The patient centered care (PCC) model is recommended by the Institute of Medicine for individuals with intellectual and developmental disabilities. The problem identified in this quality improvement (QI) project was that PCC practices had not been included in the training curriculum within the organization. Framed within the plan-do-study-act model of QI, the purpose of this project was to develop an educational initiative on PCC that included a curriculum plan, a pretest/posttest, a protocol, a revision of the training policy, and an implementation and evaluation plan. Drawing upon the evidence-based literature and using a team approach, a curriculum plan on PCC practices was developed which included a pretest/posttest to evaluate staff knowledge on the curriculum before and after the training. Three content experts from the committee approved the curriculum and validated the pretest/posttest items. The content validation index was 0.99 showing that each item reflected the content and objectives of the curriculum. As well, a training protocol was developed which identified the steps for provision of the curriculum to maintain consistency for all users. The training policy was revised to set expectations for all staff for the incorporation of the PCC practices into the organization. This initiative will be implemented into the organization using Kurt Lewin’s model of change to guide PCC practices. A recommendation was made to add a small section on “people’s first language” to the training to preserve patients’ dignity and respect during communication. This project contributes to social change by promoting PCC practices among healthcare workers thus limiting healthcare disparities and improving access for persons with intellectual developmental disabilities.

Many U.S. adolescents struggle with obesity and a lack of motivation to be healthy and physically active, which affects individual as well as public health. The purpose of this mixed-method study was to evaluate students' motivation to participate in physical education class and better understand the teaching strategies currently used by physical education teachers who participated in an interview and 2 observations. Self-determination theory framed the research questions, which focused on students' intrinsic motivation to participate in physical education class and physical education teachers' use of autonomy supportive teaching strategies. Learning Climate and Basic Need surveys were administered to 6th-8th grade students (n = 261). Analysis of descriptive statistics revealed students felt the strongest fulfillment of relatedness from their teacher (M = 5.6) and autonomy support to be the least (M = 4.6). Overall inferential statistics revealed similar results when teachers were compared. Analysis of variance resulted in no significant differences between the teachers as related to competence, relatedness, autonomy, and perceptions. Qualitative data was coded and revealed similar themes; all data revealed relatedness scores were the highest for all the teachers, and autonomy support was the lowest for all the teachers. Positive social change provides an updated 9-week curriculum plan with new units that have been designed to enhance their motivation and create awareness of lifelong physical activities; autonomy supportive teaching strategies have been incorporated in the curriculum.

Physicians must participate in developing medical protocols to ensure that medical best practices are adopted for patients' social benefit. Healthcare leaders have struggled to gain sufficient physician participation in developing medical protocols. Using technology-based crowdsourcing to assimilate knowledge from physicians may help healthcare managers improve medical protocol development. Using self-determination theory, this quantitative causal-comparative design aimed to determine whether differences in intrinsic and extrinsic motivation existed among the 132 participating physicians who did or did not participate in developing medical protocols in a crowdsourcing environment. Participants were recruited by e-mail through an independent physician association. Motivation levels were measured by the Aspirations Index via an online survey. A total of 55.3% of respondents participated in developing medical protocols. Differences were anticipated in the levels of participation in developing medical protocols between intrinsically and extrinsically motivated physicians. Rank correlations were computed between the number of protocols completed and all of the motivation scores. Personal growth and community contribution were significantly correlated with the number of addressed protocols. Positive social change may occur through improving medical protocols and healthcare outcomes by informing healthcare leaders about physicians' motivation to participate in developing medical protocols. By understanding these motivators, leaders can highlight the benefits of protocol development to encourage physician participation. If participation is enhanced, protocol quality and healthcare effectiveness may be improved, benefitting patients and healthy individuals.

Syftet med denna studie var att bidra med kunskap om läsmotivation hos högstadieelever i lässvårigheter ur ett elev- och lärarperspektiv. Med en kvalitativ ansats i form av semi-strukturerade forskningsintervjuer undersöktes vilka faktorer som elever och lärare uppfattade som främjande för läsmotivation. Dessutom undersöktes lärares upplevelser av hur de uppmärksammade elever i lässvårigheter, samt vilken ledning, stimulans och extra anpassningar som de upplevde stöttande. Forskningen som låg till grund för denna studie lyfte fram flera motivationshöjande faktorer; hemmet som förebild, tidig lästräning, stärka elevernas självförtroende i läsning, undervisa om lässtrategier, berika ordförrådet, använda intresseväckande texter, valfrihet, att arbeta med strukturerade textsamtal, samt att främja goda relationer i klassrummet. Denna studie hade en fenomenologisk inriktning som studerar människors livsvärldar och ser det unika i var och ens upplevelser. De teoretiska utgångspunkterna var self-determination theory, självbestämmandeteorin (SDT), och self-efficacy. Inom SDT är inre motivation viktig och dess samspel med den yttre motivationen. För ett välbefinnande behövs enligt SDT autonomi, kompetens och samhörighet. Self-efficacy handlar om individens tro på sin egen förmåga att utföra uppgifter och denna tilltro har betydelse för skapandet av motivation. Sex högstadieelever i lässvårigheter och åtta högstadielärare med olika ämneskombinationer deltog i studien. Analysmetoden som användes var konventionell innehållsanalys och elevernas och lärarnas upplevelser kategoriserades med hjälp av denna. Resultatet visade att de faktorer som lyftes fram i den tidigare forskningen sammanföll med det elever och lärare berättade. Det som var specifikt för eleverna var vikten av lästräning och synlig läsutveckling, arbetsro, framtidsplaner, samt att lärare frågade vad som funkade för eleverna. De åtta lärarna upplevde att det var lätt att uppmärksamma elever i svårigheter. Elever behöver ha tillgång till inläst material, uppleva samhörighet i klassrummet och att lärare bemöter dem med arbetssätt anpassade för deras olika behov. Våra slutsatser är att elever i svårigheter är unika individer och därför måste lärare samtala med var och en för att förstå vad de behöver för att utvecklas så mycket som möjligt. Lärare behöver tänka extra på elever i lässvårigheter redan när de planerar sin undervisning. För ökad läsmotivation behövs en tidig och positiv läsutveckling så elever inte hamnar i lässvårigheter.

African American males with disabilities meet challenges in K-12 public education and higher education. Educational practices often focus on a deficit interpretation of the abilities of African American males with disabilities. Educational stakeholders who do not reflect their layered identities of race, gender, ability, and socioeconomic status often make educational decisions for this student population. The purpose of this study is to include in the educational conversations the voice of an African American male with disabilities who experienced K-12 public education and higher education. Using narrative inquiry and analyzed through the lens of DisCrit, findings from the study revealed two themes that explain the participant’s lived experiences. Educational stakeholders and others who see themselves in the participant can learn valuable information from the participant's narrative.

Self-advocacy for persons with disabilities involves demonstrating knowledge of oneself and knowledge of rights afforded to individuals with disabilities through one's communication with others and leadership skills. These self-advocacy skills are significantly associated with positive outcomes after high school for students with a range of disabilities. However, knowledge of elementary students' self-advocacy skills is limited. One reason for this lack of evidence is that a psychometrically sound instrument designed to measure the cumulative skills within the self-advocacy construct did not exist. The purpose of the current study was to create a measure of self-advocacy skills that can be used with elementary students identified as having ADHD: the Self-Advocacy Measure for Youth (SAMY). Seventy-six parents/caregivers of elementary school youth identified as having ADHD and an IEP or Section 504 plan were included in the preliminary validation study. Analyses of their responses provided initial support that the items included in the SAMY fit the theoretical construct of self-advocacy as no items were indicated for removal or modification. Strong internal consistency was indicated for the Total Scale (α = .93) and subscales (Knowledge of Self, Knowledge of Rights, Communication and Leadership Skills α = .87, .87, .79, and .84 respectively), and test-retest analyses based on 20% of respondents (n = 14) provided evidence for the reliability of the interpretation of Total Scale (r =.865, p < .01) and subscale scores across one month of time. The theoretical framework, principal components analysis, and parallel analysis supported four-, six-, and two-factor measurement models, respectively, indicating the need for additional research prior to determining the most appropriate model for interpreting the SAMY scores for youth identified as having ADHD. A moderate correlation (r = .47, p < .01) between overall scores on the SAMY and on the American Institutes for Research Self-Determination Scale (AIR) provided evidence of discriminant validity. An independent t-test indicated no significant difference in the Total Scale scores for students with an IEP (M = 49.66, SD = 19.75) compared to students with a Section 504 Plan (M = 52.54, SD = 16.52); t(74)=0.68, p = .50); similar analyses performed for each subscale revealed no significant differences. A statistically significant difference existed between the Total Scale scores for students in grades K-2 (n = 23; M = 41.57; SD = 14.30) compared to students in grades 3-5 (n = 53; M = 55.08; SD = 18.41; t(74)= -3.13, p = .003) based on independent t-tests. The Pearson correlation coefficient revealed a significant, moderate correlation between school level and SAMY Total Score, r =.34, p < .01. This positive correlation between overall self-advocacy skills and elementary school level supported the theoretical progression of self-advocacy skill growth mirroring overall development. Implications for school psychologists and suggestions for future research are discussed.

No description available.

This thesis examines citizenship education in Aotearoa New Zealand. In particular, it reviews what education there is in the New Zealand curriculum about Aotearoa's democratic arrangements, including the provisions for the political voices of Maori. Recent political debate suggested the reform of these provisions through a citizensinitiated referendum. This thesis sought to identify what formal education is provided to citizens to inform their response in such a referendum. Critical discourse analysis and a content analysis method were utilised to analyse data. A review of the social studies curriculum revealed some citizenship education material in education, but a distinct neglect of issues about the Maori-Pakeha relationship as they relate to Aotearoa's bipolitical democracy. For example, there is an absence of material about the Maori Electoral Option. This thesis contributes to the calls for the strengthening of citizenship education in Aotearoa. It does so by affirming the benefits of such education to Aotearoa's democracy, through the empowerment of citizens to engage in democratic society. Such a citizenship education is posed through the concepts of presence, freedom, and critical consciousness from a Maori world-view (Te Ao Marama).

This thesis analyses the Tamil minority problem in Sri Lanka in the light of self-determination and state sovereignty. State practice with respect to self-determination is discussed, in particular cases of Aaland Island, Katanga, Biafra and Bangladesh. Historical background, location and composition, as it relates to the Tamil minority problem in the country, are described, and the specific issue of self-determination in the Sri Lankan context of secession is dealt with. The research attempts to ascertain the legal conditions which would warrant secession. / Master of Laws (Hons.)

Despite the widely documented physical, psychological, and social benefits of regular participation in physical activity (Bauman & Campbell, 2001; Blair, Kohl & Barlow, 1995; Paluska & Schwenk, 2000; U.S Department of Health & Human Services, 1996), less than half of the Australian population participate in 'sufficient' levels of physical activity in terms of time and frequency of participation (Bauman, Ford & Armstrong, 2001). Thus the examination of social psychological determinants of regular participation in leisure-time physical activity is important. A mixed methods approach was adopted to identify and test the important social psychological determinants of regular participation in leisure-time physical activity. Phase one of the study was qualitative in nature and adopted a grounded theory approach. A number of important themes emerged from the qualitative phase, including: definitions and meanings of physical activity; physical activity and choice, obligation, reasons for participation; enjoyment of physical activity; changing perceptions and influences on physical activity from childhood to adulthood; and priority of physical activity. The interrelations between these themes and their impact on regularity of participation were explored. These findings, along with theoretical propositions and evidence from previous studies, contributed to the development of a model of the social psychological determinants of regular participation in leisure-time physical activity. They also contributed to the development of items to measure important concepts in the model. Phase two was quantitative in nature and used structural equation modelling to test the model. The quantitative phase involved a sample of 250 people aged 19-87 years living in an Australian capital city. Self-report questionnaires measured regularity of participation in leisure-time physical activity (dependent variable), leisure-time physical activity behaviour regulation, intrinsic motivation towards leisure-time physical activity, enjoyment of leisure-time physical activity, and priority of leisure-time physical activity (independent and mediating variables). Each of the independent and mediating variables was multidimensional in nature, the components of which were assessed using confirmatory factor analysis in structural equation modelling prior to the testing of structural models. After some adjustment, the predictors were satisfactorily represented by their respective multifactor models, except intrinsic motivation, which was best represented by a single factor model. Following modification, the proposed model of the social psychological determinants of regular participation in leisure-time physical activity was found to be a good fit of the data. Relationships within the model indicated the importance of the priority of leisure-time physical activity factors in the prediction of regular participation in leisure-time physical activity. The influence of preference for leisure-time physical activity on regular participation in leisure-time physical activity was mediated by level of priority and making time for leisure-time physical activity. That is, people who preferred to participate in leisure-time physical activity over other types of leisure tended to make it a higher priority, and, in turn, tended to make time to participate. Making time was subsequently associated with increased regularity of participation in leisure-time physical activity. The enjoyment factors influenced regular participation in leisure-time physical activity through their influence on preference for leisure-time physical activity. Activity enjoyment had a positive influence on preference and enjoyment dependent on surroundings had a negative influence. However, in the overall model, the behaviour regulators and intrinsic motivation attenuated the influence of the enjoyment factors on preference for leisure-time physical activity. This suggested that people's underlying behaviour regulators and levels of intrinsic motivation have a similar influence on their preference for leisure-time physical activity as their feelings of enjoyment. However, behaviour regulators and intrinsic motivation appear to be more powerful influences of preference than enjoyment. Intrinsic motivation towards leisure-time physical activity positively influenced regular participation in leisure-time physical activity through its influence on preference for leisure-time physical activity. It also had a direct influence on regularity of participation. Thus, people who were more intrinsically motivated tended to participate more regularly in leisure-time physical activity partly because they formed preferences for physical activity over other types of leisure. Furthermore, the direct influence of intrinsic motivation on regular participation suggested that there were explanations, beyond that of preference and priority, for why those who were intrinsically motivated tended to participate more regularly in leisure-time physical activity. The behaviour regulators of external regulation (negative), introjected regulation (positive) and identified regulation (positive) influenced regularity of participation in leisure-time physical activity mostly through their influence on intrinsic motivation towards leisure-time physical activity. That is, when people felt their physical activity was externally regulated, they felt less intrinsically motivated to participate and this was subsequently associated with less regular participation. On the other hand, when people were regulated by introjection and identification, they tended to feel more intrinsically motivated and this was subsequently associated with more regular participation. External regulation and introjected regulation also had a direct negative influence on preference for leisure-time physical activity and perceptions of the availability of time, respectively. Thus, people who felt externally regulated tended to have less preference for leisure-time physical activity and those who were regulated through introjection were more likely to perceive that they did not have the time to participate. This study contributes to the body of knowledge by highlighting the importance of preferences and prioritisation on perceptions of time availability, and subsequently, regularity of participation in leisure-time physical activity. It also demonstrated that behaviour regulators and intrinsic motivation are important determinants of regular participation in leisure-time physical activity in a general community sample. These findings have theoretical and practical implications for researchers, leisure professionals, and policy makers. They also suggest a number of significant areas of further research.