of the family toward them. Nephrology care of CRF patients mitigates clinical complications. However, on its own, it is not enough to minimize the psychological impact of the entering dialysis. Nephrology care must go beyond clinical care. The patients need to be well informed about the disease and treatment, especially patients like ours who came from low socioeconomic position. This kind of patients should be supported by an interdisciplinary team.

The study was designed to determine the relationship between the psychological constructs of "fear of failure (FOF)" and "fear of success (FOS)" and motor performance in badminton. Forty-three males and fifty-one females in beginning badminton classes were administered the FOF and FOS scales, followed by three independent skills tests and a round-robin singles tournament. Conclusions were that FOF and FOS are two separate performance motives; FOF appears to be the dominant motive for females; both FOF and FOS are related to motor performance in face-to-face competition, while only FOS is related to performance in isolated skills.

Aims: The overall aims of the study were to identify the information needs of Chinese HF population and to examine the effectiveness of a heart failure disease management programme (HFDMP) on patients' clinical outcomes, health-related quality of life (HRQoL), and psychological status. / Background: Heart failure (HF) is a major and increasing public health problem globally. In China, there were approximately 4,000,000 patients with HF in the year 2000 and the number is continuously increasing due to the aging population. HF greatly influences patients' lives in all aspects. Programmes are therefore in imperative need to manage the disease and increase patients' sense of well-being. / Conclusion: Findings of the study provide further evidence that the simple combination of education and telephone follow-up could improve patients' medication adherence, HRQoL, and psychological status among Chinese HF population. Moreover, booklet developed in the study, to a certain extent, can be used as the tool for clinical HF education in China. The study also provides clues and direction for health professionals to develop interventions under the situation of busy clinical work and limited resources in Chinese health care practice. / Methods: First of all, a questionnaire survey (phase I, n=347), of which the questionnaire validation (n=247) was also included, and qualitative interviews with 26 patients and 24 health professionals (phase II) were consecutively conducted to know the information needs of patients with HF. According to the results of phase I and phase II studies, a booklet was developed to address the information needs of patients. Then a prospective controlled trial (phase III, n=160) was undertaken to examine the effectiveness of a HFDMP, including the components of two-session inpatient booklet education and weekly telephone follow-up for 4 weeks after discharge, on patients' performance of 6-minute walking test (6-MWT), clinical outcomes [death, cardiac-related admission (CRA) and length of stay (LoS) in hospital], medication adherence, HRQoL, and psychological status (depression and anxiety). Data collection was carried out at baseline, at 4 weeks (programme end) and 3 months (study end) after hospital discharge. Inferential statistics including independent t-test, paired t-test, Chi-square test, Fisher's exact test, the Mann-Whitney U test, and the Generalized Estimating Equation model, were used to compare the baseline and various outcome variables within and between groups. / Results: According to the results of phase I, the questionnaire entitled "Heart Failure Patient Learning Needs Inventory" is valid and reliable to measure learning needs among Chinese HF population. Based on the information needs identified in phase I and II, infonnation about HF regarding definition, symptoms, risk factors, classification, treatment strategies, and self-management strategies such as weight and symptoms monitoring, low-salt diet, medication compliance, exercise, and emotion management was included in the booklet. The accuracy, readability, and applicability of the booklet were established by an expert panel and potential users. / With regard to the effectiveness of the HFDMP on patients' outcomes, patients in the experimental group showed greater improvement through the study period than those in control group in the following aspects: a significantly better medication adherence (p &lt; 0.001) as measured by the Chinese version of the Morisky Medication Adherence Scale, a significantly better HRQoL (p &lt; 0.001) as assessed by the Chinese version of the Minnesota Living with Heart Failure Questionnaire, and a significantly greater reduction in depression and anxiety (p &lt; 0.001) as assessed by the Chinese version of the Hospital Anxiety and Depression Scale. However, effectiveness of the programme on patients' 6-MWT, death, CRA, and LoS were not confirmed in the present study. / Yu, Mingming. / Adviser: Sek Ying Chair. / Source: Dissertation Abstracts International, Volume: 73-06, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 267-310). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract and appendix also in Chinese.

This study, using qualitative exploratory, descriptive and contextual research design, explored and described student nurses’ perspectives of the high failure rate in biological sciences. The study was conducted at one of the campuses of the school of nursing in the Free State province of South Africa. A purposively selected sample of 1st and 2nd year student nurses registered for the programme of education and training leading to registration as a nurse (general, psychiatric and community) and Midwife (R425, 1985; paragraph (iii) as amended) at the selected campus of the School of Nursing in the Free State was used. World café was utilized for data collection. Thematic analysis of data done using Braun and Clarke (2006) and for world café participants’ created documents, Blakeman, Samuelson and McEvoy (2012) method of document analysis was applied. The findings identified the internal and external causes of high failure rate in biological. Internal causes included students-related factors, which included difficulty in understanding the content and lack of motivation. The external causes involved content overload, inadequate utilisation of available limited resources, ineffective teaching methods and unfair assessment practices. Suggestions that were made by the students to improve the success rate in biological sciences were based on the perceived causes. Recommendations made included in-service education on interactive, evidence-based teaching learning methods in anatomy and physiology, provision of support for students with no background knowledge of biological sciences. / Health Studies / M.A. (Nursing Science)

Indiana University-Purdue University Indianapolis (IUPUI) / Women who fail to confront sexism can experience negative intrapersonal consequences, such as greater negative self-directed affect (negself) and greater obsessive thoughts, particularly if they are highly committed to challenging sexism. Female undergraduates (N = 392) were sampled to investigate whether failing to confront past sexism influences future task performance and whether any effects on performance occur through the depletion of cognitive resources. Participants were randomly assigned to recall either confronting or failing to confront past sexism, then completed measures of affect, obsessive thoughts, working memory, and performance. Women who recalled failing to confront were expected to have greater negself and obsessive thoughts related to the situation and lower working memory and performance, and desire to respond to the situation was expected to moderate these effects. As predicted, compared with women who recalled confronting, women who recalled failing to confront reported greater negself. Contrary to predictions, there was no significant effect of confrontation condition on obsessive thoughts, working memory, or performance. However, condition interacted with desire to confront, such that the more women who recalled failing to confront wanted to respond to the situation, the more negself they reported and the lower their working memory. In addition, for women who recalled confronting, greater desire to respond was associated with higher performance, while desire to respond was unrelated to performance for women who recalled failing to confront. In contrast to predictions, neither obsessive thoughts nor working memory mediated the failure to confront-performance relationship, and there was no evidence of moderated mediation. In sum, although the cognitive variables of obsessive thoughts and working memory did not mediate the effect of failing to confront on performance, the results nevertheless demonstrate the importance of confronting sexism, particularly when one wants to do so, and have important implications for settings like the workplace where women may face discrimination and have to decide whether or not to confront.