Background: Staphylococcus aureus is an aerobic, Gram positive commensal organism that is capable of causing a wide spectrum of disease. This study contributes to previously published literature regarding daptomycin versus vancomycin use in S. aureus bacteremia (SAB). Methods: Adult patients admitted between 2010 and 2014, billed for ICD-9 code V09.0, 038.11, 038.12, 041.11, or 041.12, and received vancomycin and daptomycin were included in this retrospective analysis. Patients were stratified by time to change in antibiotics from vancomycin to daptomycin to the early switch (1-3 days), intermediate switch (4-7 days), or late switch (8 days or later) group. The primary outcome was treatment failure defined as 30-day recurrence, 60-day all-cause mortality, and 90-day all-cause readmission. Results: 193 patients were enrolled in the final cohort. The overall treatment failure rate was 18% with no differences between early switch, intermediate switch, and late switch (P=0.72) groups. Independent predictors of treatment success were length of stay (OR=1.035) and time to positive culture (OR=0.961). Conclusions: Results of this study did not demonstrate a difference in treatment failure based on time to switch from vancomycin to daptomycin. Future research should focus on optimizing use of vancomycin and daptomycin and medical management of SAB.

College environments can pose both academic and social challenges for students with disabilities. For teachers and parents of children with Aspergerâ??s syndrome (AS) and high functioning autism (HFA), these challenges include communication, behavioral, and social difficulties that can hinder their attainment of educational objectives. Limited research has been conducted regarding postsecondary outcomes of elementary and secondary public school interventions provided to these students. This case study gathered information from postsecondary students with AS and HFA regarding their experiences of public school social skills interventions and their perceived impact on current social and academic outcomes. Findings were interpreted using critical theory (CT) and critical disability theory (CDT) approaches, which suggested an advocacy perspective and provided the participants a â??voiceâ?? to express their lived experiences, offering an opportunity for others to learn from these experiences. Participants included a sample of 12 young adults with HFA and AS currently enrolled in postsecondary educational settings who were recruited through college/university disability services offices, school districts, and support groups. Interview data were examined in order to glean descriptions of the participantsâ?? social experiences and determine emergent social and academic themes among cases. Study findings indicated a need for improved guidance and education in the area of social skills for students with autism spectrum disorders (ASD) and proposed avenues for positive social change by providing educators, parents, and advocates information to support the development of improved social supports and more effective outcomes for students with ASD.

Despite increased access to prenatal care, birth outcomes continue to be a major source of disparity among women in the United States. The focus on lifestyle choices and negative behaviors prior to a pregnancy to reduce adverse birth outcomes has become a well-documented strategy. The purpose of this study was to determine if preparing for a pregnancy in advance improves birth outcomes for African American women of childbearing age between the ages of 12 and 45 years in the State of Rhode Island (RI). The theoretical foundation for this study was based on Prochaska's model of change, which is also known as the readiness to change model. This study was conducted using secondary data from the Rhode Island Department of Health PRAMS data set. The research questions determined if African American women received preconception care education at the same rate as White women, if African American women had a higher rate of infant mortality than other races, and if African American women had a higher rate of unintended pregnancies than White women in the state of Rhode Island. Independent t tests and chi square tests were used to answer the research questions. The results indicated a difference between the infant mortality rates for African American women compared to other races as well as a difference between African American women compared to White women with regard to unintentional pregnancies in Rhode Island. However, there was no difference in African American women compared to White women receiving preconception education in the state of Rhode Island. The implications for positive social change include micro- and macro-level changes in support of how planning for a pregnancy in advance can reduce poor birth outcomes.

Patients with heart failure (HF) must monitor and recognize escalating symptoms to manage worsening HF in a timely manner. However, routine symptom monitoring is not commonly performed by this population. Providing a symptom diary along with an education and counseling session may help HF patients promote symptom monitoring and interpretation. The accumulated information about changes in daily symptoms will allow patients to easily compare current symptom status to the past without depending on memory and can rapidly capture worsening HF. To date, few studies have tested the effect of a daily symptom diary. The purpose of this dissertation was to develop and test a symptom diary intervention to improve outcomes in HF patients. Prior to testing the intervention, preliminary work included: (1) determining the impact of symptom clusters on cardiac event-free survival; (2) evaluating the quality of existing symptom measures designed for HF patients; (3) evaluating the effect of physical symptom items that were often included in a depressive symptom instrument on cardiac event-free survival; and (4) evaluating the association between symptom monitoring and self-care management. Based on this information, a randomized, controlled pilot study was conducted to test the effect of a symptom diary with an education and counseling intervention on prognosis, healthrelated quality of life (HRQOL), and self-care maintenance at 3 months follow-up. A total of 44 hospitalized patients with HF were randomly assigned to either usual care or intervention providing a daily symptom diary with education and counseling. There were trends toward fewer HF events and improved self-care maintenance in the intervention group compared to the usual care group. However, there was no difference in HRQOL between the two groups. The results of this dissertation suggest the importance of assessing symptom clusters and further studies to improve the quality of existing HF symptom measures. Results from this dissertation also provided the evidence of the advantages of regular symptom monitoring to facilitate early identification of worsening HF and initiation of timely responses. However, further studies are needed to provide additional evidence of the positive impact of a use of daily symptom diary in patients with HF.

In New Zealand, approximately 10% of births are considered premature, that is less than 37 weeks gestation. With advances in medical technology, young infants are surviving gestation periods as few as 23 weeks. It is expected that many of these severely premature infants will demonstrate some problem in their academic, or cognitive function including language functioning. It is agreed that children who are born severely premature often present with language problems, the nature of the difficulties are not clear. Research examining language abilities that involve cognitive functions such as inference generation have demonstrated that children born prematurely exhibit difficulties with phonologic short-term memory and executive function. Language tasks such as inference understanding require children to integrate real-world knowledge with the linguistic information to generate and produce language that is more complex. The aim of this study was to discover if the language of children born severely premature differs from that of language-age matched peers. This study examined high-level language abilities of school-age children born severely prematurely, specifically, language tasks that involved executive functions including working memory, story inferencing, and recognising absurdities. Six children who were born less than 28 weeks gestation participated in this study. Their results on the above measures were compared to a language-aged matched comparison group, determined by performance on a standardised test. It was hypothesised that the children born severely premature would not differ from their language-age matched peers on measures of general language ability but differences would exist on measures of language processing and inferencing. The findings overall showed little difference between the preterm group and their language-age matched peers on measures except for the measure of chronological age. Although no group difference was found for the measure of working memory, a larger variance on this measure was observed in the preterm group.

This dissertation presents findings from a study investigating of the effects of a middle-school intervention, using the "Skill-Builders" curriculum, on participating students' attitudes, self-efficacy, achievement, self-regulated learning, and classroom learning behaviors in mathematics. The main research questions were 1) will a nine week school-counselor-led intervention using the "Skill-Builders" curriculum have a significant effect on the outcome variables of interest, and 2) will the effects be different for females than for males. A repeated measures ANOVA was used to test for differences between conditions and between sexes on all outcome measures. Results from the study demonstrated statistically significant post-intervention differences between students in the experimental and control conditions on their attitudes toward math learning, self-efficacy, achievement, and self-regulated learning behaviors, and the gains made by students in the experimental condition were maintained at follow-up. Students in the control condition showed no changes or declined on measures of attitudes, achievement, self-efficacy, and self-regulated learning behaviors at post-test and follow-up. Results also indicated a significant interaction for sex and condition, which suggests that the intervention had different effects for the participating females than the males. Implications of the findings, within the theoretical framework of the study and within the context of school counseling outcome research, are discussed.

The purpose of my study was to explore what and how university students learned from their experiences working as peer educators. In my study, I was only interested in investigating peer educators working in formal peer education programs within the post-secondary setting. I defined learning as “a comprehensive, holistic, transformative activity that integrates academic learning and student development” (italics in original, ACPA & NASPA, 2004, p. 2). I used a modified version of the CAS 2009 learning outcomes framework to understand what peer educators learned. Those six CAS learning outcomes are: knowledge acquisition, construction, integration, and application; cognitive complexity; intrapersonal development; interpersonal competence; humanitarianism and civic engagement; and practical competence. I adopted a qualitative, descriptive, exploratory approach to the study of the content and context of peer educators’ learning. I selected participants for my study from a pool of peer educators of a student affairs’ learning assistance peer education program at a mid-sized Ontario university. I conducted face-to-face, in-depth interviews with seven peer educators. My research revealed what peer educators in a single peer education program learned; it also provided insight into their experience of learning within the peer education program, i.e., how they learned. This study offers some insight into the potential for learning, as well as potential facilitators of learning, in the university peer educator role. The findings of my research indicate that the peer educators whom I studied learned in each of the six CAS learning outcomes. The facilitators of learning that these peer educators described in their interviews include learning from experience, interactions with others, reflection, and training. The findings of my study suggest that further research could be conducted, at various institutions as well as within and across peer education programs. / Thesis (Master, Education) -- Queen's University, 2012-10-15 11:35:06.19

Propensity score matching is commonly used to estimate causal effects of treatments. However, when using data with a hierarchical structure, we need to take the multilevel nature of the data into account. In this thesis the estimation of propensity scores with multilevel models is presented to extend propensity score matching for use with multilevel data. A Monte Carlo simulation study is performed to evaluate several different estimators. It is shown that propensity score estimators ignoring the multilevel structure of the data are biased, while fixed effects models produce unbiased results. An empirical study of the causal effect of truancy on mathematical ability for Swedish 9th graders is also performed, where it is shown that truancy has a negative effect on mathematical ability.

Employment relations literature is concerned with what is exchanged between the employer and the employee via an employment contract, a social contract or a psychological contract, with perceived mutual obligations (Rousseau, 1995; Capelli, 1999; Kalleberg, 2001). The psychological contract finds its foundation in the perceptions of the employee, that is, what the employee believe the employer has offered the employee in terms of their work relationship and the social contract refers to the expectations and obligations employers and employees have for their work and the employment relationship (Grahl, & Teague, 2009). The new employment contract differs from the old employment contract in that it is largely informal and even unwritten (Gilbert, 1996). This is in line with the new trend of business management as used by people-driven world-class organisations with a globalised focus (Gilbert, 1996). A research need exists to examine the potentially different or redundant effects of promises and expectations on the development of the obligations that are perceived to constitute the employment, the social and the psychological contracts (Martocchio, 2004; Shore, Tetrick, Taylor, Coyle-Shapiro, Liden, McLean-Parks, et al. 2004). The primary objective of this research is to investigate the relationship between the social- and the psychological contracts of private security employees (N=217) in the Vaal Triangle in terms of employability, job insecurity, job satisfaction, life satisfaction and intention to quit. This study is submitted in article form. The research method for each of the two articles consists of a brief literature review and an empirical study. Factor analyses, as well as Cronbach alpha coefficients were computed to assess the reliability of the research. Validity, Pearson product moment correlation coefficients as well as regression analysis were utilised to examine the relationship between the constructs employed in this research. The Employment Contract Scale (ECS) was also utilised as a research instrument, as the questionnaire-method proves to be largely reliable. Reliability analysis confirmed sufficient internal consistency of the subscales. The observed correlations were found to be comparable with the values reported in previous research by Edward and Karau (2007). By using multiple regression analysis, it was established that by investigating the relationship between the social- and the psychological contracts of private security employees (N=217) in the Vaal Triangle in terms of employability, job insecurity, job satisfaction, life satisfaction and intention to quit (the primary objective of this research) that job satisfaction and intention to quit predicted the social contract and that job satisfaction and life satisfaction predicted the psychological contract. No relationship however exists between employability, intention to quit and the psychological contract. Recommendations are advanced for future research. / MA (Labour Relations Management) ,North-West University, Vaal Triangle Campus, 2013

The purpose of this study was to explore the efficacy of juvenile offender assessments. Data from 104 juvenile offender assessments were analyzed and followed up with placement, subsequent offending, and outcome data from the juvenile and adult systems. Constructs consistently assessed included intellectual functioning, academic achievement, and personality functioning; however, under-diagnosis of intellectual deficits, learning disabilities, and personality disorders was found. Results indicated the assessment of family functioning, substance use, and social functioning should be included in comprehensive assessments, as they may result in alternative placement and treatment options of benefit to the juvenile offender. A juvenile offender typology proposed by DiCataldo and Grisso (1995) was successfully utilized and proved predictive of recidivism, future harm to others, and outcome.