Nursing theory has contributed significantly to discussions of so-called culturally competent biomedical healthcare delivery. This study explores how Labor and Delivery nurses at a large, urban teaching hospital negotiate the care of a hyper-diverse patient population and construct working understandings of competence. Archival research, semi-structured interviews and participant observation demonstrate that cultural competence is not a distinct concept, but rather functions as an ambiguous symbol used to discuss a variety of challenges with advocating for patients and delivering care in communities faced with issues of racism, immigration, low socioeconomic status, and multiple comorbidities.

It is well documented that Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome (HIV/AIDS) disproportionately affects Hispanics and Latinos in the United States (US). While Hispanics represented 17% of the US population in 2014, they accounted for nearly one-fourth (23%) of all new estimated HIV diagnoses. Furthermore, Hispanics/Latinos made up nearly one-fifth (21%) of all persons living with HIV infection in the United States (and six dependent areas). Hispanic/Latino populations face numerous barriers that negatively impact their outcomes along several steps of the HIV care continuum. This paper will discuss the HIV care continuum, particularly focusing on disparities that Hispanic and Latino populations may face progressing through several steps of the continuum. Furthermore, a focus on defining barriers that this population may face accessing and maintaining regular HIV care will be used to explore ways that providers can deliver culturally tailored, appropriate HIV care to this population. An emphasis on the social determinants of health on the HIV outcomes of Hispanics/Latinos will be crucial in addressing the disproportionate share of the HIV burden that this population encounters.

Dirofilaria immitis, commonly known as dog heartworm, is a dangerous filarial nematode that is transmitted by a mosquito vector. Although this parasite is historically localized to regions closer to the equator, the last few decades have experienced an increase in the amount of dog heartworm cases in Northern California, most notably in Lake and San Joaquin Counties. The primary vector of D. immitis in Northern California is Aedes sierrensis, but it is not prevalent enough in some counties to explain the increase in infections. Because of this, more prevalent and abundant species should be assessed for their ability to transmit heartworm. Culex pipiens complex (wild) and Culiseta incidens (laboratory-raised colonies) were chosen as potential vectors during this study due to their ability to meet several key vector criteria, their relative abundance in the areas of interest, and the fact that they habitually take bloodmeals from domestic dogs. Additionally, Ae. sierrensis colonies were used in this study, based on previous knowledge that they are highly competent vectors. Female mosquitoes were infected with 2.5, 5, or 10 mff/ul of D. immitis-infected blood, and decapitated at 15, 18, and 21 days post-infection. Mosquitoes were subsequently tested via qPCR for the presence and relative quantification of D. immitis DNA. We found that Ae. sierrensis and Cx. pipiens complex were both able to support the development of D. immitis to its infective stage, while Cs. incidens was not a competent vector. We also concluded that including a standard curve of known amounts of D. immitis larvae makes it possible to approximate the intensity of the infection in the mosquito. The identification of these important vectors, and the ability to assess infection intensity, may be helpful in the continued vector control efforts in Northern California and beyond.

This study explores the impact of authentic materials on the oral competence of students. In extension, this study is interested in the perspectives and experiences of authentic materials among teachers in French in Swedish secondary school.A solid theoretical framework has been made in the aim at understanding and appreciating the key words of this research, such as oral competence, authenticity, and authentic documents to guarantee a common understanding of these terms which form the basis of this study. In addition, this step allowed to highlight the importance of these criteria in Swedish official educational documents but also to understand how authentic documents help develop students' oral skills.For the purposes of the study a qualitative design was chosen, and data was collected by three semi-structured interviews with three teachers. The results of this study show that two out of three teachers do not particularly consider the criterion of authenticity, and one identified reason was that these teachers simply did not consider this criterion, for lack of time and preferring to use a textbook. However, the teacher who regularly uses authentic materials experiences that it improves the motivation of students and make them more inclined to communicate orally in the target language. Thus, this study points out that few teachers may consider the criterion of authenticity and the use of authentic documents, since out of 3 teachers questioned, only one regularly uses authentic materials. The conclusion is drawn that teachers might be unaware of the many benefits with using authentic materials, which was highlighted during the theoretical research but also in the results of interviews which suggests that the students speak more easily in the target language when the teacher uses authentic materials, preferably in a playful way.

This PhD by published work consists of: • two single authored articles in refereed journals; • four jointly authored articles in refereed journals; • one jointly authored editorial; • one jointly authored book, including four single authored chapters; They were published in the period 2003-2013. Philip Gilligan submitted the jointly written publications as part of his submission for the award of Degree of Doctor of Philosophy by Published Work in 2013. This thesis identifies substantive findings, theoretical insights, new questions and practice/policy implications arising from the published work. The body of work has and continues to stimulate debate about the need to recognise and appreciate the significance and relevance of religion and related belief in the lives of people accessing health and social care services in the UK. It outlines the general relevance and impact of religion and related belief and explores questions and research concerned with the extent to which social work takes these matters into account in its practices, polices and professional training. It prompts practitioners to reflect on their own and others’ religious beliefs by providing a framework of nine related principles to assist them in their professional practice. One key finding is the need for service providers and policy makers to develop new services that are more responsive to the diverse needs of people living in the UK today by recognising and adopting some of the diverse helping strategies employed and imported by different communities. / The full text of the published articles submitted with this PhD thesis are not available in full text in Bradford Scholars due to copyright restrictions.

Health care changes, including increased hospital admissions, an aging population and the chronicity of diseases and conditions have led to increased collaboration with unregulated professionals. Within the professions of occupational therapy and physiotherapy, there is a paucity of literature that addresses the perceptions of Occupational Therapist Assistants and Physiotherapist Assistants (OTAs and PTAs) with respect to their competence in clinical practice. This research study investigates the perceptions of clinical competence of OTA and PTA graduates from one Ontario community college. A phenomenological theoretical framework was used to explore the participants’ lived experiences. Eight individual in-depth interviews were used to gather data representing the graduate OTAs and PTAs’ perspectives. In addition, the viewpoints from a stakeholder focus group of eight participants comprised of occupational therapists, physiotherapists, and administration personnel from one Ontario hospital were used to triangulate the data.. Four themes emerged: 1) employing effective communication, 2) emerging knowledge, skills and competencies in clinical practice, 3) transitioning into clinical practice, and 4) developing confidence as an OTA and PTA. The Person Environment Occupation (PEO) model (Law et al., 1996) was used to organize the themes and to assist in determining the optimal fit between the themes. Confidence was articulated as a continuous concept that facilitated the graduates’ competence in their clinical skills. Proficiency in their roles, a supportive transition, and demonstrated competence were the presenting factors that empowered the graduate OTAs and PTAs to affirm their competence in clinical practice. This research study is foundational for future research related to OTAs and PTAs in the areas related to use of title, educational credentialing, and collaborative competency documentation. / Thesis / Master of Science (MSc) / Currently, there are changes in health care services that require modifications to the delivery of the treatment. Occupational Therapist Assistants and Physiotherapist Assistants (OTAs and PTAs) work within patient rehabilitation; however, their perceptions of competence have not been assessed. This study reviews the perceptions of the OTAs and PTAs when completing their role with patients by interviewing them and interviewing the staff that work with them. The data from this thesis will provide us with an enhanced understanding of the perceptions of OTAs and PTAs and the supports they believe enable them to be competent and confident health care professionals. This information will facilitate the identification of the next steps in research specific to OTAs and PTAs in the areas of competency and educational programs.

This thesis aims to provide insight into how academic institutions teach health care professionals about cultural influences on mental health and clinical encounters, as well as how health care providers implement these ideas in their work. Fifteen semi-structured interviews were conducted with mental health care providers in Hamilton. Providers varied significantly in their definition and experience of cultural competence. Few providers had received training in cultural competence, and the experiences of those who had received such training were generally not congruent with what is described in the literature. While the literature describes a shift towards a skills-based paradigm, health care education appears to continue to focus on knowledge and attitudes. Many providers are more familiar with other frameworks for addressing cultural issues; however, these have important implications for quality and access to care for migrant and newcomer individuals. / Thesis / Master of Science (MSc)

The development of a preimplantation embryo is a stepwise process consisting of morphological, biochemical, and genomic changes. Much remains unknown about the attainment of embryo competency to develop and establish pregnancy. To investigate this, we compared methods of selection at the oocyte or embryo level for improved blastocyst production. Brilliant cresyl blue staining was used to sort oocytes by their growth status (not fully grown vs. fully grown) and the timing of the first embryonic cell division to sort embryos. We found that an embryo's cleavage kinetics are more indicative of their competency than the growth status of the oocyte that gave rise to that embryo. We further investigated the cryopreservation survival of embryos with fast or slow cleavage kinetics and found no significant differences in their ability to hatch post-thawing. Next, we used the complete sequence of the cattle Y chromosome to identify oligonucleotides for efficient sexing of samples. These materials may be used to understand sexual dimorphism as a biological factor in future experiments. Finally, we designed a new method to induce targeted DNA sequence deletions and mRNA cleavage in zygotes using CRISPR-Cas. We targeted the gene OCT4, since the literature shows variable knockout outcomes. Our method improved deletion efficiency while accounting for preexisting or maternally inherited mRNA of the target gene. Our findings can be used to better understand early embryo development and biological drivers of quality, which can be leveraged to improve embryo production and transfer outcomes. / Master of Science / The development of an early embryo involves many biological and structural changes. Much remains unknown about the influences on embryo quality and ability to successfully develop. To investigate this, we compared methods for selecting the highest quality cattle eggs or embryos. We found that the observation of an embryo's development speed is better for selecting high quality embryos than egg quality. We further investigated the freezing survival of embryos with fast or slow growth. We found that the freezing survival of fast and slow growing embryos is not different. Next, we used the complete sequence of the cattle Y chromosome to identify PCR primers for determining sample sex. These resources can help us understand how an individual's sex can influence biological differences. Finally, we designed a new method for removing the total function of a gene in embryos. For this, we deleted segments of DNA and cut RNAs. Our findings can be used to better understand early embryo development and biological drivers of quality, which can be leveraged to improve embryo production and transfer outcomes.

Background: Opportunities for development for nurses is affected by the possibility in the interprofessional teams. Their working environment with good: management, workingclimate, teamwork, respect, trust, communication are important factors in competence development. Aim: to get increased knowledge of the experience nurses have regarding competence development through learningopportunities and educations, and theirs impact on care. Method: mixed methods, a qualitative method based on open questions in the survey study, and a quantitative presentation from the numerical answers. Results: the qualitative part is related from 15 informants, 10 had a bachelor’s degree and 8 with master’s degree. They had been employed between 8 months and 28 years, average of 8 years, at the current ICU or postoperative unit. The strongest effect of competence development through experience, deeper and wider knowledge was an increased safety and security. This improved their possibility to give better information, communication and an increased feeling of safety to patients, close relatives, and other personnel. Conclusion: For relatively new employees there is an increased opportunity for competence development, whilst more senior employees experienced that there was less progress at their knowledge level or higher. Longtime employment does not correlate to the highest self-estimated knowledge level, there was only 1 expert and 1 proficient-expert of 15 informants.

The purpose of this study is to find out how store managers in Swedish retail explain the importance of motivation for learning among employees and which factors influence these processes, and whether, according to the store managers, it has any effect on the organizations' development. The collected empirical evidence has taken place through a qualitative method where the respondents in the study have been interviewed. The theories used as part of the analysis for the collected empirical evidence are intrinsic and extrinsic motivation, surface and deep learning, Billet's theory of workplace affordance and Hertzberg's theory of motivators and hygiene factors to include theories related to both motivation and learning in the workplace. The results show that the store manager has an important role for the store and the employees, which also includes creating opportunities for learning and through motivation also contributing to increasing development and well-being in the workplace for the employees. Much indicates that organizations that work with development of learning and motivation create more opportunities for their employees and becomes more profitable, but also that the individuals are responsible for creating the conditions for their own learning.