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AimTo report the development and psychometric evaluation of a scale to measure rural and remote (rural/remote) nurses’ perceptions of the engagement of their workplaces in key dimensions of primary health care (PHC).BackgroundAmidst ongoing PHC reforms, a comprehensive instrument is needed to evaluate the degree to which rural/remote health care settings are involved in the key dimensions that characterize PHC delivery, particularly from the perspective of professionals delivering care.MethodsThis study followed a three-phase process of instrument development and psychometric evaluation. A literature review and expert consultation informed instrument development in the first phase, followed by an iterative process of content evaluation in the second phase. In the final phase, a pilot survey was undertaken and item discrimination analysis employed to evaluate the internal consistency reliability of each subscale in the preliminary 60-item Primary Health Care Engagement (PHCE) Scale. The 60-item scale was subsequently refined to a 40-item instrument.FindingsThe pilot survey sample included 89 nurses in current practice who had experience in rural/remote practice settings. Participants completed either a web-based or paper survey from September to December, 2013. Following item discrimination analysis, the 60-item instrument was refined to a 40-item PHCE Scale consisting of 10 subscales, each including three to five items. Alpha estimates of the 10 refined subscales ranged from 0.61 to 0.83, with seven of the subscales demonstrating acceptable reliability (α⩾0.70). The refined 40-item instrument exhibited good internal consistency reliability (α=0.91). The 40-item PHCE Scale may be considered for use in future studies regardless of locale, to measure the extent to which health care professionals perceive their workplaces to be engaged in key dimensions of PHC. [ABSTRACT FROM PUBLISHER]

Some previous studies have shown that the availability of orthographic information leads to positive effects for second language (L2) phonology, while others document negative effects. In this paper, we examine the role of orthography on novel spoken-word learning by comparing word pairs that differed in most or all of their segments (nonminimal pairs) and those that only differed in one phoneme (minimal pairs) that was considered easy or difficult to discriminate. We tested the performance of learners whose native languages have transparent orthographies as well as learners with opaque orthographies. Our findings show that regardless of linguistic background and native orthographic system, availability of orthographic information during word learning did not have an effect on nonminimal pairs or perceptually easy minimal pairs. However, it had a positive effect on two minimal pairs that had the highest accuracy among the seven perceptually difficult ones, indicating that orthography only helped contrasts that were relatively easy to discriminate. The implications of these findings for L2 teaching and for future directions within L2 phonology are discussed. [ABSTRACT FROM AUTHOR]