Why do students choose to study particular courses and what is the impact of these choices on their later progression? Quite often the reason for the choice appears to be obvious and straightforward, and their after course trajectory is already determined. The education system has, what some may view as an easy to follow progression route when students reach the end of Key Stage 4, i.e. GCSE to A level, and then university for those who meet the criteria. With A levels considered by many to be the 'gold standard', there is probably no expectation by schools, parents and students that they will do anything else. But what about those who may not meet the criteria and A levels may not be the most appropriate progression route for them? This thesis examines the factors that influence the choices made by students who have decided to study a course other than A level. This is done through longitudinal case studies derived from the use of questionnaires, focus groups and individual interviews using BTEC L3 Science as a vehicle. Four educational establishments agreed to participate in the research to varying degrees, with one establishment providing the participants who provided the case studies. Many previous studies that have investigated student choice have often done so from either the perspective of structural factors or individual agency, but not usually both. Hemsley-Brown and Fosketts' 2001 Integrated Model of Educational Choice has been used to provide a theoretical framework as it allows consideration of both structural factors and individual agency. The model was used at two different points in the research, but in a different way at each point. The result was a series of individual stories that gave an insight into the factors that influence student choice and also how the balance of power in the decision making process shifted in favour of the student as they progressed through the course. At the start of the course structural factors such as the systems that exist within education had a significant role in the choice of course for the students, to the point where it was effectively a 'non-choice' for them. By the end of the course individual agency played a significant role and the students were able to adapt and make the systems work for them to enable them to make the best possible choices to meet their own needs.

Clinical trials play an important role in advancing therapeutic and preventive care with many current modalities resulting from prior research. While prior research has described barriers to participation in therapeutic clinical trials, much less in known about barriers related to participation in trials aimed at prevention, prostate cancer prevention in particular. Physicians have been shown to play a critical role in access to trials; however, less is known about the individual and structural factors that influence their participation in prostate cancer prevention trials. This research provides rich ethnographic detail within the context of an ongoing trial. Research participants included physician/investigators who were either directly (serving as a co-investigator) or peripherally (referring patients for participation) involved in prostate cancer prevention intervention clinical trial (PCPICT), as well as those who were considered for participation but declined. Methods included open ended semi-structured interviews, participant-observation and a survey. Participants were recruited via direct inquiry, email and/or letter regarding participation. The results of this study show that individual and structural factors intersect, influencing both the willingness and ability of physician/investigators to participate or refer patients for participation in a prostate cancer prevention intervention clinical trial. Individual factors such as explanatory views on prevention, notions of risk and uncertainty, shared decision-making and duality of roles appear to have a greater influence on the willingness of physicians to participate while structural factors such as staffing, other resources and time are more influential in regards to the ability to participate. This research served as a critical first step towards providing an in-depth understanding of the individual and structural factors that influence a physician's participation in this type of trial. It builds from prior work where a better understanding of barriers and identification of successful strategies to overcome them was a noted void. The researcher identifies areas where additional research would be beneficial and provides applied recommendations for those considering the design of future cancer prevention intervention projects.

Syftet med denna studie är att undersöka hur Räddningstjänsten sprider kunskap som erhållits från erfarenheter och övning, samt vilka strukturella faktorer som påverkar denna spridning. Med strukturella faktorer avses exempelvis hierarkier, avdelningsgränser, strategier för kunskapsöverföring och belöningssystem. Studiens empiri har samlats in genom semi-strukturerade intervjuer och är således en kvalitativ studie. Urvalet består av sju medarbetare på olika befattningar som bedömts som nyckelpositioner för kunskapsspridning. Studien utgår ifrån olika Knowledge management-strategier och Communities of practice för att förklara skapande och spridning av organisatorisk kunskap.   Resultatet påvisar att det finns olika spridningsmetoder för kunskap som består av ett avvikelsesystem, insatsrapporteringssystem samt Communities of practice inom arbetslagen. Data visar att spridningseffektiviteten varierar och att det föreligger olika hindrande och främjande faktorer för spridning av kunskap metoderna emellan. I studien framkommer det att kunskap sprids mest effektivt inom arbetslagen och avvikelsesystemets tydliga ansvarsfördelning och infrastruktur fungerar bättre än insatsrapporteringssystemet, då detta saknar struktur och har en svårhanterlig mängd information. / The purpose of this study is to examine how the Swedish fire brigade disseminates knowledge from experiences, obtained from emergencies and practice, and the structural factors that affect this distribution. Structural factors referred to in this study are for example hierarchies, department boundaries, strategies for knowledge transfer and reward systems. The study's empirical data were collected through semi-structured interviews and is thus a qualitative study. The studies population consists of seven employees in various positions identified as key positions for knowledge dissemination. The study is based on various Knowledge management strategies and Communities of practice to explain the creation and dissemination of organizational knowledge. The result demonstrates that there are various methods of dissemination of knowledge consisting of a deviation system, effort reporting system and Communities of practice in work teams. Data show that the efficiency of dissemination varies and that there are both hindering and facilitating factors affecting the efficiency. The study shows that knowledge is disseminated most effectively within teams and that the deviation systems clear infrastructure works better than the effort reporting system, due to it’s lack of structure and unwieldy amount of information.

Low participation of racially ethnic minority youth in snow sports activities may be caused by racism through structural and symbolic factors. The purpose of this study was to explore the lived experiences of teachers from school-based programs and resort ski school programs as well as coaches from afterschool club and community-based organizations regarding the structural and symbolic influences on the participation of racially ethnic minority youth in snow sports. Using critical race theory as the conceptual framework, a qualitative, phenomenological inquiry was centered on the experiences of ethnic minority youth related to potential racism in structural and symbolic factors regarding participating in snow sports activities. Participants were selected by a purposeful, homogenous sampling strategy, and data were collected from semistructured interviews of the 12 participants. Data were analyzed through the use of NVivo12 to search for codes, categories, and themes related to racism and the structural and symbolic factors that influence racially ethnic minority youth participation in snow sports activities. The findings of this study help bring an increased understanding of why there continues to be a lack of racially ethnic minority youth in snow sports through themes, such as exposure and access, cultural representation, and racism, which may be useful to schools, resorts, clubs, and similar organizations who educate youth and promote snow sports activities. The results of this study may help bring about positive social change by supporting culturally responsive practices throughout the snow sports industry, which aim to provide fair, equitable, and inclusive opportunities for racially ethnic minority groups to participate in snow sports.

The existing cancer-related disparities among Inuit are rooted in the structural conditions that create health and health care inequities. No comprehensive review currently exists about structural factors that facilitate or hinder Inuit’s access to and experiences with cancer care services in Canada. The overall aim of this scoping review was to synthesize the available published and grey literature on the structural factors that influence cancer care experienced by Inuit in Canada. Guided by the Joanna Briggs Institute (JBI) scoping review methodology, searches were conducted in a number of electronic databases, grey literature sources, and relevant journals. The extracted data were synthesized using thematic analysis and presented using tables and narrative summaries. Quality assessment was performed for each included study on its relevance to Inuit communities. A total of 30 papers were included in this review. The structural factors were identified and described through five categories related to: colonization, as well as health systems, social, economic, and political structures. Addressing the structural barriers that Inuit face in the cancer care trajectory requires a system-wide approach. Thesis results inform health care delivery and nursing practice with the goal of improving health equity for Inuit in cancer care.

No description available.

No description available.

Magister Public Health - MPH (Public Health) / Teenage pregnancy remains a complex issue globally. According to the World Health Organisation (2014), the average global birth rate of girls aged 15-19 years was 49 per 1000 births reported globally. In South Africa, the general household survey conducted in 2014 revealed that 5.6% of females 14-19 years were reported to have been pregnant in 2013, with teenage pregnancy increasing by age from 0.8% for the age group of 14 years to 11.9% for teenagers aged 19 years. In South Africa, a range of health policies and programs exist to address teenage pregnancy, including school-based sex education, peer education programmes, adolescent friendly clinic initiatives and mass media interventions. Despite such initiatives, the number of teenagers becoming pregnant remains high. Teenage pregnancy reported in Mangaung district is 7%, which is three times more than the provincial target of 2% for teenage pregnancy. This research therefore aimed to explore the reasons behind teenage pregnancy in Heidedal, Mangaung District, Free State Province, South Africa. Two in- depth interviews were conducted, one with twelve teenage mothers and the other with four key informants who were selected based on insight and experience they possess in working with teenagers. The key informants suitable for the study included a nurse, life orientation teacher, ward councillor and a counsellor working for a non-governmental organization that supports the implementation of youth programmes in the health facility. Thematic analysis was used to analyse data and key themes, afterwards concepts were interpreted so that explanations could be constructed to answer the research aim and objectives. The study aimed to contribute to understanding reasons behind the high teenage pregnancy rates in Mangaung District. This information will be useful to policy makers in developing policies and strategies that will address factors identified to be influencing teenage pregnancy.

This thesis focuses on the structural and behavioural factors that placed South Asian immigrant women living with HIV/AIDS in the Greater Toronto Area at risk. Informed by Connell's social theory of gender (1987), this study examined the role of hegemonic masculinity in legitimizing male power and contributing to the HIV risk of these women. By conducting one-on-one interviews with 12 HIV-positive immigrant women, meaningful constructions of the women's narratives and accounts of their experiences relative to HIV were created. This study examined the intersection of power ideologies such as gender, race and class in specific contexts as they generated particular experiences that affected women's risk for HIV. Following a community-based research approach, a collaborative relationship was established with the Alliance for South Asian AIDS Prevention where qualitative methods of analysis and an inductive approach with an iterative process were followed. Factors such as isolation, economic dependence on their husbands, discrimination, racism, investment in psychologically and emotionally abusive relationships, combined with the absence of support from their family of origin exacerbated the women's risk of HIV infection. The strong ties exhibited by most of the women to their religious/ethnic communities helped sustain a gender-based social hierarchy. To facilitate dialogue and social change for South Asian women, gender and culture need to be situated in social and historical contexts. As such, programs should be understood within a larger critical understanding of the social power relations and history of Canadian immigration patterns. Using anti-racist frameworks, initiatives should address violence against women, while tackling interrelated issues (i.e., housing, poverty, etc.). This work draws attention to oppressions through the experiences of a community of women who are rarely given a voice within the context of research on HIV/AIDS. It will be also helpful for Ontario’s HIV prevention strategy and the field of women's sexual health.

This thesis focuses on the structural and behavioural factors that placed South Asian immigrant women living with HIV/AIDS in the Greater Toronto Area at risk. Informed by Connell's social theory of gender (1987), this study examined the role of hegemonic masculinity in legitimizing male power and contributing to the HIV risk of these women. By conducting one-on-one interviews with 12 HIV-positive immigrant women, meaningful constructions of the women's narratives and accounts of their experiences relative to HIV were created. This study examined the intersection of power ideologies such as gender, race and class in specific contexts as they generated particular experiences that affected women's risk for HIV. Following a community-based research approach, a collaborative relationship was established with the Alliance for South Asian AIDS Prevention where qualitative methods of analysis and an inductive approach with an iterative process were followed. Factors such as isolation, economic dependence on their husbands, discrimination, racism, investment in psychologically and emotionally abusive relationships, combined with the absence of support from their family of origin exacerbated the women's risk of HIV infection. The strong ties exhibited by most of the women to their religious/ethnic communities helped sustain a gender-based social hierarchy. To facilitate dialogue and social change for South Asian women, gender and culture need to be situated in social and historical contexts. As such, programs should be understood within a larger critical understanding of the social power relations and history of Canadian immigration patterns. Using anti-racist frameworks, initiatives should address violence against women, while tackling interrelated issues (i.e., housing, poverty, etc.). This work draws attention to oppressions through the experiences of a community of women who are rarely given a voice within the context of research on HIV/AIDS. It will be also helpful for Ontario’s HIV prevention strategy and the field of women's sexual health.