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Public school physical educators have the opportunity to help students understand the importance of engaging in regular physical activity in order to combat America's obesity problem. However, students are often unmotivated to participate in their physical education classes. Providing students with an autonomy supportive environment increases intrinsic motivation. Self-determination theory states that higher levels of intrinsic motivation should lead to an increase in behavior, or higher activity levels in a physical education class. This study examined (a) the effects of increased autonomy on self-determination, and (b) the effects of increased autonomy on physical activity levels. Seventh and eighth grade girls (n = 122) in four classes participated in two fitness units (one allowing choice of activities, the other no choice). The 14-item abridged Situational Motivation Scale (SIMS) was administered pre and post each unit. Pedometers were used to measure step counts during both units. Results of the SIMS data showed there was a significant difference in motivation between the trials for all students, and between the groups (pre and post) during the second unit. There was no significant difference in step counts for all students between Unit 1 and Unit 2, and no difference between groups. The results revealed that increased autonomy in activity selection increases student self-determination, and therefore, should be implemented into the physical education curriculum. To truly determine the relationship between increased autonomy and activity levels, students need to be in an environment where they can be responsible for their own behavior, and where they can choose how much effort they are willing to put into the activities they have chosen.

The study that has been undertaken sets out to explore teacher attitudes towards the subject of self-assessment. It also aims at finding out specific strategies and tools used, and what the teachers feel would aid with the promotion and implementation of self-assessment in the modern language classroom.To this end we conducted a number of interviews, in the south of Sweden, with teachers of varying experience who actively practice self-assessment in their classrooms. The teachers were positive to the concept of self-assessment, but stressed a number of areas that presented problems, available time and the ambiguity of the syllabi being examples. They adopted a number of strategies in order to overcome these problems. Furthermore, they identified a number of key advantages in using the approach, both from their perspective and that of the students’. It strengthens student confidence, clarifies goals and promotes active learning.

BACKGROUND: Nationally, 85% of general surgery graduates pursue fellowships reducing the incoming general surgical workforce with a predicted shortage of 41,000 general surgeons by 2025. In recent studies, the lack of confidence appears to be a major factor contributing to resident decision to pursue fellowship. The aim of the study was to determine if a hybrid academic/community program contributes to early autonomy and the decision to pursue fellowship in general surgery graduates. METHODS: We evaluated the level of confidence, level of autonomy, and decision to pursue fellowship at a hybrid academic/community program that historically graduates 70% of their residents into general surgery practice through an anonymous survey. Participants responded using Likert scales along with simple polar questions. RESULTS: Most current residents (90%) reported, upon graduation, that they feel very confident (45%) or fairly confident (45%) performing major cases independently. Most attendings (64%) reported that during their third year of residency, they began performing the majority (more than 75%) of their major cases as surgeon junior while current residents (55%) reported they were performing the majority as a second-year resident. Fifty-five percent of residents felt that confidence played a role in the decision to pursue fellowship. Thirty-three percent of our current chief residents and only 34% of the total general surgery residents plan to pursue fellowships. Conclusions: Our study showed that our residents appear to have earlier levels of autonomy than that experienced by our practicing surgeons when they were residents. Confidence continues to play a role in the decision to pursue fellowship and overall our residents are confident in technical skills at graduation. Our unique program continues to graduate the majority of our surgical residents into successful general surgery practice.

This research explored psychological, social, and relational aspects of caregiving. It examined documented resolution of ethical dilemmas precipitated by veterans' medical crises and involved formal caregivers, informal caregivers, and veteran patients. The unit of analysis was caregiving relationships. The main research question asked, how does case documentation and documented processes of resolving ethical dilemmas in institutional healthcare for veterans reflect relational ethics? Relational ethics was defined as fairness of interpersonal give and take and included efforts to elicit, understand, and honor veteran's values and care preferences. The caregiving context was a Veterans Affairs Medical Center (VAMC). The research population was 25 male veterans whose cases required intervention by the VAMC ethics committee. The research was conducted in three phases using grounded theory methodology. The research purpose, guided by symbolic interaction theory, was to develop substantive theory in relational ethics. Study analyses used Atlas.ti qualitative software. Main study one, Veteran-Formal Caregiver Relations, focused on relational processes internal to the VAMC. It explored how members of professional healthcare disciplines documented ethical caregiving concerns amongst themselves and in interactions with veteran patients. Agency emerged as the core category. Agency meant that veteran patients could make choices and act on those choices in ways that impacted their care. When veterans' agency was compromised, formal caregivers' roles became more salient. The substantive theory was the dynamic process of clarifying agency. Main study two, Formal-Informal Caregiver Relations, focused on interactions between VAMC staff and veterans' significant others. It explored medical center staff communications with informal caregivers regarding veterans' health problems. Documented interactions confirmed the impact of relational ethics. Agendas and advocacy emerged as key categories that determined and respected veterans' relational autonomy. Relational autonomy validated other ethical concerns and resource demands, considered social context, and included obligations as well as entitlements. The substantive theory was the agenda to advocate for relational autonomy. Substantive theories from the two main studies were integrated. Categorical dimensions were combined into substantive theory; that doing the right thing in institutional caregiving for veterans was the dynamic process of clarifying agency with the agenda to advocate for relational autonomy. / Ph. D.

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The first two chapters of this dissertation focus on the child health outcomes in brief, child diarrheal incidence in India, and child growth measures in Rwanda. The third chapter examines the determinants of timely access to health care in emergency departments in the United States. All three essays are different in their area of interest, data sources, and methodology.ESSAY 1 India has recorded the highest number of child diarrheal deaths at the global level. Oral Rehydration Therapy (ORT) would just provide hydration and few mineral supplements for infected children. However, their malnutrition and weakened immune system cannot be reversed. Malnutrition affects child growth, and causes stunting, and makes them susceptible to other forms of infections. The rotavirus vaccine provides a pseudo-sense of protection from non-rotaviral diarrhea. Preventing diarrhea right away from the source of the infection would be a better solution. Since most diarrheal pathogens are water borne, disinfection treatment of drinking water at the point of use could prevent diarrheal incidence of children and adults as well. Household data from the National Family and Health Survey and their estimators viz., Propensity Score Matching (PSM), and Inverse Probability Weights Regression Adjustment (IPWRA) have been employed to examine the effects of water treatment techniques in households. This chapter attempted a novel approach in studying all the popularly used water treatment techniques currently practiced in India in one study. They have been ranked for multi-value treatment effects model. Water filters with ceramic candles are more effective than other point-of-use water treatment techniques, followed by chlorination, water purifiers, and boiling. ESSAY 2 Rwanda is a sub-Sahara African country affected by genocide with a patriarchal family structure system. Higher poverty and gender imbalance were not alleviated by gender equality being on the political agenda. Despite the highest female representation in the parliament in the world, gender equality and liberty are confined to elite women. Additionally, flawed laws for women's equality made women's empowerment a paradoxical phenomenon. Women at the gross root levels, i.e., community and household, are still dependent or interdependent on men (husband/father). This has been confirmed by the findings in Chapter 3, that is, for most decisions, women are taken jointly with their partners. A minimal percentage of women are autonomous in their decisions and in their home. This study made an attempt to examine the mother’s autonomy in Rwanda and its impact on child health. Mother’s autonomy is negatively related to child’s height and weight for their age. Although the expected association between mother’s autonomy and child height/weight is positive, it would also depend on the historical and cultural context of the country of interest. Instrumental variable analysis is used to study women’s autonomy due to its complex and endogenous nature. Spousal educational difference and marriage-to-birth interval are valid instruments but weakly identified. ESSAY 3 An increasing burden on emergency services that exceeded its resources led to congestion in the emergency department (ED), with patients waiting for physicians on the examination bed and for inpatient bed transfer. This creates a blockage between access to healthcare and emergent patients. ED measures adopted to reduce ED congestion, boarding, and waiting times, such as ambulance diversion management, fast tracking of patients with low acuity, and bed coordination do not effectively control waiting time and boarding. ED crowding is a patient flow, but not necessarily a hospital resource deficiency. This is evident from the findings that even EDs with new treatment spaces still keep patients waiting for an inpatient bed, however, they reported a shorter wait time for the physician. Optimal utilization of nurses by floating them to needy units is effective in timely transfers of patients to inpatient beds compared to EDs without floating nurses.

In Ontario, supporting "a system of care that provides women and their families with equitable choice in birth environment and provider," (PCMCH & MOHLTC, 2017, p.33) has been identified as one of the central objectives of the Provincial Council for Maternal and Child Health's Low Risk Maternal Newborn Strategy. In theory, pregnant people in Ontario can choose to seek maternity care from a midwife, a family physician, or an obstetrician; however, in practice, pregnant people's choice of provider remains constrained. Extant literature suggests that in order to afford pregnant people the opportunity to exercise autonomous choice of provider, health systems must ensure that an acceptable range of provider options is available and accessible within the local organization of maternity care, that pregnant people are made aware of and knowledgeable about the available provider options, and that pregnant people have the ability and resources to navigate access to their provider of choice (Mackenzie, 2014; Sutherns, 2004). As a result, I designed this thesis to fill a gap in the evidence base to determine whether or not provincial policies had translated into the levels of access, awareness, and resourcing required to afford pregnant people the opportunity, ability and propensity to exercise autonomous choice of provider within the local maternity care system in Ontario's Champlain Region. I sought to elicit the structural conditions that would be necessary to equitably support pregnant people's access to and choice of a maternity care provider. In the pursuit of these objectives, I adopted an integrated knowledge translation approach (Bowen & Graham, 2013), using an explanatory sequential mixed methods design (Creswell, 2014), which encompassed two complementary stages: (1) quantitative geospatial mapping to assess pregnant people's access to the full range of maternity care providers across the Champlain Region; and (2) qualitative focus groups and individual interviews with parents, providers, and policy-makers to explore the individual, organizational, and system-level factors that are enabling or restricting access and autonomy. Using a systems approach to the investigation of this locally-identified issue, I demonstrate in this thesis that pregnant people within the Champlain Region have inequitable opportunities to exercise autonomous choice of maternity care provider due to (1) system and organizational-level factors that are creating imbalances in the supply, distribution and mix of maternity care provider options, and (2) pregnant people's differential access to the enabling information and resources required to exercise autonomous choice of provider and to navigate access to their services.

This thesis consists of an analysis of the canonical notion of the pedagogical relation, as introduced by Hermann Nohl in the 1930’s following the tradition of pedagogy and education in Germany. This notion, which has both been central in current debates on educational theory, for example in the work of Norm Friesen and Tone Sævi, has certain implications and political consequences. With an aim to expanding the notion and exploring its shortcomings, I identify certain central pillars, and focus on two of them, namely autonomy and the unified subject. The essay explores these and proposes other theoretical readings in order to contrast and broaden the landscape of thought regarding pedagogy and relations, and thereby the notion of the pedagogical relation. To this end, I first discuss the notions of relational autonomy and transindividualism, in order to put in evidence the liberal, often unnamed, roots of the (hegemonic) notion of autonomy and to open up to other ways of conceiving it. Then, I delve into a psychoanalytic reading of Jacques Lacan’s thought on education and his four discourses, through the work of Anna Pagès and Anna Herbert. In so doing, the notion of the unified subject is problematized, exploring the instability of the subject as a departure. This uncertainty, together with the notion of transindividuality, are presented as some possible ways of thinking about pedagogy, opening up to future discussions such as pedagogical relations, the philosophy of the teacher, and educational aims.

Visual inspection in autonomous robotics is a task in which autonomous agents are required to gather visual information of objects of interest, in a manner that ensures safety, efficiency and comprehensive coverage. It is, therefore, crucial for identifying key landmarks, detecting cracks or defects, or reconstructing the observed object for detailed analysis. This thesis delves into the  challenges encountered by autonomous agents in executing such tasks and presents frameworks for scenarios ranging from operations by multiple spacecrafts in close proximity to celestial bodies in Deep Space to terrestrial deployments of Unmanned Aerial Vehicles (UAVs) for inspection of large-scale infrastructures. The research thus pursues two main directions: Firstly, a novel formation control strategy is developed to enable autonomous agents to perform proximity operations safely, efficiently, and accurately in order to map the surface of Small Celestial Bodies (SCBs). This investigation encompasses control and coordination strategies, leveraging a realistic astrodynamic model of the orbital environment to navigate safely around SCBs. Along this direction, the contributions focus on enabling a distributed autonomy framework in the form of a cooperative stereo configuration between two spacecraft, allowing acquisition of 3D topological information of the candidate SCB. The framework employs a Leader-Follower approach, treating the maintenance of the desired stereo-formation as a 6 Degree-of-Freedom (DoF) nonlinear model predictive control (NMPC) problem. The second research direction focuses on addressing the problem of enabling robotic inspection for terrestrial applications. With the growing demand for efficient and reliable inspection techniques to improve in-situ situational awareness, the research concentrates on addressing the problem of obtaining detailed visual scan of available structures without any a priori knowledge of either the environment nor the structures. Thus, the key contributions of the presented work reside in the implementation of a unified autonomy, with the unification drawing it's root from the merging of two distinct research perspectives: Inspection and Exploration planning. The contribution establishes a novel solution by introducing a map-independent approach with a synergistic formulation of a reactive profile-adaptive view-planner coupled with a hierarchical exploration strategy and an environment-invariant scene recognition module. By integrating exploration and inspection methodologies, this research seeks to enhance the capabilities of UAVs in navigating and inspecting unknown structures in unfamiliar environments.  Through theoretical developments, extensive simulations and experimental validations, this thesis contributes to the advancement of the state-of-the-art in visual inspection with autonomous robots. Moreover, the findings extend current capabilities of autonomous agents in the field of space exploration as well as in disaster response and complex infrastructure inspection.