Assessment Of Learning Essay Example for Free

Assessment Of Learning Essay Assessment of learning refers to strategies designed to confirm what students know, demonstrate whether or not they have met curriculum outcomes or the goals of their individualized programs, or to certify proficiency and make decisions about students’ future programs or placements. It is designed to provide evidence of achievement to parents, other educators, the students themselves, and sometimes to outside groups (e. g. , employers, other educational institutions). Assessment of learning is the assessment that becomes public and results in statements or symbols about how well students are learning. It often  contributes to pivotal decisions that will affect students’ futures. It is important, then, that the underlying logic and measurement of assessment of learning be credible and defensible. TEACHERS’ ROLES IN ASSESSMENT OF LEARNING Because the consequences of assessment of learning are often far-reaching and affect students seriously, teachers have the responsibility of reporting student learning accurately and fairly, based on evidence obtained from a variety of contexts and applications. Effective assessment of learning requires that teachers provide †¢ a rationale for undertaking a particular assessment of learning at a particular  point in time †¢ clear descriptions of the intended learning †¢ processes that make it possible for students to demonstrate their competence and skill †¢ a range of alternative mechanisms for assessing the same outcomes †¢ public and defensible reference points for making judgements Rethinking Classroom Assessment with Purpose in Mind †¢ 55. The purpose of assessment that typically comes at the end of a course or unit of instruction is to determine the extent to which the instructional goals have been achieved and for grading or certification of student achievement. (Linn and Gronlund, Measurement and Assessment in Teaching ) Reflection: Think about an example of assessment of learning in your own teaching and try to develop it further as you read this chapter. 56 †¢ Rethinking Classroom Assessment with Purpose in Mind Chapter 5 †¢ transparent approaches to interpretation †¢ descriptions of the assessment process †¢ strategies for recourse in the event of disagreement about the decisions. With the help of their teachers, students can look forward to assessment of learning tasks as occasions to show their competence, as well as the depth and breadth of their learning. PLANNING ASSESSMENT OF LEARNING The purpose of assessment of learning is to measure, certify, and report the level  of students’ learning, so that reasonable decisions can be made about students. There are many potential users of the information:†¢ teachers (who can use the information to communicate with parents about their children’s proficiency and progress) †¢ parents and students (who can use the results for making educational and vocational decisions) †¢ potential employers and post-secondary institutions (who can use the information to make decisions about hiring or acceptance) †¢ principals, district or divisional administrators, and teachers (who can use the information to review and revise programming). Assessment of learning requires the collection and interpretation of information about students’ accomplishments in important curricular areas, in ways that represent the nature and complexity of the intended learning. Because genuine learning for understanding is much more than just recognition or recall of facts or algorithms, assessment of learning tasks need to enable students to show the complexity of their understanding. Students need to be able to apply key concepts, knowledge, skills, and attitudes in ways that are authentic and consistent with current thinking in the knowledge domain. What am I  assessing? Why am I assessing? Rethinking Classroom Assessment with Purpose in Mind †¢ 57 Assessment of Learning In assessment of learning, the methods chosen need to address the intended curriculum outcomes and the continuum of learning that is required to reach the outcomes. The methods must allow all students to show their understanding and produce sufficient information to support credible and defensible statements about the nature and quality of their learning, so that others can use the results in appropriate ways. Assessment of learning methods include not only tests and examinations, but  also a rich variety of products and demonstrations of learning—portfolios, exhibitions, performances, presentations, simulations, multimedia projects, and a variety of other written, oral, and visual methods (see Fig. 2. 2, Assessment Tool Kit, page 17). What assessment method should I use? Graduation Portfolios Graduation portfolios are a requirement for graduation from British Columbia and Yukon Senior Years schools. These portfolios comprise collections (electronic or printed) of evidence of students’ accomplishments at school, home, and in the community, including demonstrations of  their competence in skills that are not measured in examinations. Worth four credits toward graduation, the portfolios begin in Grade 10 and are completed by the end of Grade 12. The following are some goals of graduation portfolios: †¢ Students will adopt an active and reflective role in planning, managing, and assessing their learning. †¢ Students will demonstrate learning that complements intellectual development and course-based learning. †¢ Students will plan for successful transitions beyond Grade 12. Graduation portfolios are prepared at the school level and are based on specific Ministry criteria and standards. Students use the criteria and standards as guides for planning, collecting, and presenting their evidence, and for self-assessing. Teachers use the criteria and standards to assess student evidence and assign marks. There are three major components of a graduation portfolio: 1. Portfolio Core (30 percent of the mark). Students must complete requirements in the following six portfolio organizers: arts and design (respond to an art, performance, or design work); community involvement and responsibility (participate co-operatively and respectfully in a  service activity); education and career planning (complete a graduation transition plan); Employability skills (complete 30 hours of work or volunteer experience); information technology (use information technology skills); personal health (complete 80 hours of moderate to intense physical activity). 2. Portfolio Choice (50 percent of the mark). Students expand on the above areas, choosing additional evidence of their achievements. 3. Portfolio Presentation (20 percent of the mark). Students celebrate their learning and reflect at the end of the portfolio process. ( Portfolio Assessment and Focus Areas: A Program Guide) 58 †¢ Rethinking Classroom Assessment with Purpose in Mind Chapter 5 Assessment of learning needs to be very carefully constructed so that the information upon which decisions are made is of the highest quality. Assessment of learning is designed to be summative, and to produce defensible and accurate descriptions of student competence in relation to defined outcomes and, occasionally, in relation to other students’ assessment results. Certification of students’ proficiency should be based on a rigorous, reliable, valid, and equitable process of assessment and evaluation. Reliability  Reliability in assessment of learning depends on how accurate, consistent, fair, and free from bias and distortion the assessment is. Teachers might ask themselves: †¢ Do I have enough information about the learning of this particular student to make a definitive statement? †¢ Was the information collected in a way that gives all students an equal chance to show their learning? †¢ Would another teacher arrive at the same conclusion? †¢ Would I make the same decision if I considered this information at another time or in another way? Reference Points Typically, the reference points for assessment of learning are the learning  outcomes as identified in the curriculum that make up the course of study. Assessment tasks include measures of these learning outcomes, and a student’s performance is interpreted and reported in relation to these learning outcomes. In some situations where selection decisions need to be made for limited positions (e. g. , university entrance, scholarships, employment opportunities), assessment of learning results are used to rank students. In such norm-referenced situations, what is being measured needs to be clear, and the way it is being measured needs to be transparent to anyone who might use the assessment  results. Validity Because assessment of learning results in statements about students’ proficiency in wide areas of study, assessment of learning tasks must reflect the key knowledge, concepts, skills, and dispositions set out in the curriculum, and the statements and inferences that emerge must be upheld by the evidence collected. How can I ensure quality in this assessment process? Rethinking Classroom Assessment with Purpose in Mind †¢ 59 Assessment of Learning Record-Keeping Whichever approaches teachers choose for assessment of learning, it is their records that provide details about the quality of the measurement. Detailed records of the various components of the assessment of learning are essential, with a description of what each component measures, with what accuracy and against what criteria and reference points, and should include supporting evidence related to the outcomes as justification. When teachers keep records that are detailed and descriptive, they are in an excellent position to provide meaningful reports to parents and others. Merely a symbolic representation of a student’s accomplishments (e. g. , a letter grade or percentage) is inadequate. Reports to parents and others should identify the  intended learning that the report covers, the assessment methods used to gather the supporting information, and the criteria used to make the judgement. Feedback to Students Because assessment of learning comes most often at the end of a unit or learning cycle, feedback to students has a less obvious effect on student learning than assessment for learning and assessment as learning. Nevertheless, students do Ho w can I use the information from this assessment? Guidelines for Grading 1. Use curriculum learning outcomes or some clustering of these (e. g. , strands) as the basis for grading. 2.  Make sure that the meaning of grades comes from clear descriptions of curriculum outcomes and standards. If students achieve the outcome, they get the grade. (NO bell curves! ) 3. Base grades only on individual achievement of the targeted learning outcomes. Report effort, participation, and attitude, for example, separately, unless they are a stated curriculum outcome. Any penalties (e. g. , for late work, absences), if used, should not distort achievement or motivation. 4. Sample student performance using a variety of methods. Do not include all assessments in grades. Provide ongoing feedback on formative  performance using words, rubrics, or checklists, not grades. 5. Keep records in pencil so they can be updated easily to take into consideration more recent achievement. Provide second-chance assessment opportunities (or more). Students should receive the highest, most consistent mark, not an average mark for multiple opportunities. 6. Crunch numbers carefully, if at all. Consider using the median, mode, or statistical measures other than the mean. Weight components within the final grade to ensure that the intended importance is given to each learning outcome. 7. Make sure that each assessment meets quality standards (e.g. , there should be clear targets, clear purpose, appropriate target-method match, appropriate sampling, and absence of bias and distortion) and is properly recorded and maintained (e. g. , in portfolios, at conferences, on tracking sheets). 8. Discuss and involve students in grading at the beginning and throughout the teaching and learning process. (Adapted from O’Connor, How to Grade for Learning ) Resource: Marzano, Transforming Classroom Grading 60 †¢ Rethinking Classroom Assessment with Purpose in Mind Chapter 5 rely on their marks and on teachers’ comments as indicators of their level of  success, and to make decisions about their future learning endeavours. Differentiating Learning In assessment of learning, differentiation occurs in the assessment itself. It would make little sense to ask a near-sighted person to demonstrate driving proficiency without glasses. When the driver uses glasses, it is possible for the examiner to get an accurate picture of the driver’s ability, and to certify him or her as proficient. In much the same way, differentiation in assessment of learning requires that the necessary accommodations be in place that allow students to make the particular learning visible. Multiple forms of assessment offer multiple pathways for making student learning transparent to the teacher. A particular curriculum outcome requirement, such as an understanding of the social studies notion of conflict, for example, might be demonstrated through visual, oral, dramatic, or written representations. As long as writing were not an explicit component of the outcome, students who have difficulties with written language, for example, would then have the same opportunity to demonstrate their learning as other students. Although assessment of learning does not always lead teachers to differentiate  instruction or resources, it has a profound effect on the placement and promotion of students and, consequently, on the nature and differentiation of the future instruction and programming that students receive. Therefore, assessment results need to be accurate and detailed enough to allow for wise recommendations. Reporting There are many possible approaches to reporting student proficiency. Reporting assessment of learning needs to be appropriate for the audiences for whom it is intended, and should provide all of the information necessary for them to make reasoned decisions. Regardless of the form of the reporting,  however, it should be honest, fair, and provide sufficient detail and contextual information so that it can be clearly understood. Traditional reporting, which relies only on a student’s average score, provides little information about that student’s skill development or knowledge. One alternate mechanism, which recognizes many forms of success and provides a profile of a student’s level of performance on an emergent-proficient continuum, is the parent- student-teacher conference. This forum provides parents with a great deal of information, and reinforces students’ responsibility for their learning. The Communication System Continuum: From Symbols to Conversations (O’Connor, How to Grade for Learning ) Grades Report cards (grades and brief comments) Infrequent informal communications Parent-teacher interviews Report cards with expanded comments Frequent informal communication Student-involved conferencing Student-led conferencing Reflection: What forms do your reports of student proficiency take? How do these differ according to audience? Rethinking Classroom Assessment with Purpose in Mind †¢ 61 Assessment of Learning An Example of Assessment of Learning. Elijah was interested in assessing student mastery of both the modern and the traditional skills required for survival in the Nunavut environment where he teaches. The overarching theme of survival is taught in the early grades and culminates at the senior level in a course delivered in Inuktitut. Students learn how to take care of themselves and others, and how to adapt what they know to the situation at hand. Survival requires not only skills and knowledge, but also a concept the Inuit people call qumiutit, or the ability in an emergency situation to pull out of stored memory information that will enable a person to cope, not panic. Traditionally, this was learned in a holistic manner, grounded in Inuit traditional guiding principles that were nurtured and developed from birth, and taught and reinforced in daily living. Throughout the term, Elijah took his students to an outdoor area to practise on-the-land survival activities, using both traditional and modern methods. He always took with him a knowledgeable Elder who could give the students the information they needed to store away in case of emergency. The students watched demonstrations of a skill a number of times. Each student then practised on his or her own, as Elijah and the Elder observed and assisted. Elijah knew that students need to have a high level of expertise in the survival skills appropriate for the northern natural environment. Elijah assessed each student on each survival skill (e. g. , making fire the traditional way, tying the knots required for the qamutik cross-pieces on a sled). What am I assessing? I am assessing each student’s performance of traditional and modern survival skills. Why am I assessing? I want to know which survival skills each s tudent has mastered and their readiness to s urvive in the natural environment. 62 †¢ Rethinking Classroom Assessment with Purpose in Mind. Chapter 5 Elijah knew that the best way to determine if students have mastered the skills is to have them perform them. When students believed they were ready, Elijah created an opportunity for them to demonstrate the mastered skill to a group of Elders, who then (individually, then in consensus) determined if the performance was satisfactory. A student’s competence in a survival skill is often demonstrated by an end product. For example, competence in knot tying is demonstrated by a knot that serves its purpose, and competence in fire building is demonstrated by a fire that is robust. As the Elders judged each student’s performance of the skills, Elijah recorded the results. He shared the information with each student and his or her parents in a final report, as shown here. Ho w can I use the informatio n from this assessment? Now that I know which skills each of the students has mastered, I can report this information to the s tudents and their parents. I can use this information to identify a learning path for each s tudent. How can I ensure quality in this assessment process? Ensuring quality with this approach involves clear criteria: either the student performs the skill s uccessfully or does not. I need to provide adequate opportunities for the s tudent to demonstrate the skills under various conditions and at various times. What assessment method should I use? I need an approach in which students can demonstrate the traditional survival skills that they learned. The method I choose should also allow me to identify which skills they did not master. Rethinking Classroom Assessment with Purpose in Mind †¢ 63 Assessment of Learning Shelters: †¢ emergency shelters †¢ igloo building4 †¢ qamaq5 †¢ tents Transportation needs: †¢ making the knots required for the qamutik cross pieces on a sled †¢ building a kayak/umiak. †¢ fixing a snowmobile (spark plugs, repairing track, drive belt) †¢ keeping a boat seaworthy Navigational issues: †¢ reading the land †¢ reading the sky †¢ understanding seasonal variations †¢ reading inuksuit †¢ using GPS †¢ map reading Preparation for land travel: †¢ packing a qamutiq (sled) †¢ load, balance †¢ necessities: snow knife, rope, food, water, heat source †¢ letting others know where you are going †¢ necessary tools, supplies, snowmobile parts, fuel †¢ using communication devices Food sources: †¢ plants and their nutritional properties †¢ hunting, skinning, and cutting up seal, caribou, etc. †¢ kinds of food to take on the land,  and their nutritional properties ____________________ 4. Expertise in igloo building includes understanding of types of snow, the shape and fit of blocks, and the use of a snow- knife. 5. A qamaq is a rounded house, built of scrap wood or bones, and covered with skins, cardboard, or canvas. Report on Survival Skills Student: _______________________________________________ Date: _______________________ Traditional Survival Skills Modern Survival Skills Adaptability to the Seasons Attitude Success Next Steps 1) Skills Building a fire / means of keeping warm: †¢ fuel sources †¢ getting a spark †¢ propane heaters, stoves †¢ clothing. 2) Relationship to the Seasons Assessing conditions / recognizing danger signs: †¢ seasonal changes †¢ land changes †¢ water changes †¢ wind changes †¢ weather changes Climatic changes: †¢ weather changes and how this affects the land and water †¢ knowledge of animals and their characteristics and behaviours 3) Attitudinal Influences (Having the right attitude to learn) †¢ respect for the environment (cleaning up a campsite upon leaving, dealing with the remains of an animal, not over-hunting/fishing) †¢ respect for Elders and their knowledge †¢ ability to learn from Elders 64 †¢ Rethinking Classroom Assessment with Purpose in Mind Chapter 5. Elijah’s report identified which of the students had mastered the specified skills required to survive in the Nunavut environment. It outlined other areas (such as adaptability to the seasons and attitudinal influences) about which peers, parents, and family members would need to provide input before a comprehensive assessment could be made. The assessment also identified those students not yet ready to survive in the natural environment. But the Elders did not stop working with the students who did not reach mastery. Elders see learning as an individual path in which skills, knowledge, and attitudes are acquired along the way. If a particular skill was beyond the capability of a student, the Elders identified other areas where that person could contribute to the common good of the community, and was accepted for the gifts he or she brought to the group. In this way, the Elders helped Elijah differentiate the learning path for each of his students. SUMMARY OF PLANNING ASSESSMENT OF LEARNING Assessment for Learning Assessment as Learning Assessment of Learning Why Assess? To enable teachers to determine next steps in advancing student learning to guide and provide opportunities for each student to monitor and critically reflect on his or her learning, and  identify next steps Assess What? each student’s progress and learning needs in relation to the curricular outcomes each student’s thinking about his or her learning, what strategies he or she uses to support or challenge that learning, and the mechanisms he or she uses to adjust and advance his or her learning. What Methods? a range of methods in different modes that make students’ skills and understanding visible a range of methods in different modes that elicit students’ learning and metacognitive processes Ensuring Quality †¢ accuracy and consistency of observations and interpretations of student learning  Ã¢â‚¬ ¢ clear, detailed learning expectations †¢ accurate, detailed notes for descriptive feedback to each student †¢ accuracy and consistency of student’s self-reflection, self-monitoring, and self-adjustment. †¢ engagement of the student in considering and challenging his or her thinking †¢ students record their own learning Using the Information †¢ provide each student with accurate descriptive feedback to further his or her learning †¢ differentiate instruction by continually checking where each student is in relation to the curricular outcomes †¢ provide parents or guardians with descriptive feedback about student  learning and ideas for support. †¢ provide each student with accurate descriptive feedback that will help him or her develop independent learning habits †¢ have each student focus on the task and his or her learning (not on getting the right answer) †¢ provide each student with ideas for adjusting, rethinking, and articulating his or her learning †¢ provide the conditions for the teacher and student to discuss alternatives †¢ students report about their learning Rethinking Classroom Assessment with Purpose in Mind. †¢ 65 Assessment of Learning to certify or inform parents or others of student’s proficiency in  relation to curriculum learning outcomes the extent to which students can apply the key concepts, knowledge, skills, and attitudes related to the curricular outcomes a range of methods in different modes that assess both product and process †¢ accuracy, consistency, and fairness of judgements based on high-quality information †¢ clear, detailed learning expectations †¢ fair and accurate summative reporting †¢ indicate each student’s level of learning †¢ provide the foundation for discussions on placement or promotion †¢ report fair, accurate, and detailed information that can be used to decide the next steps in a student’s learning.

As Predictors of Implicit Leadership Theories

As Predictors of Implicit Leadership Theories This study seeks to investigate how employed individuals form Implicit Leadership Theories (ILTs), or personal assumptions about the characteristics of a business leader. The existing literature consistently explains that employed individuals, through socialization and past experiences with leaders, develop ILTs. However, such studies have neglected to examine directly how ones past leaders have affected the formation process, therefore leading to a hypothesis examining this formation process. As a competing hypothesis, subordinates personalities will also be assessed on the extent to which subordinates form ILTs congruent with their own personality and how having a leadership self-image affects this relationship. Lastly, it is also predicted that subordinates share a common element when assessing ILTs, such that they will rate participative leadership behaviors higher than any other leadership behaviors. Personality and Past Experiences As Predictors of Implicit Leadership Theories Introduction Employees perceptions, prior expectations, and cognitive prototypes regarding the leadership process have dominated part of the leadership literature (Foti Lord, 1987; Kenney, Schwartz-Kenney, Blascovich, 1996; Larson, 1982; Lord Maher, 1993). Based on such literature, it has been determined that working individuals, through socialization and past experiences with leaders, develop Implicit Leadership Theories (ILTs), or personal assumptions about the traits and abilities that characterize an ideal business leader (Epitropaki Martin, 2004 PAGE NUMBER). ILTs stem from cognitive structures, or schemas, that specify traits and behaviors that followers believe an ideal leader should exhibit. They are stored in the memory, and when followers interact with a person in a leadership position, such schemas become stimulated (Kenney et al., 1996). These leadership schemas provide organizational members with a cognitive basis for understanding and responding to supervisor behavior, and they are essential elements of organizational sense-making (Poole, Gioia, Gray, 1989; Weick, 1995). The potential role of ILTs within organizational settings has been highlighted in the literature (Bass Avolio, 1989; Epitropaki Martin, 2004; Lord Maher, 1993; Offermann, Kennedy, Wirtz, 1994). Implicit leadership theories have been represented as a recognition-based approach to leadership (Lord, 1985). Based on this approach, employees compare their implicit leadership theories with their leaders traits and behaviors (Calder, 1977). This matching process is expected to form the impressions employees hold for their leaders. Each individual develops a unique schema (which is sometimes referred to as a prototype) on what traits and behaviors constitute an ideal leader, specifically in the business world. A prototype is an abstract conception of the most representative member or most widely shared features of a given cognitive category (Phillips, 1984, p. 126). These leadership prototypes are said to be formed through exposure to social events, interpersonal interactions, and prior experiences with leaders (Epitropaki Martin, 2004). Therefore, the general definition of ILTs has led to the belief that past experiences predict the formation of such theories. Such prototypes are formed by role schemas (or normative expectations) that allow followers to understand and interpret leaders traits and behaviors (Calder, 1977). As such, it is proposed that leadership is a common label applied to the traits and behaviors congruent with the observers ILTs. When a person exhibits potential leadership characteristics (as defined by the ILT), subordinates assess the potential leader for distinctiveness (as in distinct leadership attributes and behaviors) regarding that behavior (Calder, 1977). If the behavior is distinguishable from the behaviors of other group members, then leadership may be attributed to the person. Similarly, it has been suggested that the perception of leadership involves the activation of a leader category (Phillips Lord, 1981). As such, a persons attributes and/or behaviors are compared to prototypical leader characteristics, activating the leader category if there is a match between attributes and the prototypical attributes and behaviors. In this regard, Lord and his associates (e.g., Lord, 1985; Lord Maher, 1993; Phillips Lord, 1981) have contributed to the ILT field. On the basis of Roschs (1978) theory of cognitive categorization, such literature suggested a categorization theory to leadership and argued that leadership perceptions form a number of hierarchically organized schemas or cognitive categories, each of which is represented by a set of prototypes. Additionally, once a person is categorized as a leader, the activated leader prototype causes followers to selectively attend to, encode, and retrieve schema-consistent information and to provide consistent information where such information does not exist (Phillips Lord, 1981 cited in Kenney, Blascovich, Shaver, p.411). Moreover, Lord and others (Lord et al., 1984; Phillips Lord, 1982) have found that people use categories to differentiate between leaders and non-leaders and between effective and ineffective leaders, which seems essential to the formation of ILTs. Other cognitive categorization theories (e.g., Barsalou, 1985; Smith Medin, 1981) however, argue that classification occurs as observers compare stimuli with ideals or specific examples stored in memory. An ideal includes characteristics that category members should exhibit if they are to serve as a representative to the category (Barsalou, 1985). As such, a category members prototypicality increases with its similarity to the categorys ideal. Therefore, in some cases, categories may be organized around ideal prototypes rather than typical prototypes. For example, a follower might judge a leader based on an ideal notion (ILT) when evaluating whether a leader is worthy of influence (Barsalou, 1985). Similarly, the closer the stimulus is to a categorys ideal, or the more category exemplars the stimulus resembles, the more likely the observer will classify the stimulus as a member of that category (Kenney, Schwartz-Kenney, Blascovich, 1996). In this example, the category is a leader w ho is worthy of influence. It has also been argued that there is a possible feedback loop between employees categorization of a supervisor as congruent to the implicit leadership profile and their perceptions of the supervisors behavior (Lord Maher, 1993). Leadership categorization processes can have an influence on perceptions of actual leader behavior, but they are also likely to be affected by a persons general day-to-day experiences with a manager. It might be through their exposure to their actual leaders behaviors that employees engage in a categorization process and make active comparison between their actual supervisor and the implicit profile stored in memory. Furthermore, perceivers may then rely on existing categorizations and evaluations of congruence to further simplify the processes required to recognize leadership in others. Once someone is categorized as close or distant to a perceivers ILTs, the relevant leadership schema generates further assumptions about the persons behavior, affecting per ceptions of that behavior. Additionally, once people attach a label to an object, person, or event, this process of categorization guides how they interpret much of the subsequent information they encounter concerning that object, person, or event. Over time, this additional information tends to strengthen the original categorization (Lord Maher, 1993). Measure of ILTs and Effects on Validity To date, there is no single and widely accepted measure of implicit leadership theories. Several researchers have developed independent lists of traits to measure ILTs, but such lists are rarely replicated in other research, and they often use different clusters of traits. However, attributes such as intelligent, honest, dynamic, and motivated seem to exist in all the lists elicited, and a distinction between positive (prototypic) and negative (anitprototypic) traits has been made by most researchers (Epitropaki Martin, 2004; Offermann, Kennedy, Wirtz, 1994). In addition, ILT trait lists can be fairly long, as in Lord et al.s (1984) scale of 59 items, the Schein Descriptive Indexs (SDI; Schein, 1973) 92 item scale, and Offermann et al.s (1994) scale of 41 items (Epitropaki Martin, 2004). Other scales include the Campbell Leadership Indicator (CLI; Campbell, 1991), Kenney et al.s (1996) Leaders Described as Worthy of Influence, and House et al.s (1999) Culturally Endorsed Implicit Leadership Theories (CILTs). It is important to note here that leadership instruments as a whole have used both traits and behaviors to measure the construct. Specifically, the trait approach emphasizes attributes of leaders such as personality, motives, values, and skills, whereas the behavior approach emphasizes the importance of what leaders actually do (e.g., activities, responsibilities, functions, etc.; Yukl, 2002.). However, behavioral theories are often considered a stronger approach in leadership literature, and thus will be the approach taken in the present study. Specifically, a meta-analysis examining the Ohio State leadership behaviors of Consideration and Initiating Structure dimensions illustrated important support for the validity of Initiating Structure and Consideration in leadership research (Judge, Piccolo, Ilies, 2004). Generalizability of ILTs A variety of individual difference variables have been considered as potentially being related to ILTs. The present study primarily examines personality as individual differences in relation to ILTs. If individual differences do not affect ILTs, then the ILTs would be generalizable across different groups of people. Such generalizability has been examined in relation to some groups of people, including gender, type of role or job, and culture. However, the generalizability of ILTs is supported by contradictory evidence. Generalizability findings have mainly focused on the areas of consistency across gender (Deal Stevenson, 1998; Offermann et al., 1994), consistency from students to professional samples (Offermann et al., 1994), and consistencies across cultures (Bryman, 1987; House et al., 1999). All three areas are generally supported across the generalizability studies, as findings support claims that ILTs remain unaffected by individual and contextual differences, and the degree to which employees resort to categorical thinking and use ILTs as a map to evaluate their actual supervisors behavior does not vary as a function of context or individual differences (Epitropaki Martin, 2005). However, other findings argue that some variations do exist. For example, even though men and women have similar perceptions of prototypic leaders, men rated traits such as aggressive, competitive, and feelings not easily hurt higher than women did, and women rated traits such as being aware of others feelings, helpful, and self-confident higher than men did (Deal Stevenson, 1998). In other words, one groups ILT is not necessarily the same as another groups. In addition, there is much discrepancy in ILT ratings in the cross-cultural literature on leadership. For instance, Gerstner (1994) compared leadership prototypes of a business leader across several countries using an attribute-rating task. Results indicated that there are reliable differences in the prototypical leadership perceptions of members from the various countries sampled. Such findings were built upon other literatures asserting that perception is not solely an innate, physiological function of the cognitive process, but is also a subjective process reflecting the self, including cultural background (Markus Kitayama, 1991). Likewise, it was also previously found that characteristic traits of a leader in one culture may be very different from prototypical traits in another culture (Shaw, 1990). Additionally, Hofstede (1976) has proposed that the more similar two individuals are in terms of nationality, the more likely they are to perceive their social environment similarly. Overall, therefore, the generalizability claims of ILTs appear inconclusive, but pertinent information may be lacking. As such, further investigation should be undertaken. Additionally, other hypotheses by Eptriopaki and Martin (2005) examined the degree to which people use ILTs as a benchmark to make sense of their supervisors behavior, and suggested that it might change as a function of context. For instance, a limited capacity model has been applied to leadership perceptions and leader behavior ratings (Epitrokpaki Martin, 2005; Lord Maher, 1990). This model acknowledges peoples limited memory capacity and their reliance on general cognitive simplification mechanisms (such as ILTs), particularly in conditions of high cognitive load. Furthermore, it was also proposed that employees in jobs of high demand will rely more on their ILTs to rate the quality of the leader-member exchange (LMX) relationship they develop with their manager (Epitropaki Martin, 2005). It was further proposed that employees in exchanges of short duration would rely more on their ILTs to rate the quality of the relationship they develop with their supervisors than those in ex changes of long durations. Such variations have not been examined further, and there is still a clear need for future examination of all demographical variables. When considering the formation of ILTs, the present proposal will hold cultural differences constant, as only U.S. residents will serve as participants. Ethnicity and gender differences will be controlled. As described above, the definition and illustration of ILTs often refers to past experiences playing a role in the formation of such theories. However, studies have neglected to examine directly how ones past leaders have affected the formation process. The first hypothesis in the present study attempts to explain how the role of past experiences affects the ILT formation process by examining ratings of subordinates most and least effective leaders. Therefore, the following is hypothesized about the effects of experience on predicting implicit leadership theories: Hypothesis 1: Subordinates past experiences with various types of leaders will predict their implicit leadership theories. ILTs will be more strongly related to descriptions of ones most effective leader than to descriptions of ones least effective leader. The Formation of ILTs Expanded: The Effects of Personality The present study also examines how ILTs could be formed by personality. Historically, results of investigations relating personality traits to leadership have been inconsistent and often disappointing. Most reviews of the literature have concluded that the trait approach has fallen out of favor among leadership researchers. The original source of skepticism with the trait approach is often attributed to Stogdills (1948) influential review. Although Stogdill did find some consistent relations, he concluded, The findings suggest that leadership is not a matter of passive status or of the mere possession of some combination of traits (Stogdill, 1948, p. 66). As Bass (1990) noted, after Stogdills (1948) review, situation-specific analyses took over, in fact, dominating the field of leadership theory and research (p. 59). Many attempts have examined the personality traits in effective leaders (Hogan, 1994; Judge Bono, 2000; Tett Burnett, 2003), but the definition of what comprises an e ffective leader may be partly responsible for theory abandonment. Perhaps this is because there are unique differences among individuals personalities, it seems likely that individuals implicit leadership theories, or their expectations of an effective leader, will be differ from person to person, and these differences could be related to personality of the person whose ILT is examined. The ILTs approach reflects a resurgence of interest in leadership traits, but the emphasis is now placed on the perceptual processes underlying the conceptualization of leadership. When defining ideal leadership, it is important to remember that ones personality may affect what behaviors he or she thinks are most effective for leading others (Cucina, Vasilopoulos, Sehgal, 2005). A similar case has already been argued for the role that supervisors implicit theories play on performance appraisals (Borman, 1987; Cronbach, 1955; Uggerslev Sulsky, 2008). For instance, it has been found that raters often use their own distinctive dimensions to evaluate the performance of their employees (Borman, 1987). Such evidence has led to the implementation of frame-of-reference (FOR) training, or a training program that helps raters hold a common understanding of how to rate an organizations performance dimensions. FOR training has been shown to help increase the accuracy of performance ratings, thereby countering the effects of supervisors implicit theories of performance. Therefore, if it has been found that supervisors have implicit theories based on their own personal performance ideology, it only seems logical that subordinates could too have their own personal theories on the performance of leaders. Social Perceptions based on Similarity Some of the ILT literature has suggested that implicit theories can provide stability to dyadic relationships when they fulfill a similarity paradigm (Epitropaki Martin, 2001; Turban et al., 1990). For instance, the similarity-attraction paradigm (Byrne, 1971) states that similarity between individuals with regard to personal attributes or other characteristics is linearly related to interpersonal attraction, such that similarity gives rise to attraction while dissimilarity engenders repulsion. In the context of outcomes, it has been argued that interpersonal attraction fosters supervisor-subordinate compatibility and in turn, performance. For instance, the resulting interpersonal connection encourages accurate perception of supervisor performance expectations and, consequently, improved subordinate performance (Deluga, 1998). In addition, there is evidence that perceptions of similarity, both in a general sense (Wexley Pulakos, 1983) and with regard to specific attributes such as demographic characteristics (Epitropaki Martin, 2001), attitudes (Phillips Bedeian, 1994), values (Ashkanasy OConnor, 1997), competence (Kim Organ, 1982) and personality traits (Bauer Green, 1996; Keller, 1999), have been associated with perceptions of leader-member exchange quality. Moreover, it has been found that subordinates who regard themselves as being similar to their supervisors communicate more with them, and are rated as higher performers than those who do not (Turban et al., 1990). This may describe the previously mentioned gender differences found in terms of individual ratings on effective leader attributes. Other relationships, like mentorships, have also evidenced success based on attraction due to the similarity of race and gender, and perceived similarity of beliefs and attitudes (Turban, Dougherty, Lee, 2001). Overall, perceived similarity in a dyad (such as a supervisor-subordinate pair) is often related to favorable or pleasurable outcomes. Social Perceptions and Self-Serving Biases Individuals often believe that what they do, or how they contribute at work, is important. For instance, literature on positive self-illusions suggests that individuals may prefer leaders similar to the self, because such individuals tend to hold unrealistic, positive illusions of the self (Taylor Brown, 1988). Assuming that becoming a leader and leadership are construed as socially desirable, individuals may keep unrealistic expectations of assuming a leadership position and project their own traits onto idealized leadership images. In other words, as individuals tend to view themselves in an overly positive manner, believing that they themselves could be leaders, they may be most satisfied and most likely to want to continue working with leaders who are similar to them (Taylor Brown, 1988). They might judge such leaders to be more effective, which is similar to ILT perceptions. The social cognition literature also suggests that individuals engage in self-serving biases when describing attributes that are necessary for performance (Cucina, Vasilopoulos, Sehgal, 2005). It has been suggested that individuals tend to indicate that their own personality traits are those that are necessary for successful performance. Research in this domain initially (Lewicki, 1983) examined self-serving biases when looking at prototypes of social categories. It was evidenced that if an individual has a favorable impression of a target (e.g., a leader), then he or she will be more likely to assume that the target has the same characteristics as ones self. In addition, she will ascribe her own strengths and positive attributes to the target. While there is currently no available literature on self-serving biases and implicit leadership theories, several studies have examined how self-serving biases affect ratings of leadership orientation (Dunning, Perie, Story, 1991; McElwee, Dunning, Tan, Hollman, 2001). In these studies, participants tended to rate leaders as goal- or people-oriented depending on which orientation the participant possessed. Interestingly, such self-serving biases were only present when rating leadership performance, as opposed to leadership creativity (Dunning, Perie, Story, 1991). In addition, liking the target leader was not found to mediate or moderate the relationship between orientation of the leader and orientation of the participant (McElwee, Dunning, Tan, and Hollman, 2001). Perhaps the trait activation model (Tett Burnett, 2003) can assist in explaining how people develop the previously discussed self-biased belief systems, and consequently, their expectations. For instance, according to the trait activation model, a person will rate specific behaviors high on importance for successful performance, because those specific behaviors (and their underlying personality trait) are what make him or her effective. Because of such beliefs, those behaviors become valued by the individual. For example, a conscientious person will likely engage in organizational behaviors and work in a methodical fashion, because that is what he or she thinks is necessary in order to perform successfully on a job. When a persons traits are valued by ones organization (or perhaps ones leader), the person will probably experience more satisfaction with the job (Tett Burnett, 2003). In return, an individual may expect a leader to have similar traits as the self if these traits are seen as valuable and related to performance. Applying this rationale, it is hypothesized that a self-serving belief system will affect the formation of followers implicit leadership theories in terms of trait-based principles. Such a hypothesis lies on the foundation that personality is the underlying driving force behind how individuals behave, or why certain types of behaviors are valued. In other words, it is speculated that a subordinate will rate how an effective leader should perform (i.e., ILT), based on implicit assumptions about the behaviors that make the subordinate most effective. It is proposed that followers will hold implicit leadership theories based on a self-serving bias: that is, a bias that successf ul people are like themselves. Thus, followers will expect an effective leader to exhibit behaviors congruent with the followers own personalities. Hypothesis 2: Subordinates personalities will affect the formation of their implicit leadership theories. As such, subordinates will rate leaders who exhibit behaviors that correspond to their own personality traits as more effective than leaders whose behaviors do not correspond to the subordinates personality traits. Specifically: Subordinate conscientiousness is positively associated with rating a business leader high on initiating structure. Subordinate agreeableness is positively associated with rating a business leader high on consideration. Subordinate extraversion is positively associated with rating a business leader high on inspiring commitment. Subordinate agreeableness is positively associated with rating a business leader high on participative style. The rationale for this hypothesis rests on inferences about the relationships between specific personality traits and specific (leader) behaviors. Regarding Hypothesis 2a, the correspondence between scoring high on conscientiousness and rating a business leader high on initiating structure stems from the constructs definitions. For instance, because those who score high on conscientiousness are said to have high levels of thoughtfulness, with good impulse control and goal-directed behaviors (Goldberg, 1992), it seems feasible to assume that such persons would assign high ILT ratings for leader dimensions like initiating structure. Initiating structure refers to leader behaviors such as encouraging the use of uniform procedures and maintaining definite standards of performance (Stogdill, 1963), leader behaviors that parallel the definition of conscientiousness. Similarly, because those who score high on agreeableness are said to have high levels of trust, altruism, kindness, affection, and other prosocial behaviors, it is predicted that such persons would have high ILT ratings for the leader dimension of consideration. Consideration refers to leader behaviors such as treating all group members as ones equal and looking out for the personal welfare of group members, behaviors that seem to parallel the definition of agreeableness. Similarly, it is also predicted that those who score high on agreeableness will have high ILT ratings for the leader dimension participative style. Leaders with a participative style consult with their subordinates when facing problems and ask them for suggestions concerning how ideas should be implemented (Northhouse, 2004). Lastly, because those who score high on extraversion are said to have high levels of excitability, sociability, assertiveness, emotional expressiveness, and optimism, it is predicted that such persons would assign high ILT ratings for leader dimensions like inspiring commitment. Inspiring commitment refers to the leader behaviors of proposing change with great enthusiasm and exerting optimism when describing a difficult activity or mission for a work unit (Yukl, 1998). These behaviors seem to parallel the definition of extraversion. Leadership Self-Image Self-schemas are sets of cognitive structures that provide for individual expertise in particular domains of social behavior (Markus, Smith, Moreland, 1985). As schematicism increases in a conceptual domain, such as leadership, so does sensitivity to the behavior of others in that domain. Thinking of oneself as a leader may make ones own characteristics more salient for judging leaders. As a result, it will be important to note whether or not individuals see themselves as leaders, because it may affect if they expect a leader to be like them. That is, if the people think of themselves as leaders, then the Hypotheses 2 are more likely to be true. If, on the other hand, the person has no self-image as a leader and does not ever want to be a leader, the self-serving hypothesis might be less true. It would not be very self-serving to see another person being effective at something (e.g., leadership) as similar to oneself if leadership plays no part in ones self-image. Therefore, the relationships in Hypotheses 2 should be moderated by ones self-image regarding leadership. Hypothesis 3: Subordinate leadership self-image will moderate the relationship between subordinate personality and formation of implicit leadership theories. The relationship between personality and the formation of implicit leadership theories will be stronger when subordinates have a leadership self-image. A proposed model that is consistent with the preceding hypotheses can be viewed in Figure 1. By examining how ILTs may be formed, especially if ones past experience plays a role, important implications could be explored. For instance, Eptiropaki and Martin (2005) noted the potential role ILTs could play in the socialization of newcomers. As such, ILTs can potentially have a significant impact on the development of interpersonal relationships during the organizational socialization process (Eptiropaki Martin, 2005, p. 673). Subsequently, current training programs of leadership could seriously benefit by including some form of ILTs training to increase managers awareness of their subordinate ILTs. Figure 1. The effects of personality and experience on predicting implicit leadership theories. Experience with Behaviors of Multiple Leaders Personality of Subordinates Implicit Leadership Theory Leadership Self-Image Demographic Considerations Previously mentioned generalization issues will be considered when conducting the study. Gender effects on ILTs are of interest in past research, as are age and experience. Younger and less experienced employees might have different conceptions of ideal leadership from employees with more experience and more exposure to organizational leaders (Brown Lord, 2001). Age, education level, occupational title, and years employed will therefore be examined and controlled if necessary. In addition, ethnicity will be recorded, but the sample will be limited to United States residents to avoid previously found cross-cultural differences. Participative Leadership Even though there are often individual differences among people, maybe working individuals just generally prefer a participative leader over a certain type of leadership that is based on their personalities or past experiences. For instance, practicing participative leadership offers a variety of potential benefits, including likelihood to increase the quality of decision-making (Scully, Kirkpatrick Locke, 1995), to contribute to the quality of employees work life (Somech, 2002), and to increase employees motivation (Locke and Latham, 1990), commitment (Armenakis, Harris, Mossholder, 1993), and satisfaction (Smylie, Lazarus, Brownlee-Conyers, 1996), all of which suggest that subordinates react well to participation leadership. Participative leadership is based on the process of joint decision-making by two or more parties in which the decisions have future effects on those making them. The amount of participation by any individual is the amount of influence he or she has on the decisions and plans agreed upon (Vroom, 1959). Specifically, participative leadership involves the efforts of a supervisor to encourage and facilitate participation by subordinates when making decisions that could have been made by the manager alone. Participative leadership can take many forms, such as revising a tentative decision after receiving protests, asking for suggestions before making a decision, or allowing others to make a decision subject to a supervisors final authorization (Yukl, 2002). Field and House (1990) examined the validity of the Vroom-Yetton decision-making model of leadership, and found it was validated for managers, but not for subordinates. Although they were not explicitly studying ILTs, their results sug gest that because the model was developed and validated on managers perceptions of leader styles in relation to their perceptions of effectiveness, it is biased towards managers implicit leadership theories. Subordinates in their study, however, perc

Determinants And Implications For Focused Antenatal Care Interventions

Determinants And Implications For Focused Antenatal Care Interventions The coverage of antenatal care (ANC) in many areas is known and there are a number of interventions to encourage use of ANC services by pregnant women. However, for women who attend ANC, it is important that they register at the appropriate time and pay a given number of visits over the pregnancy period to ensure that they receive the interventions recommended for the antenatal period at the right time. When a pregnant woman makes regular contact which her skilled antenatal care provider, she is in a position to receive various services such as those meant for prevention of eclampsia, intermittent preventive treatment for malaria, early detection of HIV/AIDS infection and prevention of mother-to-child transmission, micronutrient supplementation, birth preparedness and provision of information on danger signs occurring while she is pregnant or during delivery.1 Presently, Nigeria is transiting to the Focused Antenatal Care (FANC) approach promoted by the World Health Organization (WHO ) which is aimed at ensuring that each antenatal visit counts and that antenatal care interventions are delivered at the appropriate time.2 FANC is one of the pillars of safe motherhood. The goal of FANC is to ensure that pregnancy is normal through for major actions: identification of pre-existing health conditions, early detection of complications arising during the pregnancy, health promotion and disease prevention and birth preparedness and complication readiness planning.3The interventions are deployed in such a way that they are appropriate for the womans stage of pregnancy.4 Unlike the previously used routine care which was ritualistic and frequent visits, the FANC approach emphasizes evidence-based goal-directed actions, family-centred care, quality, rather than quantity of visits as well as care by skilled providers.3 4 Thus, numerous routine visits are no longer recommended and are considered a burden to women and the health care system. The FANC approach also deemphasizes the routine risk assessment approach for classifying women into high and low risks groups.2 With the risk assessment approach, women attending antenatal care were offered services which include blood pressure check, urinalysis to detect protein or bacteria, and blood test to rule out syphilis or anaemia.5 However many women classified as low risk end up having a false sense of security, are unable to recognize and respond to problems and end up developing complications. In addition, most high risk women give birth without complications and the excess care provided constitutes an inefficient use of scarce resources. The FANC approach in Nigeria requires that pregnant women would have paid the first visit for ANC by the 16 week of pregnancy or earlier when the women first thinks she is pregnant, the second between the 24th to 28th week, the third at the 32nd week and the 4th at the 36th week of pregnancy.2 Some authors have considered early booking to mean that a woman pays her first visit before the 14th week to achieve the aim of improved outcome of pregnancy both for a mother and her unborn child.6 Thus, by 36 weeks, a pregnant woman should have made the required minimum of four visits while those with risk of complications of conditions that can impact on pregnancy would require additional visits. The time of booking and ANC attendance can affect the effectiveness of interventions recommended for pregnant women and thus the goals of FANC. Early booking helps ensure that problems are detected and managed early.2 The first visit gives the opportunity to record information on family, maternal and medical history, carry out a physical examination, request laboratory tests, provide care including intermittent preventive treatment (IPT) for malaria in pregnancy (if beyond first trimester), provide counselling including birth plan, use of insecticide treated bed nets (ITN), HIV counselling and testing and to discuss the schedule for care. The subsequent visits are necessary for noting complaints, targeted physical examination, reviewing test results, providing care including IPT for malaria, obtaining information on use of ITN, birth plans and carrying out HIV counselling. Justification for the study Interventions for pregnant women aim protect the woman and her unborn baby for the remaining period of the pregnancy and their provision should be timely. The later the timing of first visit the shorter the period of cover and the higher the risk of development of problems and complications for the woman and her baby. Thus it is not just important to know the proportion of pregnant women attending ANC, it is also important to know when attendees commence such visits and whether they pay an adequate number of visits. Although a number of studies have documented the timing of first visit and number of visits to ANC in the south-west region of Nigeria, little is known about the pattern in the south eastern region of the country. Additionally, most of the studies are limited in scope as they are facility based (usually tertiary hospital based) and thus reflect experience amongst pregnant women who are able to access such facilities even though primary health centres are the closest to people and usually the only available point of care in rural areas. Aim: This study is aimed at documenting the socio-demographic predictors of timing of ANC booking and subsequent attendance amongst pregnant women in order to understand the impact these can have on deployment of focused antenatal care interventions for pregnant women. Objectives: To determine the timing of booking and pattern of subsequent ANC attendance among pregnant women attending primary level facilities To examine whether the timing of ANC booking and clinic attendance is affected by individual level socio-demographic factors To assess the appropriateness of timing of booking and attendance for effective delivery of focused antenatal care interventions To examine how the findings of the study can impact on the deployment of antenatal care interventions for pregnant women. CHAPTER TWO LITERATURE REVIEW The concept of focused antenatal care is based on the assumption that since every pregnancy faces the risk of development of complications, every pregnant woman should be monitored to avoid development of such complications.2 Lack of antenatal care is known to be a major risk factor for development of negative pregnancy outcomes. However, when antenatal care is appropriately delivered, it has the potential to positively impact on maternal mortality and morbidity.7 Studies have shown that many women obtain care quite late during the pregnancy period and the care obtained is usually inadequate.2 8 9 The first visit for antenatal care in Africa usually takes place around the fourth to fifth month of pregnancy.5 In the African region, 73% of pregnant women aged 15 49 years pay at least one visit to a health care provider for antenatal care while only 44% pay at least four visits.10 A study by Al-Nasser in Saudi Arabia showed that majority (60.8%) of pregnant women attending antenatal clinic in primary health care centres were first seen before the 20th week of gestation.11 Fekede, et al noted that 42.8% of 360 pregnant women in an Ethiopian town attending antenatal clinic did so for the first time within the 3rd trimester while only 6.5% had the recommended minimum of four visits.12 In Nigeria, the figures assessing antenatal care utilization are below the African regional values as 58% of women aged 15-49 years receive ANC from a skilled health provider at least once during pregnancy while 45% of women make four or more visits for ANC.2 10 Based on the 2008 NDHS the median gestational age at booking is 5 months.2 Among 395 women attending antenatal clinic in public and private facilities covering the primary, secondary and tertiary levels of care in Ibadan, southwest Nigeria, 25.8% paid the first visit for antenatal care within the first trimester. Mean gestational age at booking was found to be 18.5 (Â ±6.3) weeks while the mean number of antenatal visits was 4.0 (Â ±2.4).13 A study carried out among 378 pregnant women attending a tertiary hospital in Edo state Nigeria noted that the 6th month of pregnancy as the peak period of first visit for antenatal care among the women.14 Okunlola et al found a mean gestational age at booking of 21.82 (Â ±7.0) weeks wi th only 14.1% of the women paying attending for the first time within the first trimester.6 In a tertiary facility in Osogbo Nigeria, the mean gestational age was found to be 20.3 (Â ±6.2) weeks and 82.6% of those studied booked late.15 Amongst 400 women attending antenatal clinic at a tertiary facility in Ile Ife, Nigeria, 71% had registered by the 20th week of gestation.16 Aluko and Oluwatosin found low rates of first trimester booking and irregular visits for antenatal care among women attending clinics in a mission hospital in Ibadan south west Nigeria.17 Socio-demographic factors and parity have been found to directly influence the timing of first visit for antenatal care though the results are sometimes dissimilar. Most women (79.9%) attending antenatal clinic in a tertiary hospital in Edo state Nigeria were found to have booked late.18 However, there was no significant difference in age, parity, level of education and social class between women booking early and late. In a study carried out among pregnant women attending a the Lagos University Teaching Hospital, Adegbola found a mean gestational age at first booking of 18.5 (Â ±8.3), 18.4 (Â ±7.4) weeks for nulliparous and primiparous women respectively.19 The overall mean gestational age at booking was 19.1(Â ±7.2) weeks. Women with parity 5 booked at significantly higher mean gestational age of 25.9 (Â ±) weeks and women of lower social class tend to book earlier for antenatal care. Similarly Adeyemi, et al found that late booking was thrice as common in multiparous women com pared with the nulliparous group and the difference was significant.20 Other authors have found an association between parity and timing of first visit, and number of antenatal visits.11 21 A number of studies have documented the factors that affect use of ANC amongst women in the developing countries;9 these determinants are also likely to affect the timeliness of attendance for ANC. Chandrashekar, et al found that women who are poor, illiterate, multiparous, unskilled and over 30 years of age were less likely to receive antenatal care in India.22 Age was found to be a significant predictor of ANC attendance in a community based study in Ethiopia where women aged 15-24 years were found 2.75 times more likely to attend than those aged 25-34 years.12 Geographic place of residence can also have an impact as women living in urban areas are more likely to receive antenatal care during pregnancy. Women have also been found to concurrently use multiple antenatal care providers and this can affect the timing of booking in a facility. Adeoye, et al found that 25% and 30.5% of women attending two antenatal care clinics in a tertiary facility in Ebonyi state were concurrently using both formal and informal providers of antenatal care.23 Of 535 women attending a tertiary facility in Enugu Nigeria, 69.5% were booked in more than one facility.24 The time of commencement of ANC visits has implications for the period of protection that pregnant women have from interventions. For example where women attend antenatal care late in pregnancy, they may not receive the recommended 2-3 doses of Intermittent Preventive Treatment (IPT) for malaria in pregnancy using sulphadoxine-pyrimethamine combinations.25 Data from the 2008 National Demographic and Health Survey (NDHS) shows that among 11,027 women aged 15 49 years with a live birth within a period of 2 years preceding the survey, only 8.0% received at least one dose of IPT while 4.9% received 2 or more doses.2 The proportion was 9.9% and 5.4% respectively for the south east region of Nigeria. It is important that pregnant women are available at the appropriate time for delivery of IPT which is best given when the growth of the foetus is occurring at its highest velocity (16th 24th week) as this helps to reduce placental parasitaemia, foetal growth reduction and the resultant low birth weight.26 It is also known that the negative impact of malaria is worse among women with their first and second pregnancies compared to those that have had more than two pregnancies.27-29 Thus primi and secundi-gravidae need to pay their first visit early enough to ensure adequate protection through the pregnancy period. The same consideration holds sway for interventions such as insecticide treated nets for which the potential protective time period depends on how early in pregnancy a woman starts sleeping under the net. All it all, timely attendance to ANC is important to enhance the potential for positive pregnancy outcomes since it provides pregnant women with the opportunity to receive recommended interventions and the protection from problems and complications. Socio-demographic and maternal factors such as parity can affect the timeliness of ANC visits by pregnant women. CHAPTER THREE METHODOLOGY Study area: This study will be carried out in Enugu State, South-East Nigeria. Enugu state comprises of 17 Local Government Areas (LGAs), has a total population of 3,257,298 people and an annual growth rate of 3.0.30 Three of the 17 LGAs (Enugu North, Enugu South and Nsukka) are urban, one (Enugu East) has a mix of urban and rural areas while the remaining 13 LGAs are rural. The people of Enugu are of Igbo ethnicity and are predominantly Christians. A substantial proportion of the working population in the state is engaged in farming, trading, and public service employment. Study site: Two areas will be purposively selected for the study to enable collection of data across for those in both urban and rural areas of the state. These are Udi LGA comprising Udi North and South Development Councils will be used to represent the rural areas while Enugu North and South LGAs will represent the urban areas. Udi has a population of 234,002 while Enugu North and South have a population of 244,852 and 198,723 respectively.30 Udi LGA has 14 primary health facilities that offer ANC services while Enugu North and South (referred to as Enugu) together have 12 primary facilities that offer ANC (appendix 1). Study design: This will be a cross-sectional study involving eliciting of information from pregnant women attending primary health centres for antenatal care through exit interviews using a pre-tested questionnaire. Sampling and sample size: All the primary health care facilities providing ANC in the study LGAs will be used for the study. Since the level of attendance of ANC varies for different facilities, a proportionate method will be used for determining the sample size for each facility. The proportion will be determined by considering the average weekly number of antenatal clinic attendees to the facility relative to the total from all facilities as reported by the heads of the facilities and the relative proportion will be computed. The minimum sample size required for the study is 374. This was determined using the formula for determination of sample size for population proportion,31 an ANC coverage level of 58%,2 a confidence level of 95% and an error margin of 0.05. Z= 1.96 at 95% confidence level, (two-sided). p=ANC coverage = 58% d=margin of error tolerated = 0.05 Considering a potential refusal rate of 10%, 411 women will be sampled. Study tools: Data will be collected using a pre-tested interviewer administered questionnaire (appendix 2) which will be administered by trained field workers. The questionnaire will be pre-tested amongst pregnant women attending ANC at the Primary Health Centre Abakpa, Enugu East LGA which will not be used for the study. Data analysis: Epi Info statistical software will be used for data entry while SPSS and Stata Softwares will be used for data analysis. Data will initially aim to elicit the determinants of timing of booking of ANC. Subsequently, a continuous socio-economic status index will be generated using the principal component analysis technique in STATA software package 32 to enable disaggregation of data into socio-economic quintiles. Information that will be used include households asset holdings including television, radio, refrigerator, car, bicycle, rechargeable lamp, kerosene lamp, electric fan, air conditioner, motorcycle.33 The SES quintiles generated will be used in assessing differences in timing of booking for women of various SES groups. Logistic regression analysis will be employed for examination of the determinants of the timing of booking. Data analysis will also aim to estimate the proportion of women attending at the appropriate time for delivery of recommended interventions . Chi squared test will be used to test for significance of differences observed for categorical data while chi squared for trend test will be employed for ordered categorical data. All tests of significance will be done a p value of 0.05. Ethical considerations: Ethical clearance will be obtained from the Research Ethics Committee of the University of Nigeria Teaching Hospital Enugu, while permission to carry out the study will be obtained from the Primary Health Care Coordinator of the LGAs as well as from the heads of facilities to be used. Written consent will be obtained from patients who are interviewed after they have been informed of the objectives of the study and the voluntary nature of their participation.

Kindred :: essays research papers

Kindred Writing Activity The fire, page 36: â€Å"I could literally smell his sweat, hear every ragged breath, every cry, every cut of the whip. I could see his body jerking, convulsing, straining against the rope as his screaming went on and on. My stomach heaved, and I had to force myself to stay where I was and keep quiet.Why didn’t they stop!† In the middle of the night, four white men storm into a cabin in the woods while four others wait outside. The cabin belongs to Alice and her mom. The four men pull out Alice’s father along with her mom, both are naked. Alice manages to scramble away. The men question Alice’s father about a pass, which allows him to visit his wife. Her father tries to explain the men about the loss of the pass but the men do not pay any attention to him. Instead they tie him to a tree and one of the white man starts to whip him for visiting his wife without the permission of Tom Weylin, the â€Å"owner† of Alice’s father. Tom Weylin forbid him to see his wife, he ordered him to choose a new wife at the plantation, so he could own their children. Since Alice’s mother is a free woman, her babies would be free as well and would be save from slavery. But her freedom â€Å"status† does not stop one of the patroller to punch her in the face and cause her to collaps e to the ground. Meanwhile, you can hear the noise of the whip clutching against the back of Alice’s father. He forces himself to stay quiet under this unbelievable pain and humiliation in front of his family. His face shows the pain and he is sweating but still no sound, until he breaks down and starts to beg for forgiveness. After a while, the white man who happens to be a patroller stops whipping him and with the help of the other patrollers he unties him from the tree and turns him around and ties his hands in front of him.

Free Catcher in the Rye Essays - Holden Runs, be He Cannot Hide :: Catcher Rye Essays

Catcher in the Rye - Holden Runs, be He Cannot Hide While reading Catcher in the Rye, one can easily see that Holden has a certain romantic view about his world. Holden thinks in a particular romantic way about almost everyone and everything. This unusual view upon the world actually hinders Holden rather then helps him throughout the story. By his own actions Holden is harming himself, not necessarily physically. Holden has an idealized view of the world, is introspective, and he celebrates the freedom of his spirit. Holden has a romantic view because he has an idealized outlook of the world. One example is when Holden lies. He knows that this is a vile trait, yet he keeps on doing it. This is a part of Holden's character yet, deep in his heart he loves lying to people. For example, when he was on the train with Mrs. Morrow, he goes way off on a wild story and has difficulty keeping with reality. ` "Rudolf Schmidt," I told her. I didn't feel like giving her my whole life history. Rudolf Schmidt was the name of the janitor of our dorm' (Salinger 54). In the future, this will hinder him because lying can catch you from behind when one least expects it. The way he thinks about people is another part of Holden's idealized view that gets in his way. Most of the time Holden is talking about how everyone is a pretender. This is a bad habit because Holden is pretty much judging the people without even actually having met them most of the time. `Old buddyroos. It was nauseating. The funny part was, they probably met each other once, at some phony party' (Salinger 127). This hinders him a lot because many of the people in this book seem like normal people yet, in Holden's eyes, they seem like the worst of the worst. Many of these people might actually have helped him. Especially in the case of Luce, Holden acted like a baby and this hurt him a lot. The last thing that Holden does, due to his idealized view of the world is quite strange. Holden at some random points in the book, just thinks of a crazy idea.

Timken

The Timken Company Top management of Timken hires you as consultants to perform an independent analysis and recommend the best, in your opinion, course of action in the proposed acquisition of the Torrington Company. Your task is to write a report that will address their questions and concerns, in particular: 1. 2. 3. 4. How does Torrington fit with the Timken Company? What are the expected synergies? What is your stand alone valuation of Torrington? What is your with-synergies valuation of Torrington? Should Timken be concerned about losing its investment-grade rating? How do Timken’s financial ratios compare with those of other industrial firms in 2002? How would those ratios change if Timken financed the acquisition with debt? 5. What is the price Ingersoll-Rand is likely to accept? Is Ingersoll-Rand likely to want a cash deal or a stock-for-stock deal? 6. 7. Should Timken go forward with the acquisition at all? If Timken decides to go forward with the acquisition, how should they structure the deal in terms of the price offered and the method of payment? What is the recommended bidding and negotiation strategy? Draw on as many arguments, methods and approaches as possible. Clearly explain all assumptions or judgements you make. Where applicable, refer to relevant theoretical concepts. Please note that even though this is a real business case, it is the quality of your analysis that will be marked, not how well your analysis and recommendation fit the actual subsequent developments.

American Association for Medical Assistants

AAMA Mission Statement The mission of the American Association of Medical Assistants is to provide the medical assistant professional with education, certification, credential acknowledgment, networking opportunities, scope-of-practice protection, anAAMA/MSMA Code of Ethics & Creed AAMA Medical Assistant Code of Ethics The Code of Ethics of the American Association of Medical Assistants shall set forth principles of ethical and moral conduct as they relate to the medical profession and the particular practice of medical assisting. Members of AAMA dedicated to the conscientious pursuit of their profession, and thus desiring to merit the high regard of the entire medical profession and the respect of the general public which they serve, do pledge themselves to strive always to: ender service with full respect for the dignity of humanity; respect confidential information obtained through employment unless legally authorized or required by responsible performance of duty to divulge such information; uphold the honor and high principles of the profession and accept its disciplines; seek to continually improve the knowledge and skills of medical assistants for the benefit of patients and professional colleagues; participate in additional service activities aimed toward improving the health and well-being of the community. ——————————————————————————- AAMA Medical Assistant Creed I believe in the principles and purposes of the profession of medical assisting. I endeavor to be more effective. I aspire to render greater service. I protect the confidence entrusted to me. I am dedicated to the care and well-being of all people. I am loyal to my employer. I am true to the ethics of my profession. I am strengthened by compassion, courage and faith. AAMA/MSMA Mission Statement AAMA Mission Statement The mission of the American Association of Medical Assistants is to enable medical assisting professionals to enhance and demonstrate the knowledge, skills and professionalism required by employers and patients; protect medical assistants' right to practice; and promote effective, efficient health care delivery through optimal use of multiskilled Certified Medical Assistants (CMAs). AAMA Services Introduction Publications Certification and Recertification Continuing Education Right-to-Practice Monitoring Member Discounts Group Insurance Annual Conference Networking Opportunities Join Now and Start Making a Difference The key to enjoying the advantages of AAMA membership is belonging. Find out how to become a member. The entire enrollment process takes just a few minutes, but you'll reap a lifetime of benefits. Employment of medical assistants is expected to increase much faster than the average for all occupations as the health services industry expands due to technological advances in medicine, and a growing and aging population. It is one of the fastest growing occupations. Your numbers are growing. The demand for your unique expertise is increasing, as are the complexities of your profession. The American Association of Medical Assistants (AAMA) is here to keep you abreast of changes in the health care delivery field, to protect your right to practice, and to help make your job easier. We're growing with you. Thousands of medical assistants join the AAMA each year. The AAMA is the only association in the world devoted exclusively to the medical assisting profession. Since its inception in 1955, membership has expanded to over 325 local chapters, spanning 43 states. AAMA members are your peers and colleagues. They comprise practicing medical assistants, medical assisting educators, students, and others interested in the profession. In addition, scores of physicians serve the AaMA at the chapter, state and national levels. When you join the AAMA you are investing in your career and your future. And, you are strengthening an association that has your professional interests at heart. Publications that Tap the Knowledge of Experts AAMA members automatically receive a subscription to CMA Today, the association's bimonthly publication, which provides educational articles, current medical news, health policy updates, and association happenings. Members also receive discounts on the AAMA's self-study courses, written on topics pertient to medical assisting. Certification and Recertification: To Demonstrate Knowledge of the Profession The AAMA Certifying Board awards the prestigious CMA (AAMA) credential to graduates of CAAHEP- or ABHES-accredited medical assisting programs who have successfully completed the CMA (AAMA) Certification Examination. The examination is administered by the highly respected National Board of Medical Examiners. It is mandatory for a CMA (AAMA) to recertify every 60 months to demonstrate knowledge and keep their CMA (AAMA) current. The recertification requirement can be met by examination or through continuing education. A CMA (AAMA) employed or seeking employment must have current certified status to use the CMA (AAMA) credential in connection with employment. Continuing Education: Strengthen Professional Skills and Advance Knowledge Local chapters and state societies of the AAMA sponsor seminars and workshops on the latest administrative, clinical and management topics. On the national level, AAMA offers CMA Today continuing education articles, conference workshops and self-study courses. All offer the opportunity to earn AAMA continuing education units (CEUs) for recertification credit and professional growth. Right-to-Practice Monitoring The AAMA's legal counsel works diligently to protect the medical assistant's right to practice. Member Discounts Attractive member rates are available for workshop and seminar fees, self-study courses, credit cards, loans, conferences, and more. Group Insurace Members receive special rates for professional liability, life, cancer expense, disability income, catastrophic health care, accidental death and disability insurance. Annual Conference The AAMA conference is packed full of continuing education workshops that carry CEU credit for topics targeting aspects of the profession and appealing to the medical assisting clinician, administrator, manager or educator. Networking Opportunities Participation in the AAMA provides members with the opportunity to share and learn from peers right in their own community and nationwide.