Since its inception, cardiac rehabilitation has been effective at reducing risk factors for cardiovascular disease, improving quality of life, and decreasing morbidity and mortality rates. While women benefit as much as men from the therapeutic effects of cardiac rehabilitation, a disparity exists between referral, participation, and completion rates between men and women. The intent of this thesis was to examine recent literature to determine if those disparities still exist, to identify barriers that prevent women from participating, and to determine the role of the nurse in the promotion of cardiac rehabilitation among women. Current literature reveals that women are often older, single, financially unstable, less physically active, and diagnosed with more co-morbidities at the time of their first cardiac event. Women often lack strong physician referral and support, education about cardiac rehabilitation programs, and motivation to attend programs. Evidence gathered from current literature suggests that gender is not the primary reason for the disparity between cardiac rehabilitation participation rates among men and women, but rather the disparity exist~ because of the characteristics of these older women at the time of their first cardiac event. The nurse is the vital component to increasing cardiac rehabilitation participation rates among women. The nurse must serve as a patient advocate- providing information and structure to the referral process, as an educator- teaching women the benefits and safety of cardiac rehabilitation, and as social support- providing women with encouragement and follow-up during a frightening and life-changing experience.

Yes / In the modern business era, mobile commerce (m-commerce) is changing the way the business is conducted using the Internet. However, the prominence of m-commerce among small and medium-sized enterprises (SMEs) in the UK is minimal. The purpose of this study is to evaluate the existing literature and to extend the research surrounding the barriers that prevent the adoption of m-commerce amongst SMEs. The study uses an Interpretive Structural Modelling (ISM) and MICMAC approach for guiding and helping managers of SMEs. Data was collected from an expert participant group each of whom had extensive knowledge of m-commerce. The findings represent the unstable nature of variables in the context of their impact on each other, their relationships, and themselves. The listed factors in the proposed framework and the interrelationships between them highlight the multi-dimensional element of m-commerce adoption prevention. This observation proves criticality of analysing data as a collective entity rather than viewing the barriers in isolation. The findings also indicated ‘perceived risk’ being a key barrier that demonstrates how personal opinions of the concept of adoption can have a great significance on the outcome and whether other variables will come into effect.

no

Yes / Objective To explore the barriers/facilitators to deprescribing in primary care in England from the perspectives of clinicians, patients living with frailty who reside at home, and their informal carers, drawing on the Theoretical Domains Framework to identify behavioural components associated with barriers/facilitators of the process. Design Exploratory qualitative study. Setting General practice (primary care) in England. Participants 9 patients aged 65+ living with frailty who attended a consultation to reduce or stop a medicine/s. 3 informal carers of patients living with frailty. 14 primary care clinicians including general practitioners, practice pharmacists and advanced nurse practitioners. Methods Qualitative semistructured interviews took place with patients living with frailty, their informal carers and clinicians. Patients (n=9) and informal carers (n=3) were interviewed two times: immediately after deprescribing and 5/6 weeks later. Clinicians (n=14) were interviewed once. In total, 38 interviews were undertaken. Framework analysis was applied to manage and analyse the data. Results 6 themes associated with facilitators and barriers to deprescribing were generated, respectively, with each supported by between two and three subthemes. Identified facilitators of deprescribing with patients living with frailty included shared decision-making, gradual introduction of the topic, clear communication of the topic to the patient and multidisciplinary working. Identified barriers of deprescribing included consultation constraints, patients' fear of negative consequences and inaccessible terminology and information. Conclusions This paper offers timely insight into the barriers and facilitators to deprescribing for patients living with frailty within the context of primary care in England. As deprescribing continues to grow in national and international significance, it is important that future deprescribing interventions acknowledge the current barriers and facilitators and their associated behavioural components experienced by clinicians, patients living with frailty and their informal carers to improve the safety and effectiveness of the process.

Research has extensively documented the mental health disparities that exist for ethnic and racial minorities living in the United States. With respect to Latinos, such disparities are marked by less access to care and poorer quality of mental health treatment. Studies on Latino mental health have found differences in mental health service utilization among ethnic subgroups and among different generations of Latinos. However, empirical data examining specific attitudes and barriers to mental health treatment among different generations of Latinos are limited. This study explored the relationships between Latino generational status, mental health service utilization, psychological distress, and barriers to mental health treatment. An online survey (N = 218) included samples of first-generation (n = 67), second-generation (n = 86), and third-generation or beyond Latinos (n = 65). Results indicated first-generation Latinos had the lowest rate of mental health service utilization and reported greater linguistic and structural knowledge barriers, however, they had lower perceived social stigma of mental health services when age at migration was considered. Implications of these findings for research, mental health service providers and mental health policy are discussed.

The theme of the MTh is the research of the Christian political responsibility in terms of an evangelical position. The first step is to examine the historical political background of evangelical engagements, whereas the focus is especially on the German development. The second step analyses theologically where to locate political and social barriers. It creates an overview in what way (or to what extend) the bible shows and discusses socio-political topics. Furthermore the theological base for political actions describes (themetizes) the relation between the (institution) church and the (governing) state, the understanding of salvation and God’s kingdom and also questions of eschatology. Ahead of the evangelical approach of political theology, the last chapter describes the difference from liberation theology and models of contextual theology. / Missiology / M. Th. (Missiology)

Syfte: Syftet med denna studie var att undersöka sjuksköterskors upplevelser av bemötande, kommunikationen och omvårdnad kring patienter vars språk inte hanteras av sjuksköterskan. Metod: En deskriptiv intervjustudie genomfördes med sju sjuksköterskor på kirurgiska vårdavdelningar på ett universitetssjukhus för att kunna beskriva sjuksköterskors upplevelser som svarade på studiens syfte. Materialet analyserades deduktivt i enlighet med Graneheim& Lundmans kvalitativa innehållsanalys (2004). Resultat: Respondenterna upplevde att kommunikationssvårigheter beroende på språkliga skillnader ofta leder till problem efter första mötet med patienten, som information kring vården som bedrivs, utförande av omvårdnadsåtgärder och patientens möjlighet att delta i sin egen vård. Slutsats: Sjuksköterskor upplevde att omvårdnaden kring patienter som de ej delar språk med påverkas negativt, patientdelaktigheten och autonomin kränks och att en mer generös rutin kring tolkanvändning behövs. Det förekommer dock att en kreativ inställning påverkar förmågan att kommunicera positivt. / Purpose: To investigate nurses' experiences of how communication influence the nursepatient relationship, care and nursing with a patient whose languageisn’t handled by the nurse. Method: A descriptive interview study was performed on seven nurses in the surgical care units on a university hospital to describe nursesexperiences to answer the purpose of the study in detail. The material was analyzed deductively according to Graneheim&Lundmans qualitative content analysis (2004). Results: Respondents urged that communication difficulties due to language differences often lead to problems after the first meeting with the patient, as information on health care conducted, the performance of nursing interventions and patient the opportunity to participate in their own care. Conclusion: Nurses experienced that care about the patientsthey do not share the language with to be negatively affected, patient participation and autonomy was violated and that a more generous routine with interpreters is needed. There is however, that a creative approach affects the ability to communicate positively.

Magister Educationis (Adult Learning and Global Change) - MEd(AL) / This study investigates “why adults participate in learning activities” and “what barriers deter adults from participating in learning activities.” Learning activities can include informal learning initiatives and formal education programmes. According to Larson and Milana (2006) “the question of why some people participates in adult education and training while others don’t thus” (p. 2) is as relevant and urgent as ever as we want to make lifelong learning accessible for everybody. While working at a Community College in the Western Cape (South Africa), for the period October 2007 until June 2010, I have observed and noticed that many of the learners who entered the different programmes were all of a certain age. Many of them experienced an excess of barriers deterring them from participation in learning. For the purpose of this study, I am going to use the Chain-of-Response (COR) Model by Cross (1981a) to investigate specifically the situational barriers affecting those learners. Cross (1981a) developed the COR model. The rationale behind it was to better understand what urges people to participate in higher education or learning institutions. This model can be seen as cyclic, and involves seven steps developed by Cross (1981a) which have different impacts on the decision-making process of whether to enter or participate and persist in an adult learning course. Cross (1981a) argues that “an adult’s participation in a learning activity is not an isolated act but is the result of a complex chain of responses based on the evaluation of the position of the individual in their environment” (p. 36). Responses leading to participation tend to originate within the individual, as opposed to outside forces; it can either encourage or discourage participation in learning.

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