Background: Human Immunodeficiency Virus (HIV) disproportionately affects certain populations, specifically those passing through correctional facilities. It is estimated that about 1.4% of the approximately two million people residing in correctional facilities are living with HIV. Although the health services offered in correctional facilities are limited, health status may improve substantially for individuals during their placement. Often this progress is lost once a person is released back into the community. Lack of access to care and/or financial assistance inhibits the ability to make health a priority, especially when individuals are faced with the struggle to obtain basic needs such as food, shelter, housing, and employment. This population also bears an unequal burden of non-HIV health conditions. Of those individuals currently incarcerated in the state of Georgia, 1.6% are HIV positive, 26% suffer from chronic illness, 52% have mental health issues, and 25% have reported using drugs or alcohol. In an effort to provide support for this population, Georgia State University partnered with Georgia Department of Corrections Pre-Release Planning Program (PRPP) to establish the Community Connections (CC) Program in 2009. CC program was designed to connect participants with resources that assist with successful reintegration into the community. Exit interviews were conducted with individuals after their participation, and were used to gather information about post-release challenges and outcomes associated with the CC Program. This qualitative study used these interviews to analyze the specific health-related challenges experienced by CC participants. The results from this analysis were used to provide recommendations for further improvements that address the needs of former inmates living with HIV at the policy level. Methods: This study analyzed a set of 16 in-depth, semi-structured interviews with individuals that participated in the post-release CC program during 2010 to 2012. These participants were recruited via convenience sampling, and informed consent was obtained prior to each interview. Interview questions were focused around topics pertaining to housing, employment, risk behaviors, sexual activity, social interactions, HIV care, mental health, substance abuse, and access to medication or treatment. A modified grounded theory approach was used in the analysis. Interviews were openly coded for words and phrases that pertained to health status. The results were used to determine the most pressing health-related challenges associated with this population, and to provide recommendations at the policy level for addressing such issues. Results: Commonly reported co-occurring conditions from this study were as follows: high blood pressure, epilepsy, high cholesterol, anemia, insomnia, arrhythmia, migraines, kidney disease, neuropathy, blood clots, and diabetes. Depression was the most frequently reported mental illness, followed by bipolar disorder and schizophrenia. Over half of participants reported using drugs or alcohol before, during, or following incarceration. Additional barriers to maintaining positive health outcomes included lack of medical insurance or financial assistance, the need for oral health care, and frequent hospitalization. Conclusions: Findings illustrate the need for policy-level changes that specifically address post-release challenges for former inmates, and aim to improve health-related outcomes for this population. Linking this population to services that provide basic needs such as housing and employment would enable them to focus on maintaining their health status. Further, linking this population to insurance or other forms of financial assistance immediately following release is crucial to avoiding gaps in healthcare and treatment relapse. In the state of Georgia, expanding Medicaid to make former inmates eligible would provide a major source of relief for some of these issues. Policy-level changes will not only benefit the individual, but the community as a whole by improving overall health outcomes, reducing the spread of diseases, preventing the occurrence of relapse, and reducing the likelihood of recidivism attributable to illness.

This study involves an exploration of the perceptions of four overseas Kenyan students about their educational experiences at La Trobe University. A related aim of this research is to find out how these four students� previous learning in Kenya affects their learning and living experiences in Australia, for instance, in terms of demands associated with differences in learning and teaching styles, cultural expectations and proficiencies in English. A non-positivist, qualitative methodology is adopted for this research which employs an interview-based case study approach. Qualitative research demands that the world be approached with the assumption that nothing is trivial and that everything has the potential of being a clue which might unlock more comprehensive understanding of what is being researched. While the findings of this study confirm current understandings of the issues that international students commonly face, they also provide a more complex and individualized picture of the needs and aspirations of overseas Kenyan students. As the case studies demonstrate, the academic and related challenges four Kenyan students have encountered at La Trobe University are best understood in relation to several contexts. The difficulties these international students have experienced in the context of transition or border crossing � between two countries, cultures and educational systems � were exacerbated by inadequate pre-departure preparation and orientation on arrival. Incongruities between two educational systems � in particular between their prior teacher-centred schooling in Kenya and the unfamiliar student-centred university education in Australia � colour the academic and related challenges such students struggle to address, at least in their initial year at University. The broader, global context of the commodification and marketization of higher education � along with increasing strains of an under-resourced university sector in Australia � also impinge upon the lives of these four La Trobe students, in a variety of ways.

Magister Educationis (Adult Learning and Global Change) - MEd(AL) / This study analyses the challenges faced by adult educators in reducing illiteracy among adult above twenty years of age in the Eastern Cape. The focal point is on ascertaining why there is an increase in the percentage of illiteracy in the province despite a slight decrease in other provinces. Most importantly is the determination of the significant role played by adult educators. A qualitative approach is employed to pursue the aims of the study. Data is collected using semi-structured interviews. The study has shown that lack of monitoring and supervision by ABET administrators, lack of resources for skills development and language of instruction, all contribute to the increase in illiteracy rate in the Province. For administrators of adult learning programmes it is suggested that they become more familiar with operations at Adult Learning Centres and provide training including technical where appropriate. Designers of curriculum should select curriculum resources appropriate to adult learners. Providers of direct support to adult learners should ensure that training is provided on an ongoing basis. This training should focus on teaching methods and learning approaches (pedagogy) as well as the effective use of ABET learning and teaching guides. / South Africa

Submitted in partial fulfillment of the requirements for the degree of Master of Education in the Department of Educational Psychology, University of Zululand, 1999. / The two major employers in South Africa are the government and the commercial sector. Owing to problems faced by government, jobs in the public sector are shrinking and this makes the commercial sector the only potential employer. Most jobs in the commercial sector are in the field of Economics and this poses a challenge on Economics teachers. They are faced with a challenge of teaching Economics affectively and meaningfully so that learners are made aware of the careers and job opportunities in the field of Economics. Much then can be done by the Economics teacher to help learners towards embarking on a career in the field of Economics. Research with regard to this study will be conducted as follows: * A literature study of available literature will be done. * An empirical study comprising a structured questionnaire to be completed by Economics teachers of high schools. A Likert-rype scale questionnaire with these response categories, namely Agree, Uncertain and Disagree, was constructed. Fifty respondents representing Economics teachers were randomly selected from 16 high schools in Umlazi. The data was in the form of a response to one of the three response categories (Agree, Uncertain, Disagree). Scores of the responses to each of the three categories were calculated. The descriptive technique was employed for the quantitative analysis of data. This investigation has the value that it will provide an image of Economics teachers' perceptions of motivational challenges facing them as Economics teachers. Certain recommendations have been made. The aim of these recommendations to encourage the Economics teachers to improve the teaching of Economics schools by: * Subject enhancement programmes for Economies * Regular educational audit * Further research

In this study, I aim to understand business responses to social-ecological grand challenges. Prior research has suggested that problem identification and attribution help to foster meaning and action on societal issues. In particular, framing theory has offered significant insight into individual actors' cognitive processes, their skillful articulation of socially resonant interpretive frames, and the role of particular actor categories and repertoires in framing success. At meso and macro levels, researchers have tended to focus on social movements and the outcomes of highly charged political contests between these groups and state actors. As such, we know far less about the co-creative mechanisms and contextual ‘raw materials' that underpin meaning making activities and interaction between groups, especially in instances where the focus is on firms and the significance being attached to ambiguous societal issues for which they are not directly responsible. A key outstanding question is therefore: how do firm-internal agents interpret, signify and mobilize organizational responses to grand challenges? In an effort to address these lacunae, this study explores the proactive efforts of three firms to interpret the complexity of social-ecological grand challenges that they share with the rest of society and to address these issues through meaningful and mitigating action. My inductively derived theoretical model of ‘interactional framing for issue advancement' shows how the active engagement of external influences by internal change or ‘signifying agents' facilitates action on grand challenges within and beyond the firm. While framing activities charge grand challenge issues with meaning and help to organize actors' understanding of, experience, and action around these issues, material affordances and interaction with external actors provide the enabling environment for resonant interpretations to take hold and to facilitate enactment. Grounded in my cases, the model also depicts the progressive sequencing of signifying agent efforts across three broad stages: Introduction and Disruption, Experimentation, and Enactment. My analysis contributes to the management literature by suggesting that the signification work of firm-internal agents is a process of mediation, shaped by the distinct and emergent character of grand challenges and the interplay of social and material mechanisms. Because such issues require a greater emphasis on problem-solving and novel sources of information, my account contrasts with conventional representations of meaning-making as a relatively straightforward line of action from individual logics ‘pulled down' from institutional systems and packaged attractively to appeal to ‘outsiders' less involved in the processes of signification. It also provides an alternative to the popular view of meaning construction as a ‘contest' or essentially dispute-oriented process. Instead, I argue that grand challenge issue advancement demands a more intricate, interactional and contextual process of meaning-making by interested actors and issue proponents internal and external to the firm. The model of signification work I offer in this study thus more fully captures the perspective that actors do not simply assess and attach importance to complex issues, but construct the very nature of the issue itself, and that this construction is a precursor to collaborative action on grand challenges.

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Many military children face obstacles during their lives, and these obstacles can affect their classroom environment due to their mobility, social-emotional behavior, and academics. The purpose of this study was to identify challenges, if any, that teachers indicate exist while educating military-connected students in public schools and teacher actions to address any challenges. Existing literature on military connected students and teacher perceptions of military-connected challenges was reviewed. This study examined teacher perceptions of the challenges, responses to challenges and training these teachers experienced while teaching military-connected students. A Likert-type survey of questions was administered through an online survey tool to elementary school teachers in two public school divisions in Virginia. The survey instrument was developed by Mittleberg (2014). After collecting the data, the researcher examined and analyzed data based on the survey responses. The following research questions were addressed: What challenges do teachers identify related to educating military-connected students? What practices do teachers use to address the perceived challenges? What do teachers indicate as their level of training to teach military-connected students? The study concluded with eight findings and eight implications. The findings provided teachers with the tools necessary to address the needs of military-connected students as well as provided schools and school divisions with information that could impact their professional learning decisions. Findings included but were not limited to how teachers perceived that assessment of students' background knowledge was a challenge when teaching military-connected students, how filling in students' knowledge gaps was a challenge, and how adjustment to students leaving and arriving at various times during the school year were a challenge when teaching military-connected students. A few implications were, school leaders should investigate ways to assist teachers in assessing students' background knowledge. It should be a consideration that personnel be provided with resources to help focus on meeting the needs of the students who have knowledge gaps and the development of a handbook of team building and getting to know you resources should be given to teachers to assist in building a strong classroom environment. / Doctor of Education / There are many public school divisions in the United States that service military-connected students. Of the 132 school divisions in the Commonwealth of Virginia, there is at least one military-connected student in each school division. According to Wykes (2015), Virginia is one of the top 10 states for military presence with 10% (Wykes, 2015, p. 23). Teachers in these school divisions face perceived challenges that need to be addressed. Some of those challenges include mobility, academics, and the social-emotional well-being of the military- connected student. This quantitative study focused on the perceived challenges public school teachers face when teaching military-connected students. Data were collected using a Likert-type survey with participants from two school divisions who service military-connected students. There were limitations in this study beyond the researcher's control such as the accuracy and honesty by the respondents and response rate. This study produced eight findings and eight implications. Of the eight findings, three were teachers perceived the adjustment to students leaving and arriving at various times, having a routine in place when new military-connected students arrive into the classroom after the start of the school year, and receiving the level of training needed to prepare them to support parents/guardians of military connected students in their classroom were a challenge. A few of the implications included, the need for teacher preparation programs to address the challenges military connected students face, the development of a handbook of team building activities for teachers to use in the classroom as a resource and the need for resources that could focus on meeting the needs of students' knowledge gaps to support those military connected students.

No / The challenges associated with patient-based research in palliative care are well documented. This paper focuses on the ethical challenges and discusses them in the context of a pilot study to explore the palliative-care needs of patients with moderate and severe chronic obstructive pulmonary disease. The main ethical challenge encountered related to problems surrounding the use of terminology, specifically the terms ‘palliative care’ and ‘chronic obstructive pulmonary disease’. The approving ethics committee specified that these terms be removed from all patient materials in order to protect patients from undue distress. The impact of this ethical advice on patients’ ability to give fully informed consent is discussed. This paper highlights a requirement for appropriately resourced and well-managed studies in palliative care, and identifies a need for the development of appropriate strategies in order to ensure the informed participation of patients with non-cancer diagnoses in palliative-care research.

Purpose - The purpose of this study is to investigate how the challenges of Internet of Things that manufacturers can influence can be overcome. Theoretical foundation - This study conducted an extensive literature review to identify and understand the challenges to Internet of Things and actions to overcome them. 11 technical challenges, 13 organisational and 6 resource availability challenges were identified. 4 actions were identified. Method - To fulfil the purpose, an embedded multiple case study at a global Aerospace manufacturer was conducted. 7 unstructured interviews, 12 semi-structured interviews and a survey were conducted. Respondents were picked due to their experience in Internet of Things projects and relevant technologies. The survey was conducted to evaluate the challenges’ relevance to high-technology manufacturers, on a 7-point Likert scale. The semi-structured interviews aimed to find actions to overcoming the challenges relevant to high-technology manufacturers. Findings - The evaluation of the challenges relevance to high-technology manufacturers resulted in 10 common, 9 occasional and 2 uncommon challenges. 12 actions to overcoming the challenges and their tasks were identified. Theoretical contribution - The study provides a comprehensive list of potential challenges to Internet of Things. It evaluated the challenges’ impact on high-technology manufacturers, thus challenging and validating Internet of Things challenges presented in literature. It provides a set of actions and a framework which aids in overcoming challenges that impact high-technology manufacturers’ Internet of Things initiatives, thus contributing to digital change management. Finally, it aids in the progress towards concretising Industry 4.0 and its trends toward connectivity, intelligence, and flexible automation. Practical contribution - The study provides an increased understanding of potential challenges of Internet of Things, and recommendations to how high-technology manufacturer can overcome the challenges. A framework is provided which gives an overview of which actions, and subsequent tasks, to take to overcome a specific challenge.

Background: This thesis focuses on the incidence and remission of reported food hypersensitivity in schoolchildren followed from 8 to 12 -years of age and the prevalence of hypersensitivity to milk, egg, cod and wheat among 12-year olds investigated by reported data, clinical investigation and double-blind placebo-controlled food challenges and biomarkers. Methods: The studies are mainly based on a population based cohort recruited in 2006 from three municipalities in Northern Sweden. All children in first and second grade, aged 7-8 years, were invited to a parental questionnaire study and 2585 (96% of invited) participated. The children in two of the municipalities were also invited to a skin prick test with airborne allergens. At age 11-12 years, there was a follow-up of the cohort using the same methods, with the addition of a child interview and assessment of body mass index (BMI). At the follow-up, children who reported milk hypersensitivity were invited to structured interviews and children reporting complete elimination of milk, egg, cod or wheat due to perceived hypersensitivity were invited to a clinical examination and blood sampling. According to test results, the children were categorized into different food hypersensitivity phenotypes according to preset criteria. Children categorized as current food allergy were then invited to further evaluation with a double-blind placebo-controlled food-challenge using newly developed recipes. Before their use, the recipes were successfully validated regarding detectable sensorial differences between the active and placebo substances in a separate cohort of healthy schoolchildren (n=275). Before and after the challenge series blood samples were collected for analyses of cytokine mRNA expression in peripheral blood mononuclear cells including hallmark cytokines for the humoral allergy-promoting T helper (Th) 2 response, cellular cytotoxicity-promoting Th1 response, inflammatory-, and T regulatory responses. Fecal inflammatory biomarkers were also analyzed before and after the challenge series. Results: Reported food hypersensitivity increased from 21% at age 7-8 years to 26% at 11-12 years. There was a high incidence (15%) as well as a high remission (33%) of reported food hypersensitivity. Risk factors associated with incidence and remission were different for milk hypersensitivity and hypersensitivity to foods other than milk. The agreement between reported symptoms to milk, egg, cod, wheat, soy and peanut and sensitization to the culprit food was poor. At 11 to 12-years of age the prevalence of reported allergy to milk, egg, cod or wheat was 4.8% while the allergy prevalence according to clinical evaluation was 1.4%. This figure was further halved when evaluated with double-blind placebo-controlled food challenges. The majority of children with reported allergy to milk, egg, cod and wheat were categorized as other food hypersensitivity phenotypes, the most common being probable lactose intolerance (40%) and outgrown food allergy (19%). Even though reported milk hypersensitivity among the 11-12 year olds was 14.5%, only 3% were categorized as current milk allergy. Current and outgrown milk allergy was associated with other atopic disorders and a lower BMI (OR 0.8, 95% CI 0.80-0.98). Before the challenge series, the mRNA expression of the cytokines IL-13 and IL-10 were higher among children with a positive compared to a negative challenge outcome. Conclusion: Reported food hypersensitivity was common among school children in Northern Sweden and increased from 7-8 years to 11-12 years of age, and both the incidence and remission of reported hypersensitivity was high. There was an 8-fold difference in the prevalence of allergy to milk, egg, cod or wheat when reported data was assessed by clinical examinations and double-blind placebo-controlled food challenges. Allergy to milk, egg, cod and wheat was an uncommon cause of complete avoidance of these foods due to perceived hypersensitivity. Some of the analyzed biomarkers might serve as prognostic markers for symptomatic, IgE-mediated food allergy but need further validation. / Bakgrund: Födoämnesöverkänslighet håller på att bli ett stort och kostsamt hälsoproblem i västvärlden. Prevalensen av rapporterad födoämnes-överkänslighet bland barn ökar, men det är fortfarande oklart om detta avspeglar en sann ökning i populationen. Det finns en stor spridning mellan uppmätta prevalenstal i olika studier och i de få studier där man följt upp rapporterade data med objektiva metoder ses en hög överrapportering. Data saknas om reell prevalens av födoämnesöverkänslighet bland skolbarn i Sverige. Befintliga prevalensdata baseras på rapporterad födoämnes-överkänslighet och studier saknas där angiven födoämnesöverkänslighet i en barnpopulationskohort validerats med objektiva metoder. Även om dubbelblinda provokationer räknas som ”gold standard” används i praktiken endast sjukhistoria, pricktest och analys av specifikt Immunoglubulin E (IgE) samt öppna provokationer för diagnostik. Metoderna har flera felkällor och mer tillförlitlig diagnostisk behövs, särskilt vid sena och svårtolkade symtom. Korrekt diagnos är särskilt viktig när baslivsmedel har eliminerats eftersom kostrestriktionerna riskerar att leda till negativa konsekvenser för livskvalitet och intag av viktiga näringsämnen. Syfte: Studierna i denna avhandling fokuserade på incidens och remission av födoämnesöverkänslighet bland skolbarn i Norrbotten, som följdes från 7-8 år till 11-12 års ålder, och på prevalens av överkänslighet mot mjölk, ägg, fisk och vete bland 12-åringar, undersökt med rapporterade data, klinisk undersökning samt dubbelblinda placebokontrollerade födoämnes-provokationer och biomarkörer. Metod: Den huvudsakliga delen av det här projektet är baserat på en populations-baserad kohort som rekryterades 2006 från 3 kommuner i norra Sverige. Föräldrar till alla barn i klass 1 och 2 (7-8 år) bjöds in till ett frågeformulär, som besvarades av 96% (n=2585) av de inbjudna. Barnen från två av kommunerna, Luleå och Kiruna, bjöds också in till ett pricktest med 10 vanliga luftburna allergen och 90% (n=1700) av de inbjudna deltog. År 2010, när barnen var 11-12 år, gjordes en studieuppföljning med samma metoder och med ytterligare tillägg av en intervju med barnet och bestämning av body mass index (BMI). Studiedeltagandet i enkäter och pricktest var lika högt vid uppföljningen som vid studiestart. Vid studieuppföljningen bjöds barn med rapporterad mjölköverkänslighet in till en strukturerad intervju och barn som helt undvek mjölk, ägg, fisk eller vete på grund av upplevd överkänslighet, bjöds in till klinisk undersökning och provtagning. Baserat på testresultaten kategoriserades barnen i olika fenotyper av födoämnesöverkänslighet utifrån förutbestämda kriterier. Barn som bedömdes ha en aktuell födoämnesallergi bjöds därefter in till vidare utredning med dubbelblind placebokontrollerad födoämnes-provokation. De recept som användes vid de dubbelblinda provokationerna hade dessförinnan validerats avseende detekterbara smak- och konsistens-skillnader mellan aktiv- och placebosubstans i en separat kohort av friska skolbarn (n=275). Före och efter den dubbelblinda provokationen samlades blodprover in för analys av cytokin mRNA-uttryck i mononukleära celler. Analyserna inkluderade cytokiner kännetecknande för humoralt allergidrivande T-hjälpar 2 (Th2) svar, cellulärt cytotoxiskt drivande Th1 svar samt inflammatoriskt- och T-reglerande svar. Vidare insamlades avföringsprover för analys av inflammatoriska biomarkörer före och efter genomgången provokationsserie. Resultat: Prevalensen av föräldrarapporterad födoämnesöverkänslighet ökade från 21% vid 7-8 år till nästan 26% vid 11-12 års ålder. Incidensen av rapporterad födoämnesöverkänslighet var hög (15%), liksom remissionen (33%). Riskfaktorer associerade med incidens och remission var olika för mjölk-överkänslighet och överkänslighet mot andra födoämnen. Vi såg också en bristande samstämmighet mellan föräldrarapporterad överkänslighet mot mjölk, ägg, fisk, vete, soja och jordnöt och IgE-sensibilisering mot det aktuella födoämnet. Vid 11-12 års ålder var prevalensen av rapporterad allergi mot mjölk, ägg, fisk eller vete 4.8%, medan prevalensen baserad på klinisk undersökning och provtagning var 1.4%. Prevalenssiffran halverades ytterligare när kliniskt bedömd födoämnesallergi validerades med dubbelblinda placebo-kontrollerade födoämnesprovokationer. Majoriteten av barnen med rapporterad allergi mot mjölk, ägg, fisk eller vete klassificerades som andra fenotyper av födoämnesöverkänslighet, varav de vanligast förekommande var möjlig laktosintolerans (40%) och utläkt födoämnesallergi (19%). Även om förekomsten av rapporterad mjölköverkänslighet bland 11-12 åringarna var så hög som 14.5%, kategoriserades bara 3% av dessa som en aktuell mjölkallergi. Mjölkallergi, aktuell eller utläkt, var associerat med andra atopirelaterade tillstånd och ett lägre BMI (OR 0.82, 95% CI 0.80-0.98) jämfört med barn som inte undvek mjölkprodukter. Före den dubbelblinda provokationsserien var mRNA-uttrycket av den Th2-relaterade cytokinen IL-13 och den regulatoriska cytokinen IL-10 högre bland barn med provokationspåvisad födoämnesallergi jämfört med barn med en negativ födoämnesprovokation. Såväl före som efter provokationsserien kunde högre nivåer av inflammationsmarkörerna eosinofil-deriverat neurotoxin (EDN) och kalprotektin uppmätas i avföringsprover från barn med positivt provokationsutfall jämfört med barn med negativ födoämnesprovokation. Skillnaderna i uppmätta nivåer av biomarkörer i faeces uppnådde dock inte statistisk signifikans. Slutsats: Rapporterad födoämnesöverkänslighet var vanligt förekommande bland skolbarn i Norrbotten och ökade från 7-8 år till 11-12 års ålder. Incidensen av rapporterad födoämnesöverkänslighet var hög, liksom remissionen. Prevalensen av rapporterad allergi mot mjölk, ägg, fisk eller vete var 8 gånger högre än den prevalens som kunde påvisas med dubbelblind placebokontrollerad födoämnesprovokation. Allergi mot mjölk, ägg, fisk och vete var en ovanlig orsak till att barn helt undvek dessa födoämnen på grund av upplevd överkänslighet. Några av de biomarkörer som analyserades innan provokationsserierna visade lovande resultat som möjliga, framtida prognostiska markörer för symptomatisk, IgE-medierad födoämnesallergi. Dessa resultat behöver dock valideras med ytterligare studier.