The Limited English Proficiency (LEP) population in the United States requires interpreters in order to receive appropriate medical care. However, interpreters are not used consistently in clinical encounters. This study aims to identify the barriers that interfere with providing this service, as well as to propose some possible ways of overcoming these barriers. A systematic review of the literature was conducted using Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO. Twenty articles that presented barriers to interpreter use were identified. These barriers referred to either professional interpreters or ad hoc interpreters, or were general barriers. The barriers to professional interpreter use most frequently identified related to cost. Most of the cost-related barrier citations were found in studies conducted in the U.S. The barriers to ad hoc interpreter use most frequently identified related to concern about the interpreters ability to interpret. I determined that appropriate provision of interpreters to the LEP community would require four elements: 1) The consistent use of professional interpreters, and the elimination of ad hoc interpreter use. 2) Research into the possible financial benefits that may arise from increased interpreter use, and how the cost of providing interpreters may be offset by the widespread benefits of using them. 3) Professionalization of interpreter services, with quality assurance and standardized training and evaluation of interpreters. 4) Increased education and training for patients and providers about the language services that are available and how to access them, and about how to work with an interpreter efficiently and effectively. One possible solution that would allow the implementation of all of the above elements is a national interpretation service.

Lic.avh. Luleå : Luleå tekniska univ., 2009. / Härtill 2 uppsatser.

The impact of the physical environment on communication for residents of long-term care (LTC) facilities has not been examined in depth. No study currently exists which explores environmental influences on communication within the long-term care setting. Investigation of such facilities is important because of the a large impact environmental features have on the quality of life of residents due to the often restricted nature of daily routines and reduced level of cognitive and/or physical function of residents. A definition of environment is needed in order to create a methodology for assessment and treatment of residents in LTC facilities. This study investigates what factors contribute to a positive communication environment in long-term care facilities and how the physical environment should be assessed. Observational data was obtained for three LTC residents with different types of physical and communicative impairments to determine what environmental factors inhibit or support communication. Barriers and facilitators to communication are identified, and recommendations for assessment of the long-term care environment are made. Contributions from the fields of aphasiology, environmental gerontology, and environmental psychology are described in order to contribute to the understanding of what contributes to a positive communication environment. Study results included support for: participant observation as a component of resident assessment, assessment of multiple environments, the importance considering individual needs during assessment, and assessment of resident perception of environment. Furthermore, this study presents a checklist to be used to guide observational assessments. / text

My current area of exploration questions how objects and materials can come together to create fences or barriers. I am attempting to address ideas of boundaries, divisions, and borders, and how areas and spaces are defined. I am interested in how we build them around ourselves, physically and emotionally, as a method of delineation and defence. Through considerations of boundaries the work expands to explore notions of the everyday, materiality and process.

The objective of this study was to determine the influence of child and caregiver characteristics on asthma outcomes in Hispanic children. Specific research objectives of the study were to: (1) to asses the relative influence of family characteristics, caregiver level of education, asthma severity, insurance status and acculturation, on asthma outcomes in Hispanic children; (2) to asses the direct and indirect influence of acculturation on asthma outcomes in Hispanic children, while controlling for other variables; (3) to determine the relative influence of familial characteristics, parental level of education, asthma severity, insurance status and acculturation, as they predict utilization of asthma services. The Children's Health Survey for asthma, the abbreviated Multidimensional Acculturation Scale and components of the Children's Medicaid Managed Care Questionnaire were administered during a one time visit with Hispanic caregiver's of children with asthma in a primary care setting. The primary care setting was either a local pediatrician office in Hillsborough County or the local Hillsborough County Health Department. These facilities provide primary care for local residents of the county. The interviews were conducted to identify the relative influence of barriers to asthma outcomes in this at risk population. A sample of one hundred seventy eight caregivers of Hispanic children with asthma identified significant findings that have a profound effect on pediatric asthma outcomes. Findings suggest that factors such as caregiver age and asthma severity have a negative effect on asthma outcomes in Hispanic children. This study found that advanced caregiver age was associated with poorer healthcare outcomes. Acculturation was not found to be significantly associated with asthma outcomes, directly or indirectly even with use of service utilization as a mediator. In this subject sample the level of acculturation of the caregiver does not impact health care outcomes of the child. This study showed that asthma severity and acculturation significantly impacted service utilization. Children with higher asthma severity scores were found to utilize more services. Finally, acculturation was found to have a significant impact on service utilization. The more acculturated caregivers utilized more services than less acculturated caregivers.

In a traditional male dominated field such as construction, and automotive technology, artificial barriers and attitudes have often prevented qualified females from reaching their full potential. The late entrance of females into these fields has created very few role models for nontraditional younger females entering these professions. This study was designed to create a profile for nontraditional females working in a male dominated work force. A large percentage of females have experienced some barriers due to discrepancies in gender performance. Acceptance by peers, community and administrators, combined with the challenge of balancing family and career appears to be areas of concern for nontraditional females.

The purpose of this study was to investigate physical activity (PA) engagement among older adults (OA) following discharge from a medically supervised group exercise program and to explore the facilitators and barriers that influenced maintained PA engagement. While facilitators and barriers to PA among OA in general have been well documented, facilitators and barriers particular to maintaining PA after discharge from a supervised exercise program have not been widely explored with qualitative methods or a mixed method design. Data for this mixed method, case study approach were collected in two phases. In Phase I, questionnaires were used to investigate PA engagement as well as semi-structured qualitative interviews were completed (n = 12; Mage = 80.0 years) to explore facilitators and barriers that influenced PA engagement. In Phase II, reviews of medical charts were conducted retrospectively to gather further information on PA engagement and barriers (n = 12). All 12 individuals in Phase I remained engaged in PA activity 2 – 48 months post completion of the medically supervised exercise program. This particular group of OA identified facilitators for and barriers to maintaining PA that were personally-, socially-, and program-based, and also provided suggestions to alleviate cited barriers. Four themes identified in regards to PA engagement were: (1) Personal drive: highly aware of the need to keep moving; (2) Social connections and support: we all need people; (3) Program components matter; and, (4) Convenient, Affordable, Relevant: suggestions to improve program access. The power of multi-level, multi-sector approaches that consider the broader determinants of health was highlighted in this study. Participants identified the need for health care providers (HCP) and PA instructors to continue to communicate the benefits of PA, the importance of ongoing HCP support, and the necessity of working across sectors to reduce program related barriers to promote PA engagement among OA discharged from a medically supervised exercise program. / Graduate / melodyburgoyne@hotmail.com

Purpose: Environmental sustainability was firstly thought to be an obstacle to economic development, whereas innovation promotes it. Nowadays, the contradiction between these two terms is less and the purpose of this paper is to highlight the importance of the connection between environmental sustainability and eco-innovations as this can lead to a win to win procedure with the help of the relevant strategies that should be applicable based also on scientific evidence. Design – Methodology – Approach: This paper consists of four case studies in the sustainability and eco-innovation sector in Sweden. An abductive method is used. Emails were sent and phone calls were made to the companies. Skype and telephone interviews were conducted. Findings: The findings provide a practical contribution to the companies of how certain strategies can be implemented in businesses so as to connect environmental sustainability and eco-innovations. Moreover, the findings showed that barriers did not appear that could influence or change companies’ strategies. Research limitations / implications: This paper is only limited to one dimension of sustainability, that of the environment, besides focuses on eco-innovations that come from the gulf of the environmental sustainability. Furthermore, the thesis is limited in the strategies that businesses implement towards environmental sustainability and eco-innovations, as well as the potentials barriers that may come up. Practical Implications: The practical implications are identified to the actions / strategies that businesses follow towards environmental sustainability and eco-innovations. Originality – Value: This paper finds and fills the gap that many companies have as far as the non-comprehension of how environmental sustainability and eco-innovations are connected by the means of implementing specific strategies. Key Words: sustainability, innovation, eco-innovation, strategies for sustainability and eco-innovations, barriers. Paper: Master Thesis

Walking for active transportation (AT) has been associated with individuals meeting the recommended physical activity levels. Global and local (i.e., Saskatoon) reported walking rates are low. Barriers perceived as a challenge (i.e., frequent and limiting) may influence walking. Individual differences, such as self-regulatory efficacy (SRE), may help people persist in overcoming challenging barriers, with those being more efficacious having greater persistence than their lower efficacy counterparts. The overall purpose of the present self-efficacy theory-based study was to examine whether individuals with higher and lower SRE differed in their persistence to overcome barriers to walking to/from a university campus under two experimental conditions (i.e., higher versus lower challenge). The experimental study design was a two (between: higher versus lower SRE to overcome barriers) by two (within: higher versus lower challenge vignette) mixed factorial, with three measures of persistence as the dependent variables (i.e., number of written solutions to overcoming barriers, time taken to record the solutions, and anticipatory perseverance to overcome barriers to walking in the near future). Based on self-efficacy theory and past research, individuals who had higher SRE were expected to have significantly higher persistence than their lower SRE counterparts after reading the higher challenge vignette. Participants were young adults who walked to/from a university campus. Higher and lower SRE groups were identified via a median split (nhigher = 22; nlower = 23). Each participant read a higher and lower challenge vignette (i.e., order counterbalanced across participants) in a lab-based setting, followed by completion of persistence measures after each vignette reading. Findings from a series of two by two ANOVAS provided partial support of the study hypothesis. A significant interaction between SRE groups and challenge vignettes was found with the persistence measure of time spent reporting coping solutions, F(1,43) = 4.64, p = .037. As expected, results from simple main effects showed the higher SRE group significantly differed from the lower SRE group under the higher challenge vignette condition, F (1,43) = 5.27, p = .027, by spending significantly more time reporting solutions. No other significant interactions were found between SRE groups x vignettes with the remaining measures of persistence: (1) number of reported solutions F (1,43) = 3.15, p = .083, and (2) anticipatory perseverance F (1,43) = 0.05, p = .82. The present study contributed new information on challenging barriers to walking for AT. Findings from the experiment partially supported contentions from self-efficacy theory about the importance of SRE beliefs to persistence when individuals are challenged. Future research should continue to examine the potential role that SRE beliefs play in whether individuals walk for AT.

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