Background and Purpose: Evidence now links poor oral hygiene to systemic and infectious diseases such as pneumonia. Hospitalized patients, who now retain their teeth into older adulthood, often rely on nurses to provide oral hygiene care. Nurses have the potential to impact oral health outcomes and quality of life by controlling plaque. However, oral hygiene care practices of nurses in post-acute hospital settings are relatively unknown. The purpose of this study was to explore how nurses provide bedtime oral hygiene care, how they decide on interventions provided, and how certain factors influence their ability to provide oral care. Methods: A qualitative, exploratory multiple-case study was conducted with 25 nurses working on five inpatient units at different hospitals. Nurses were accompanied on their evening rounds to observe oral care practices, the physical environment, and workflow. Thematic analysis was used to analyse the case study data base including transcripts of guided conversations, field notes, and documents. Within-case analysis was followed by cross-case analysis. Findings: Findings indicate that: (a) nurses often convey oral hygiene care to their patients as being optional; (b) nurses are inclined to preserve patient autonomy in oral hygiene care; (c) oral hygiene care is often spontaneous and variable, and may not be informed by evidence; and (d) oral hygiene care is not embedded into bedtime care routines. Implications: Oral health history and assessment data are essential to the creation of individualized, feasible oral hygiene care plans that consider patient dignity. Knowledge of the health benefits of oral care, and skills related to assessment and approaches to oral care are required by nurses. Availability of effective products and supplies facilitates provision of oral care. The evidence for oral hygiene care practices, outcomes of nurse-administered oral care, and the role of nurses in influencing the oral health literacy of patients requires further study. / Dissertation / Doctor of Philosophy (PhD) / When in hospital, older people often rely on nurses for help with oral care. Little is known about how nurses provide this type of care, but poor oral care can lead to pneumonia, gum disease, and other diseases of the body. In this study, nurses were accompanied as they provided bedtime oral care to patients. Findings showed that: (a) nurses let patients decide about doing oral care and do not encourage it, (b) nurses let patients do oral care themselves, even if they cannot do a good job, (c) the oral care given depends on the nurse, and (d) bedtime oral care, the most important time of day, is not part of the bedtime routine. Nurses should (a) ask patients about their oral health and inspect their mouths, (b) have the right supplies available so they can more easily provide effective oral care, and (c) teach their patients about the importance of oral hygiene.

The use and development of Scientific Computing Software (SCS) has become commonplace in many fields. It is used to motivate decisions and support scientific research. Software Engineering (SE) practices have been shown to improve software quality in other domains, but these practices are not commonly used in Scientific Computing (SC). Previous studies have attributed the infrequent use of SE practices to the incompatibility of traditional SE with SC development. In this research, the SE development process, Document Driven Design (DDD), and SE tools were applied to SCS using case studies. Five SCS projects were redeveloped using DDD and SE best practices. Interviews with the code owners were conducted to assess the impact of the redevelopment. The interviews revealed that development practices and the use of SE varied between the code owners. After redevelopment, the code owners agreed that a systematic development process can be beneficial, and they had a positive or neutral response to the software artifacts produced during redevelopment. The code owners, however, felt that the documentation produced by the redevelopment process requires too great a time commitment. To promote the use of SE in SCS development, SE practices must integrate well with current development practices of SC developers and not disrupt their regular workflow. Further research in this field should encourage practices that are easy to adopt by SC developers and should minimize the effort required to produce documentation. / Thesis / Master of Science (MSc)

Industrialized house building of multi-storey residential buildings is not only gaining practical importance in Sweden but is also emphasized as a way for companies to address the demands for lower and more predictable production costs, shorter delivery times and higher product quality. However, to be competitive on the market, IHB companies need to protect and capitalize their specific investments into platforms and organizations. The engagement inplatforms and industrialized way of working, it is not just about the complexity of integration but it is also about having a capability over time to handle this market variation (i.e. dynamic capabilities). Industrialized house building has mainly been investigated from an operational view, leaving a gap in the characterization from a strategical (dynamic) view. Purpose of this research is to increase understanding about industrialized house building, from a dynamic capability view, described the characteristics of industrialized house building through exploring and describing the evolution and development of and industrialized house building company. An in-depth, longitudinal case study approach was adopted to get and deeper understanding of the development of dynamic capabilities in an industrialized house building company. The unit of analysis was the long-term interaction between house-market development, the case company’s business development, and external collaboration activities between the years 1993 and 2018. The findings from the case study were then analyzed against a theoretical framework based on dynamic capabilities. Industrialized house building can be characterized by a set of dynamic capabilities constructs that are evolved and developed in order to cope with the changing conditions derived from both internal and external factors, entailed in entrepreneurship and long-term thinking. The findings indicate that the organization's focus may vary between different kinds of dynamic capabilities over-time. In addition, findings indicate that development of dynamic capabilities supporting collaboration and building trust to the market was of importance at the beginning of their journey. These dynamic capabilities evolved in close relations with external partners, due to external market pressure. This study also indicates that path dependency affects the development of dynamic capability, through collaboration, trust, and learning – which influence how the company behaves and through their investments in a platform constraining future actions.

Background: Rooming house residents have high rates of morbidity and mortality, yet little is known about why this disparity in health exists. Research Question: How are rooming houses linked to health? Case: Social exclusion of rooming house residents in downtown Ottawa, bounded by the neighborhood, and Ottawa’s political policies at the time of data collection (September 2019-June 2020). Methodology: A single embedded descriptive case study was informed by multiple sources of evidence, and involved a community advisory group (CAG). Rooming house residents took photos, participated in a community walk-about with participant observations and attended a focus group. Two additional focus groups were conducted; one with fellow rooming house residents, another with the CAG. Interviews with rooming house front-line service providers and a secondary data set of homeless service measures also informed the case. Findings: 1. Rooming house residents (n=10) took 112 photos, and (n=8) took part in a focus group where two broad themes emerged: Housing is health care, and just managing today. 2. Interviews with front-line service providers (n=11) focused on two themes: There are many costs to living in a rooming house, and rooming house front-line service providers wear many hats. 3. Between a sample of sheltered homeless (n = 60) and rooming house residents (n=52), there was no difference found for several health indicators, including frequency of care received in the emergency room, hospitalization as an inpatient, and if substance use made it difficult to stay or afford housing. Focus groups with rooming house residents who did not take photos (n=10) and the GAG (n=6) contributed to persona co-creation revealing financial and contextual factors affecting the health of rooming house residents. Conclusion: The shared spaces of rooming houses create a tension between offering community and creating a risk environment. The negative health consequences to living in a rooming house are mitigated by the many roles that rooming house front-line service providers play in filling gaps. This study suggests the need to definitively position rooming house residents on the housing continuum in order to ensure equitable distribution of resources to optimize the health of this vulnerable population.

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