Play is inarguably an important part of human development. Through play, children as young as three years of age learn social skills and values that will form the foundation of their development in to adult life. Children can be excluded from play for many reasons. Any visible or cognitive differences in a child can cause them to be marginalized in playgroups or daycares and later in their development, at school and camps. This makes it difficult for them to experience the types of play that are so important to their healthy development. This thesis examines the existing standards for accessible design, finding the contradictions in the information available, and exposing the gaps of information that make it impossible for designers to create truly inclusive play spaces for children. Collaboration with Camp Trillium, one of the foremost pediatric oncology camp programs in Ontario, will be a useful tool for gaining insight into the healing powers of inclusive play experiences for children. The product of this thesis will be the design of a system for creating inclusive play spaces that will allow children who have been marginalized by disabilities and illness to play freely with others. These fully-inclusive play spaces will aim to foster a new understanding of inclusivity in children; teaching those without distinguishing differences the value of relationships with people of differing challenges, and instilling in marginalized children a sense of self that helps them develop the confidence and social ability to penetrate the boundaries that have been inflicted on them.

Abstract The purpose of this practicum project was to facilitate access to mental health services and those health services that address issues causing emotional distress for new Francophone non English-speaking arrivals in the City of Winnipeg. The objectives were 1) to uncover Francophone mental health and specialized health resources in the city of Winnipeg, 2) to identify barriers, attitudes, and access issues pertaining to Francophone services, 3) to develop a directory of Francophone resources and links for health care professionals and other essential providers, and 4) to develop recommendations for future study and consideration. The project was implemented through telephone interviewing of 24 administrators and direct providers in 19 agencies that provided mental health and specialized health services, as well as refugee and immigration agencies. The study used qualitative methods and a semi-structured survey interview design. Via analysis of the results, the project presents an argument that language barriers are indeed preventing access to care for Francophone immigrants, refugees and international students in the City of Winnipeg. This was widely stated by participants from key organizations that work with this aggregate population on an occasional to a frequent basis. It is also evident that, with use of Bachrach’s Continuity of Care Dimensions/Principles, continuity of care for this population is equally compromised because of language barriers, lack of culturally sensitive providers, and lack of Francophone providers.

The relationship between political environment and health service accessibility (HSA) has not been the focus of any specific studies. The purpose of this ecological study is to address this gap in the literature related to the relationship between political environment and HSA. This relationship will be analyzed with the Kruskal-Wallis test, the Mann-Whitney test, and multiple least-squares regression using political environment measure, level of democracy as defined by the 2011 Economist Intelligence Unit Democracy Index (EIUDI) regime categorization, and HSA indicators (physicians, nurses, and hospital beds per 10,000 people). The level of democracy for each country on the EIUDI is classified by regime type (full democracy, flawed democracy, hybrid regime, and authoritarian regime), using the EIUDI sub-scores that the Economist Intelligence Unit (2011) considers to be the components of democracy (electoral processes and pluralism, functioning of government, political participation, political culture, and civil liberties). Multiple least-squares regression was used to determine the significant relationships among the EIUDI sub-scores and the HSA indicators. Kruskal-Wallis and Mann-Whitney tests detected significant differences in physicians, nurses, and hospital beds densities between different regime types. The Kuskal-Wallis test showed that there were differences in the distributions of physician densities between regime types (χ2 [3, N = 162] = 37.48, p = < .001), in the distributions of nurse densities between regime type (χ2 [3, N = 162] = 35.47, p = < .001), and in the distributions of hospital bed densities between regime type (χ2 [3, N = 159] = 35.31, p = < .001). In all HSA variables, post-hoc Mann-Whitney tests showed significant differences between full democracies and flawed democracies, between full democracies and hybrid regimes, and between full democracies and authoritarian regimes. In all HSA variables, no significant differences were found between hybrid and authoritarian regimes. With multiple least squares regression, the overall models identified the same 2011 EIUDI sub-scores (functioning of government and political participation) as significant for the all of HSA variables, along with region and the interaction between the variables. The regression equations were significant for physician density, adjusted R2 = .551, F(7, 154) = 29.225, p = < .001, nurse density, adjusted R2 = .412, F(7, 154) = 17.090, p = < .001, and hospital bed density, adjusted R2 = .459, F(7, 151) = 20.153, p = < .001. The results from the study and the importance of political issues for nursing are more comprehensively understood by applying the results of the study to the Health Access Livelihood Framework (HALF) developed by Obrist et al. in 2007. The results from this study tested a relational proposition of this framework related to how policies impact HSA. Analyzing the results of this study with the use of this framework allowed for a better realization of the impact that political environment has on HSA. These study findings are of significance to nurses and other health professionals because they examine the political contexts in which citizens access health services, and they help explain the effect political environment has on health. Global health issues are a concern for nurses, and they require nurses to take political action. An initial step for nurses is to understand that global health issues impact everyone across all regions and income levels. In the realization of significant global issues, nurses can take an active role in advocating for solutions to these challenges on a political level. Political engagement is important for nurses living in a globalized world. Nurses can use this information to improve HSA for the people they serve.

Thesis (M.S.)--Auburn University, 2007. / Abstract. Vita. Includes bibliographic references (ℓ. 85-90)

Thesis (M Nursing)--Montana State University--Bozeman, 2008. / Typescript. Chairperson, Graduate Committee: M. Jean Shreffler-Grant Includes bibliographical references (leaves 62-68).

Thesis (Ph. D.)--University of North Texas, Dec., 2009. / Title from title page display. Includes bibliographical references.

Thesis (Ph. D.)--University of Missouri--Columbia, 2000. / "May 2000." Typescript. Vita. Includes bibliographical references (leaves 56-72, 152-166). Also available on the Internet.

Thesis (M.A.)--Ohio University, June, 2005. / Title from PDF t.p. Includes bibliographical references (p. 68-73)

Thesis (Ph. D.)--Florida State University, 2006. / Advisor: C. Aaron McNeece, Florida State University, College of Social Work. Title and description from dissertation home page (viewed June 8, 2006). Document formatted into pages; contains xiv, 131 pages. Includes bibliographical references.

Este estudo analisa os diversos mecanismos adotados pela Central de Marcação de consultas da Secretaria Municipal de Piraí, para operacionalização do complexo regulador municipal, considerado como importante estratégia de regulação do acesso, da circulação e do acompanhamento dos usuários entre os diversos níveis de atenção, tanto na rede própria quanto na privada. A implantação dos complexos reguladores vem sendo fortemente articulada pelo Ministério da Saúde, no sentido de formar uma rede integrada de informações relativas à oferta disponível de serviços e proporcionar maior agilidade no atendimento à população. Os dispositivos utilizados no setor de marcação municipal têm influenciado de forma comprometedora a acessibilidade dos usuários, o que determinou uma reorganização do processo de trabalho, tendo sido adotado recentemente o Sistema de Gerenciamento de Agendas, desenvolvido pelo Ministério da Saúde, o Sisreg, para marcação de consultas e exames de média complexidade da rede hospitalar própria. Este sistema vem se confirmando como um importante instrumento de gestão, o que possibilitará a distribuição equânime dos recursos de saúde para a população com vistas à melhoria do acesso e da integralidade.