Tsunamis represent significant threats to human life and development in coastal communities. This quantitative study examines the influence of household characteristics on evacuation actions taken by 211 respondents in American Samoa who were at their homes during the 29 September 2009 Mw 8.1 Samoa Islands earthquake and tsunami disaster. Multiple logistic regression analysis of survey data was used to examine the association between evacuation and various household factors. Findings show that increases in distance to shoreline were associated with a slightly decreased likelihood of evacuation, whereas households reporting higher income had an increased probability of evacuation. The response in American Samoa was an effective one, with only 34 fatalities in a tsunami that reached shore in as little as 15 minutes. Consequently, future research should implement more qualitative study designs to identify event and cultural specific determinants of household evacuation behaviour to local tsunamis.

Introduktion: Samhället blir allt mer mångkulturellt och det ställer särskilda krav på hälso- och sjukvården. Mötet mellan hälso- och sjukvårdspersonal och patienter med invandrarbakgrund innebär olika utmaningar för båda parterna. För detta krävs en mångkulturell sjukvårdsmiljö och hälso- och sjukvårdspersonal med transkulturell kompetens. Syfte: Syftet med studien är att undersöka patienter med invandrarbakgrunds upplevelser av hälso- och sjukvård. Metod: En kvalitativ litteraturöversikt med deskriptiv design där tio studier har analyserats. Resultat: Språkbarriärer bidrog till sämre upplevelser för patienter inom hälso- och sjukvården. Olika försök att överkomma språkbarriärer ledde till en bättre upplevelse av hälso- och sjukvården. Patienter upplevde sig sämre behandlade i mötet med hälso- och sjukvård relaterat till sin kulturella bakgrund. Detta kunde bero på otillräcklig empati eller olika former av diskriminering. Hänsyn till patientens kultur upplevdes som något positivt och bidrog till en bättre upplevelse av hälso- och sjukvård. Patienter beskrev brist på information som ett hinder i mötet med hälso- och sjukvård. Positiva upplevelser var kopplat till att känna sig välinformerad. Slutsats: Denna studie belyser olika faktorer som kan påverka positiva och negativa upplevelser av hälso- och sjukvård. Det är viktigt att förstå patienters upplevelser av hälso- och sjukvård då det är en indikator på vårdkvalitet. När hälso- och sjukvårdspersonal reflekterar över dessa faktorer kan de utveckla sitt arbete för att bedriva en transkulturell omvårdnad av hög kvalite. / Introduction: Society is becoming increasingly multicultural and this sets several demands on health care. The encounter between healthcare professionals and patients with an immigrant background poses different challenges for both parties. This requires a multicultural healthcare environment and healthcare professionals with transcultural skills. Aim: The purpose of the study is to investigate patients with an immigrant background experiences of health care.Method: A qualitative literature review with descriptive design where ten studies have been analysed. Results: Language barriers contributed to poorer experiences for patients in contact with health care. Various attempts to overcome language barriers led to a better experience of health care. Patients felt worse treated in the encounter with health care associated with their cultural background. This could be due to insufficient empathy or various forms of discrimination. Consideration of the patient's culture was perceived as something positive and contributed to a better experience of health care. Patients described the lack of information as an obstacle in the encounter with health care. Positive experiences were linked to feeling well-informed. Conclusion: This study highlights various factors that can affect positive and negative experiences of health care. It is important to understand patients' experiences of health care as it is an indicator of the quality of care. When health care professionals reflect on these factors, they can develop their work to provide high-quality transcultural care.

Purpose: Lean Six Sigma has been playing a vital role in numerous organizations to enhance the productivity of the Supply Chain by reducing “waste and variance”. During Lean Six Sigma implementation, a change is introduced in the organization, the purpose is to understand the organizational change in this context in order not to end up failing in the implementation of this technique. Different factors affect organizational change, such as communication, successful implementation of ideas, training, empowerment of employees, the impact of unions, and support from the management. However, out of these factors, from the workforce perspective, which ones act as facilitators, and which ones act as barriers? Method: The approach that has been followed is the abductive approach as an interchange between theory and method, by combining deduction and induction. In the abductive research method, the research process starts with surprising facts or puzzling situations, and the research process is dedicated to their explanation. Findings: The study has identified if communication, successful implementation of ideas, developmental training of the workforce, empowerment of employees, management support, and employee unions act either as a barrier or a facilitator during the implementations of lean six sigma methods. Implications: By studying how these factors are acting (barriers or facilitators) there would be a certain help for the organizations in understanding the perspective of the employees in adapting to the change. This will ease the process, which would, in turn, help the organizations in an efficient implementation of Lean Six Sigma methods. Furthermore, it was found that the inclusion of Employees in decision making from an early stage will lead to efficiency in the implementation. Another implication that was found is that informal communication is as important as formal during the implementation of lean six sigma methods. Limitations: This study is based on one company.

Masters in Public Administration - MPA / This study investigates the extent to which skills development is implemented within the naval dockyard Simon's Town within the context of the NSDS and the various forms of legislation. In March 2001 the Department of Labour embarked on an initiative called the National Skills Development Strategy to address unemployment, and thus enhancing the economy. One of the areas that were identified to address the above concerns was the skills-development of its people.

Philosophiae Doctor - PhD / This study aims to determine the functionality of two adult literacy programmes (ALFA-REGULAR and ALFA-RÁDIO) provided by the Mozambican government, in Boane and Pemba. The prevailing popular conviction is that acquisition of literacy by individuals leads to positive and unproblematic social outcomes – the autonomous view of literacy (Street, 1984). This study forms a critique of this view, arguing, based on empirical evidence, that literacy is ideologically and culturally embedded in social practices and as such varies according to the social context. This is the ideological view of literacy (Street, 1984). This research employs an interdisciplinary approach constructed from the key notions of New Literacy Studies, Multiliteracies and Critical Literacy. The empirical research uses a qualitative research methodology based on a critical literacy ethnography informed by data gathered through interviews (with facilitators, learners, technicians and local leaders), classroom observations and document analysis. The empirical research seeks to determine the concept of literacy underpinning the literacy programmes in Boane and Pemba, addresses the profile of the programme facilitators and learners, examines the extent to which the literacy programmes respond to learners’ needs, motivations, expectations and access to technology, and explores the extent to which the literacy programmes address issues of development and citizenship.

No description available.

Although COVID-19 has undoubtedly altered the lives of most human beings, one could argue that the education of children with special needs has been drastically affected. Measures taken by governments and consequences of the pandemic per se have changed the notion of traditional education shifting it to a virtual plane. A total of 6 articles extracted from different databases were included in this systematic review. The aim was to explore the literature on special education and the development of children with special educational needs in relation to the barriers and facilitators they have encountered in coping with the pandemic. Findings show a significant difference between the number of facilitators and barriers found. The high number of barriers in the environment, activities and participation and mental functions, gives an overview of the obstacles that children with special educational needs have faced during the pandemic. Most of the barriers encountered appeared to be interrelated and have reshaped the way education is understood. To address this problem and try to overcome the challenges they pose, efforts must be made at higher levels of society, such as policies, laws, or government support, to ensure the proper development of children.

Background Based on the Global Trends report from the United Nations High Commissioner for Refugee, in high-income countries, there are 2.7 refuges per 1,000 national population, girls and women account for nearly 50 percent of this refuge population. In these high-income countries, compared with the general population refuge women have higher prevalence of mental illness. To our knowledge this is the first systematic review that addresses access to mental health services for refugee women in high-income countries. Thus, this review was conducted to examine the barriers to and facilitators of access to mental health services for refugee women in high-income countries for refugee resettlement. Methods MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched for research articles with qualitative component (including mixed-method or multi-method with qualitative component), in order to examine barriers and facilitators related to accessing mental health services. Relevant studies were collected on March 14, 2020 and were extracted and critically appraised by multiple authors. A narrative synthesis was conducted with the included studies to gather key synthesis evidence. Results Of the four databases searched, 1258 studies were identified with 12 meeting the inclusion criteria. The major barriers identified were language barriers, stigmatization, and the need for culturally sensitive practices to encourage accessing mental health care within a religious and cultural context. There were several studies that indicated how gender roles and biological factors played a role in challenges to accessing mental health services. The major facilitators identified were service availability and awareness in resettlement countries, social support and the resilience of refugee women to ease access of mental health services. Conclusion This review revealed socio-economic factors contributed to barriers and facilitators to accessing mental health among women refugees and asylum seekers. Addressing those social determinants of health can reduce barriers and enhance facilitators of access to mental health care for vulnerable populations like refugee women. Although there is a difference in health access policy among the top resettlement courtiers, the review found that there are no significant differences in accessing mental health for refugee and asylum seeker women among leading resettlement countries. The review findings suggest the need for further research on this topic given the potential significance of the findings on refugee and asylum seeker women mental health.

Bakgrund: Diabetes typ 2 är en kronisk folksjukdom världen över. Egenvård är en essentiell del av behandlingen vid diabetes typ 2, om den missköts riskerar patienten att drabbas av allvarliga komplikationer. Sjuksköterskan har ett ansvar att säkerställa att patienten har rätt kompetens för att uppnå en god och långsiktig följsamhet vid egenvård. Syfte: Syftet var att belysa patienters upplevelser av hinder och möjligheter till egenvård vid diabetes typ 2. Metod: Studien var en allmän litteraturstudie med induktiv ansats. Resultat: Fyra kategorier identifierades: kunskapens betydelse för egenvård, levnadsvanors påverkan på egenvård, social, kulturell och ekonomisk påverkan på egenvård samt motivationens betydelse för egenvård. Konklusion/implikation: Patienter upplever både hinder och möjligheter till egenvård vid diabetes typ 2. Kunskapsbrist, svårigheter att ändra etablerade levnadsvanor, dyr hälsosam mat, dyra sjukvårdsbesök och dyra diabetesläkemedel är hinder till egenvård. Familjens påverkan på egenvård kan vara både hindrande och främjande. Individuellt anpassad patientutbildning rekommenderas för att rusta patienter med den kunskap som krävs vid egenvård av diabetes typ 2. Utökad forskning gällande vuxna patienters upplevelse av egenvård inom Skandinavien rekommenderas. / Background: Type 2 Diabetes is a chronic public health disease worldwide. Self-management is an essential part of treatment. Patients with poor adherence to self-management are at risk of developing serious complications. Nurses have a responsibility to ensure that patients have proper competence to achieve good and long-term adherence to self-management. Aim: This study aimed to illustrate patients' experiences of barriers and facilitators to self-management in type 2 diabetes. Method: This study was a general literature review with an inductive approach. Results: Four categories were identified: the importance of knowledge for self-management, the influence of lifestyle on self-management, social, cultural and economic influence on self-management as well as the importance of motivation for self-management. Conclusion/Implication: There are both barriers and facilitators for patients with type 2 diabetes to engaging in self-management. Lack of knowledge, difficulties in changing established lifestyles as well as high cost of healthy food, healthcare visits and diabetes medications serve as barriers to self-management. Family influence on self-management can be both inhibiting and facilitating. Individually tailored patient education is recommended to equip patients with the knowledge required for self-management of type 2 diabetes. More research regarding adult patients’ experience of self-management within Scandinavia is recommended.

With the rise of accidental fentanyl overdoses and recreational opioid use in college-aged populations, the need for campus-based overdose prevention and harm reduction measures is at an all-time high. Naloxone, an opioid antagonist, is an FDA-approved, lifesaving, medication which can be intranasally delivered by laypersons. Naloxone reverses opioid overdose, essentially buying time until an overdosing individual receives emergency medical attention. While some previous studies have examined access to naloxone on college campuses, to my knowledge no study has explored distribution of naloxone in residential college areas, such as dormitories and within Greek housing. Therefore, the purpose of this thesis was to identify themes in student perception surrounding naloxone, as well as potential processes and barriers/facilitators to naloxone distribution within residential areas (e.g., dormitories, sorority housing, and fraternity housing.) This study addresses these issues through qualitative, semi-structured, interviews with a convenience sample of students at the University of Central Florida, with questions informed by the Consolidated Framework for Implementation Research and Proctor et al. implementation outcomes. Seven students (n = 7) participated in the interview, all of whom either had personal experience with substance use disorder (SUD) or were close to someone with SUD. I analyzed data for themes using a mixed deductive-inductive template analysis approach in Dedoose software. Resulting themes relating to barriers to distribution within residential areas were as follows: lack of knowledge; fear of negative consequences from external parties; desire of administrators to maintain image of a “drug free campus”; lack of funding for distribution; student desire to avoid stigmatization. Resulting themes relating to facilitators to distribution in residential areas included the following: active involvement of peers; providing free naloxone; educating students about where to get and how to use naloxone; physical accessibility; and anonymous ways to access naloxone. Targeting residential areas for naloxone distribution was also discussed as a theme. Types of people who could/should be involved in naloxone distribution included the following: residential assistants; secondary distributors; pharmacists; UCF leadership; sorority and fraternity leaders; and student liaisons. Study results could be used to inform efforts at UCF and other colleges to expand naloxone access.