Explore the vast range of titles available.

There are fierce debates over the best way to prepare teachers. Some argue that easing entry into teaching is necessary to attract strong candidates, whereas others argue that investing in high quality teacher preparation is the most promising approach. Most agree, however, that we lack a strong research basis for understanding how to prepare teachers. This article is one of the first to estimate the effects of features of teachers' preparation on teachers' value added to student test score performance. Our results indicate variation across preparation programs in the average effectiveness of the teachers they are supplying to New York City schools. In particular, preparation directly linked to practice appears to benefit teachers in their 1st year.

Certified registered nurse anesthetists (CRNAs) are essential providers of anesthesia in the United States, yet rates of burnout are alarmingly high. To further understand burnout among CRNAs, a current synthesis of the literature is warranted. The purpose of this integrative review was to identify and synthesize the prevalence, contributing factors, and associated outcomes of burnout among CRNAs. A systematic search of the PubMed, CINAHL, Scopus, and PsycINFO databases was performed. Quality appraisal was conducted using the Joanna Briggs Institute appraisal tools. A total of 15 studies were included in the review. Overall prevalence of burnout ranged from 12.5% to 72%. Significant contributing factors to burnout include lack of autonomy (n = 7), lack of leadership support (n = 4), moral distress (n = 3), and poor relations with physicians (n = 3). Intention to leave one's primary position (n = 3), decreased job satisfaction (n = 3), and fatigue (n = 1) were associated outcomes of burnout. CRNA burnout is found to have adverse individual and organizational outcomes. Contributing factors to be explored further in the CRNA population include poor CRNA-physician relations, poor CRNA-administration relations, and limited CRNA autonomy.

Primary care nurse practitioner (NP) workforce represents a substantial supply of primary care providers able to meet the demand for care. However, many barriers influence NP practice and care. This study conducted a survey of NPs in New York state to better understand NPs' role, independent practice, and teamwork in primary care organizations. Overall, 278 NPs completed the online survey. Forty-two percent of NPs had their own patient panel. The mean score of the Autonomy and Independent Practice scale was higher than that of the Teamwork scale. These scales were positively correlated, suggesting that NP independent practice may improve teamwork. •Significant proportion of NPs does not have own patient panel.•NPs report higher level of autonomy and independent practice than teamwork.•Higher NP autonomy and independent practice are associated with better teamwork.

COVID-19 has a strong hold on New York City, and it has similar effects on other areas of the country. As COVID-19 strains healthcare systems and the certified registered nurse anesthetists (CRNAs) who work within them, optimization of CRNA organizational climate promotes transformation of care delivery and may positively impact provider and patient outcomes. This article describes one healthcare system's newly refined processes for managing the surge of COVID-19 patients. It also describes the novel contributions of CRNAs to all aspects of care provision from supply and resource management to management of patients in critical care environments, to refinement of intubation and airway management for this patient population. Lessons learned during this pandemic from two facilities within this healthcare system are described. When a healthcare system's culture respects and encourages collaboration and innovation, dynamic changes can be implemented effectively during times of crises. Also, critically helpful is when CRNA organizational climate promotes equal partnerships with physicians, and administration values the CRNA contributions to care. In this case, collaboration of all stakeholders promoted best practices and improved care provision. Lessons learned may be applied to facilities where the COVID-19 surge is occurring.

This article explores the relationship between school contextual factors and teacher retention decisions in New York City. The methodological approach separates the effects of teacher characteristics from school characteristics by modeling the relationship between the assessments of school contextual factors by one set of teachers and the turnover decisions by other teachers in the same school. We find that teachers' perceptions of the school administration has by far the greatest influence on teacher retention decisions. This effect of administration is consistent for first-year teachers and the full sample of teachers and is confirmed by a survey of teachers who have recently left teaching.

We report and describe abundant, well-preserved, parallel-sided, U-shaped spreite burrows (Rhizocorallium) in the upper part of the latest Cretaceous into early Paleocene Ferris Formation of south-central Wyoming's Hanna Basin. Rhizocorallium typically is a component of the widely represented \"Cruziana ichnofacies,\" principally involving benthic marine environments seaward of the intertidal zone in shallow to offshore settings. Traditionally, this Ferris section has been interpreted as coal-bearing, continental deposits formed after full withdrawal of the Western Interior Seaway from eastern Wyoming and adjacent areas. The burrowed strata overlie fossiliferous rocks diagnostic of parts of the Puercan Land Mammal Age, early Paleocene. At time of burrow formation, and for several million years thereafter, the vicinity of the future Hanna Basin remained as an undivided, eastern component of an enormous, greater Green River Basin that encompassed almost all of Wyoming's southern half. The Rhizocorallium-bearing marine strata represent westward expansion of a previously more restricted Western Interior Seaway that persisted through latest Cretaceous time in what is now the western Great Plains. Even though tidal influences may have affected rapidly aggrading fluvial systems far upstream to the west in Montana and Wyoming, we regard actual Paleocene marine inundations to have been uncommon and geologically ephemeral events as far west as the Hanna Basin. Diverse fossil assemblages from strata of the Williston Basin, representing the first five million years of Paleocene time, have led to documentation of fully open, marine conditions as the Cannonball Formation was deposited. Stratigraphic distribution of fossils within the Cannonball shows persistence of the Western Interior Seaway in the northern Western Interior through the Cretaceous, followed by expansion (renamed the \"Cannonball Sea\") during early Paleocene time. Connections of that seaway to the south, however, remain poorly understood because of later Cenozoic massive erosion of any Paleocene rock record that had existed south of the borderland between the Dakotas. No Paleocene localities in southern Wyoming or Colorado have yet yielded assemblages of marine invertebrate body fossils or microfossils as known from the Williston Basin. No verifiable means, therefore, have been recognized to characterize the Paleocene marine record of the Hanna Basin in terms of species uniquely shared with the Cannonball biota. Short-lived, Paleocene seaway excursions into the Hanna Basin may have been: (1) direct and exclusively from the Gulf Coast; (2) solely from the Cannonball Sea, with seaway contiguity east of the emerging Black Hills; or (3) initiated from a more extensive, midcontinental seaway connecting the Arctic Ocean to the Gulf of Mexico. Substantial structural uplift of the Laramie Mountains prior to mid-Paleocene time would have precluded even brief westward pulses of marine inundation into the vicinity of the presumptive Hanna Basin.

States make policy choices about Medicaid eligibility, benefits, and reimbursement rates in the context of the larger state fiscal environment. This paper reviews the factors that made this environment so favorable in the 1990s and examines the state budget outlook. State tax revenue is likely to grow more slowly in this decade than in the last, states will face continued substantial pressures to finance K-12 and higher education, and Medicaid spending has accelerated. States will have to curtail the growth of Medicaid, raise revenue, or constrain growth in education spending to maintain balanced budgets. While this is not a scenario for doom and gloom, it does suggest that state finances will be constrained tightly over the next several years even if the economy recovers well from the recession.

Certified Registered Nurse Anesthetists (CRNAs) deliver anesthesia to more than 34 million patients per year in the United States in both inpatient and outpatient settings. Yet CRNA working conditions and workforce outcomes have not been well investigated in the literature. For a deeper understanding of both issues, a review of the literature was conducted. Following specific inclusion criteria, peer-reviewed research articles published from 2001 to 2015 were included. Data were abstracted from 13 studies and were synthesized. Four themes emerged: communication and collaboration; professional identity and autonomy; work relations issues experienced by CRNAs, who practice in a variety of healthcare settings; and CRNA outcomes. Regarding the latter, job dissatisfaction, occupational stress, incivility, burnout, workplace aggression, and intent to leave were prevalent CRNA outcomes. Future rigorous research should focus on CRNA working conditions that could be changed to diminish negative CRNA outcomes. Positive CRNA workforce outcomes in turn could have financial, access-to-care, and quality-of-care implications for organizations where CRNAs practice. Policy makers, organizations, CRNAs, and the patients and families CRNAs serve would benefit from such research.Certified Registered Nurse Anesthetists (CRNAs) deliver anesthesia to more than 34 million patients per year in the United States in both inpatient and outpatient settings. Yet CRNA working conditions and workforce outcomes have not been well investigated in the literature. For a deeper understanding of both issues, a review of the literature was conducted. Following specific inclusion criteria, peer-reviewed research articles published from 2001 to 2015 were included. Data were abstracted from 13 studies and were synthesized. Four themes emerged: communication and collaboration; professional identity and autonomy; work relations issues experienced by CRNAs, who practice in a variety of healthcare settings; and CRNA outcomes. Regarding the latter, job dissatisfaction, occupational stress, incivility, burnout, workplace aggression, and intent to leave were prevalent CRNA outcomes. Future rigorous research should focus on CRNA working conditions that could be changed to diminish negative CRNA outcomes. Positive CRNA workforce outcomes in turn could have financial, access-to-care, and quality-of-care implications for organizations where CRNAs practice. Policy makers, organizations, CRNAs, and the patients and families CRNAs serve would benefit from such research.

Approximately 40,000 certified registered nurse anesthetists (CRNAs) are included in the anesthesia workforce in the United States. They provide a critical portion of anesthesia care throughout the country often practicing in rural and underserved areas of America. CRNAs are educated and trained to provide high-quality, cost-effective care for patients. Policy makers and health care organizations consistently call for policies to enable these providers to deliver care to the full extent of their education and training. The National Academy of Medicine (former Institute of Medicine) recommends in their seminal report, The Future of Nursing: Leading Change, Advancing Health, that CRNAs practice to their full potential as full partners with physicians. In order to promote CRNA ability to practice to the full extent of their training and education and assure that patients have access to safe anesthesia services, both policy and organizational influences on their care provision and should be taken into account. Whereas focus has been paid to policy restrictions and their influence on CRNA care, little is known about organizational influences on CRNA care or organizational structures that are present in the employment settings of CRNAs. Organizational climate, which is employees’ perceptions of and experience with organizational structures within their employment settings, has been studied in healthcare settings. Studying organizational climate in healthcare settings is important because research concludes that organizational climate of healthcare settings impacts providers and patients. Registered nurse (RN) organizational climate has been well studied, and researchers identified that important aspects of RN organizational climate include autonomy, control over practice, teamwork, and collaborative relationships with physicians and staff. When RN organizational climate is favorable, job satisfaction and nurse retention improve, and patients receive high-quality care. Researchers have also studied nurse practitioner (NP) organizational climate and have identified climate characteristics that enable NPs to function to their full capacity, while promoting job retention, decreasing costs, and improving access to care. Whereas evidence is clear that organizational climate is an important concept to study within healthcare organizations, little is known about CRNA organizational climate or how it impacts CRNA outcomes or patient outcomes, nor do we know how to measure organizational climate and further asses it. Therefore, this dissertation investigates CRNA organizational climate and adapts a tool to measure CRNA organizational climate. In Chapter 1 , a background on CRNA contributions to anesthesia care in the United States is presented. In addition, challenges and restrictions affecting CRNA practice are discussed, and studying the concept of CRNA organizational climate is introduced. The theoretical and empirical underpinnings guiding the dissertation are presented, and the three aims of the dissertation are stated. In Chapter 2, aim one of the dissertation is addressed. Aim one of the dissertation is achieved by systematically reviewing and synthesizing evidence regarding CRNA working conditions and outcomes. This evidence lays the foundation for studying CRNA organizational climate. In Chapter 3, aim two of the dissertation is addressed. This aim is achieved by selecting an instrument to adapt to measure CRNA organizational climate. In this chapter, the processes of content validity testing and reliability testing of the Certified Registered Nurse Anesthetist Organizational Climate Questionnaire (CRNA-OCQ), the adapted instrument to measure CRNA organizational climate, are presented. In Chapter 4, aim three of the dissertation is addressed. This aim is achieved by the further psychometric testing of the CRNA-OCQ, which is presented in this chapter. In this chapter, the CRNA-OCQ is refined and finalized through conducting exploratory factor analysis. In addition, the internal consistency reliability of CRNA-OCQ subscales is assessed. In Chapter 5, results from the three included studies are discussed and synthesized. In addition, practice, policy, and research recommendations are presented. Lastly, the strengths and limitations of the dissertation are discussed before the conclusion.

Understanding what makes an effective teacher, as well as how teachers sort by their effectiveness across schools, is central to understanding and addressing student achievement gaps. Prior studies have found substantial sorting of teachers across schools, with the schools with the highest proportions of poor, non-white, and low-scoring students having the least qualified teachers as measured by certification, exam performance, and inexperience. Yet there have been substantial changes in the educational policy landscape over the past five years. In this paper, the authors examine these changes, asking how the distribution of teachers has changed in recent years and what the implications of these changes are for students. The authors address these questions using data on New York City teachers, students, and schools. While the findings may be specific to New York City, they may mirror changes in other large urban districts, many of which have seen similar policy changes over the past decade. The authors find that measurable characteristics of teachers are more equal across schools in 2005 than they were in 2000. Schools with large proportions of poor students and students of color, on average, have teachers whose observable qualifications are much stronger than they were five years ago. Nonetheless, a meaningful number of schools with large proportions of poor students did not demonstrate such improvement. The authors find that changes in these observed qualifications of teachers account for a modest improvement in the average achievement of students in the poorest schools. More important, the results suggest that recruiting teachers with stronger observed qualifications--for example, math SAT scores or certification status--could substantially improve student achievement. (Contains 6 tables, 9 figures, and 9 footnotes.)