Next Gen: Guiding Dads as they Spiritually Guide the Next Generation

The spiritual development during the teenage years are pivotal in determining the religious and spiritual values as teenagers transition into adulthood. As serious as this stage of development is, there is a lack of involvement in the faith development of teenagers on the part of parents, specifically Christian fathers. With this lack of paternal support during faith development, the percentage of those leaving the church during adolescents and early adulthood is rapidly increasing. The aim of the research was to understand important milestones in spiritual development of teenagers, why Christian dads are uninvolved in this development, and best strategies for communicating large quantities of development information to dads that already struggle with being involved. To better understand this problem, the following research questions were asked to better understand the problem and possible solutions: 1. Who is Gen Z? 2. Why is Gen Z leaving the church? 3. What does spiritual development look like during the adolescent years? 4. What impact does the parental relationship have on spiritual development? 5. What is the current state of paternal involvement in faith development in the home today? 6. What external sources are impacting spiritual development? After this research was conducted, additional case studies and visual analysis were also conducted to evaluate similar studies and design projects. Based off the research, a brand campaign consisting of a poster series, social media posts, mobile app, website, and activity booklet were created to educate dads on important milestones of teenage spiritual development, challenges to connect with their teenager regularly and have faith conversations and provide guides for creating a safe space to ask and answer tough questions about faith. Through these resources, dads will be better equipped to understand spiritual development and be actively involved in the lives of their teenagers. Additionally, teenagers will also have a better environment for their own spiritual development

Go Wish- Pediatrics : Pilot Study of a Conversation Tool in Pediatric Palliative Care

Problem: Difficult conversations and decisions are an unfortunate reality for parents caring for children facing life threatening conditions. Confusing, inadequate, and inconsistent communication by health care providers makes advance care planning difficult in pediatrics. Design: A mixed methods design was utilized to evaluate the effectiveness of an advance care planning conversation tool, Go Wish- Pediatrics, on the emotional resources and distress experienced by parents caring for children in palliative care. Methods: For this pilot study, a mailed invitation to participate was sent to 134 parents of children currently enrolled in palliative care which yielded a total of ten participants. Results: Parents in this study reported moderate levels of perceived emotional resources. The Go Wish- Pediatrics intervention resulted in no change in pre-post comparison of guilt and worry, unresolved sorrow and anger, long term uncertainty, and emotional resources. The most value most consistently reported as very important by the parents was their relationship with their spouse or significant other. For the qualitative portion of the study, data was collected using semi-structured interviews and analyzed using a thematic analysis. The three emerging themes of the parents’ perception of the Go Wish- Pediatrics intervention included operationalizing thoughts into action, empowered to join the conversation, and a lighthouse in the fog. The mixed methods analysis utilized comments from the participant interviews to explore a deeper explanation of how parents experienced the parental distress and emotional resources subcategories. Conclusions: Parents identified that the Go Wish- Pediatrics intervention was beneficial in helping initiate conversations related to topics that are often difficult to approach. The intervention also served a communication bridge to support communication between spouses or significant others as well as with the healthcare team. The utilization of the Go Wish card game also revealed that parents involved with palliative care for their child have very different priorities. The use of the Go Wish- Pediatrics intervention helps individualize communication to the priorities and needs of families

SET THE NET: THE HERITAGE SIGNIFICANCE OF FISH CAMP AND WILD SALMON IN BRISTOL BAY, ALASKA

In over 10 years of environmental and socioeconomic studies surrounding the controversial Pebble Limited Partnership mine project design and permitting, commercial salmon fishers’ voices in Bristol Bay, Alaska remain unheard. To meaningfully participate in cultural resource management decision-making that affects them, communities need to speak, yet fisher communities rarely have an established voice. This dissertation uses critical collaborative ethnography and Indigenist research paradigms to describe how the recognition of living heritage communities can be facilitated through the identification of ethnographic landscapes. Such landscapes reflect the meaningful relationship of culture and place, concepts that are currently under-represented in Alaska. Not only my Self as a fisher, but also Other as researcher are presented in a single narrative that weaves together fisher interviews and conversations. As part of a growing body of collaborative research, this dissertation aims to decolonize research by seeking out alternative histories and amplifying marginalized voices of fishers who perpetuate experiential knowledge, and transmit this heritage to future generations through the yearly harvesting of the renewable resource of wild salmon

An Integrative Review of the Literature on Technology Transformation in Healthcare

Healthcare transformation through technology is a core objective of health reform. It is important for decision makers to understand the likelihood that reform policies will in fact transform. This study evaluates evidence of technology transformation in healthcare through an integrative review of the healthcare and business literature, guided by the theory of punctuated equilibrium (TPE). TPE describes the process of transformation within organizations, markets, and groups. The theory explains transformation as a pattern of long periods of incremental change (equilibrium) punctuated by short periods of dramatic change (revolution). An underlying deep structure defines the environment of the organization, market, or group. Radical change in the deep structure of the environment is necessary for transformational change. This integrative review covered the period January 2004 through April 2012. The inclusion criteria required that the article or study address both the implementation of health information technology in the United States and describe one of the three components of TPE. Five hundred twenty articles focusing on transformational change were identified through structured database searches of MedLine/PubMed, Business Source Complete, Social Science Research Network, and others. The articles were reviewed, and coded using the three elements of TPE. A directed content analysis of the coded data produced 10 themes describing the three TPE elements: variations in the environment, market complexity, regulation, flawed risk and reward, theories of technology acceptance, barriers, ethical considerations, competition and sustainability, environmental elements of revolution, and internal elements of revolution. The results describe a healthcare market exhibiting strong equilibrium and substantial resistance to change from HIT. Minimal descriptions of the revolutionary element of TPE were evident. The deep structure of healthcare indicates that the historical provider and hospital-centered market prevails. Conditions that might encourage alteration of this deep structure were: empowering and engaging patients; updating care delivery models; and reducing market uncertainty. The revolutionary changes seen in other complex markets from banking to travel to manufacturing relied heavily on the power of the consumer to alter deep structure. Although the concept of patient centeredness was present in the literature there was little clarity regarding the patient as an agent of structural change. To our knowledge this is the first application of TPE to investigate technology transformation in healthcare. Others have demonstrated TPE as a viable model for explaining transformational change in other markets. The study is limited by the study timeframe and the absence of newer literature reflecting the impact of recent policy changes. Despite this limitation the findings suggest that TPE presents a potentially valuable framework to guide evaluation of the progress of policies that encourage transformation from technology. Some propose that altering the complex deep structure of healthcare may require a complete destruction of existing processes before new processes, innovations, and technologies can emerge. The Affordable Care Act (2010) and the meaningful use provisions of the HITECH Act (2009) are moving healthcare toward new patient centered models of care. Uncertainty around the future of reform policies from possible repeal or amendment likely contributes to resistance to transformational change. This may perpetuate the historical rational and incremental pattern of HIT advancement. Patients as consumers have the potential to influence change given the appropriate tools. The importance of consumers to the transformation process suggests that policies fostering technologies that integrate patients into new care delivery models are likely paramount to realizing technological transformation

Experiences of living and dying with Lewy body dementia:A longitudinal narrative study

Background Lewy body dementia is a life-limiting condition with multiple, complex symptoms. As the condition progresses much of the caring and nursing duties fall to families. However, little is known about how people with Lewy body dementia and their families are affected by the condition. The overall aim of this thesis was to explore the experiences of people living with Lewy body dementia, and their family carers over time. An integrative systematic review of the literature was conducted. A convergent integrated design was applied to facilitate the synthesis of published research exploring the experiences of people living with Lewy body dementia and family carers. There was scarce qualitative evidence identified on the lived experience, with a predominant biomedical focus and cross-sectional designs. Methodology In order to gain unique insights into people’s experiences of living with Lewy body dementia a narrative methodology was chosen. A social constructionist approach influenced the research conducted, drawing from the psycho-social discipline and experience-centred narrative theory. The underpinning perspective was that knowledge and reality are socially produced, and humans’ understanding, and interpretations of their world occurs through stories. Method A longitudinal narrative study using three sequential interviews and life story work was completed to gain unique insights into five couples’ experiences of living with Lewy body dementia. Participants were recruited from memory clinics and the ‘Join Dementia Research’ database within the east of England. Narrative data were collected using dyadic narrative interviews with each couple over a six-month period (August 2019 – Februrary 2020). The analysis of the stories was conducted using Murray’s levels of narrative analysis in health psychology. Murray’s anaytical framework enabled stories to be analysed at the personal, interpersonal, positional, and societal level. Findings The main finding from this study was that the overarching narrative of ‘social connectedness’ was found to be important, and this continued over time. In this study, social connectedness represents a stepwise description of how a person is actively involved with others and their surroundings, leading to a sense of comfort and wellbeing. Seven stages of social connectedness were identified: maintaining social connections, developing new connections together, social disconnection, support from adult children, marital disconnection, connecting to health and social care, and emotionally separated but living together. Lack of social connectedness leads to social disconnection. Repeated losses over time resulted in difficulty in maintaining social connections giving rise to a reduced sense of agency. Loss of continence, energy, and independence, together with difficulty managing medications, significantly impacted on couples’ quality of life and ability to remain connected through all stages. Conclusion Maintaining a social life and support network was important for both people living with Lewy body dementia and family carers. The findings contribute to the methodological literature that gives voice to those living with dementia over time. They highlight how physical and personality changes, communication challenges, and behavioural difficulties, undermine established social connections. The stepwise diagrammatic representation of social connectedness provides guidance for more targeted healthcare interventions and management of Lewy body dementia

Perceptions of care and caring: An orthopaedic perspective

“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn life around,” (Leo F Buscaglia 1924-1998). Caring is a universal phenomenon (Leininger, 1988a, 1991) that influences the way we think, feel and act and is the focus of debate worldwide. Studied since the days of Florence Nightingale and reflected in the literature are numerous theoretical opinions in the search for a comprehensive understanding of caring in the health experience of human beings (Newman et al., 1991). This ethnographic thesis has a caring science perspective (caring in orthopaedics) with the aim of acquiring a greater understanding of perceptions of caring in an orthopaedic clinical setting from both patient and health care professional perspectives. There is a wealth of literature relating to caring which attempts to define and interpret its meaning from several theoretical perspectives. In respect of institutional or professional caring, nursing has historically been synonymous with the notion of care and caring, modest research has been attributed to caring amongst other health care professionals in the wider context. The study used a sequential exploratory mixed methods design and was underpinned by Watson’s Theory of Transpersonal Care in order to discover and illuminate the essential caring behaviours valued by both care givers and care recipients. A total of 30 patients and 53 health care professionals consisting of doctors, nurses, physiotherapists and occupational therapists participated in the study through a three stage approach consisting of questionnaires, observation and semi-structured interviews. The findings revealed both similarities and differences between patients and health care professionals relating to the importance of positive caring behaviours revealed during caring interactions. The questionnaires disclosed that patients statistically rated caring behaviours demonstrated by health care professionals lower than the professionals rated themselves. The data analysis from the participant observation and semi-structured interviews established that although all of the caring caratives according to Watson’s Theory of Care were evident in caring interactions they varied as to the number of times they were exhibited by the respected health care professional groups. Overall patient perception of caring focused upon behaviours related to the caring carative ‘assurance of human presence’ whilst health care professionals considered caring behaviours relating to the caring carative ‘respectful deference’ as the most important. This thesis highlights the need of the patient to feel ‘cared for’ and ‘cared about’ and in today’s modern health care system caring should not be monopolised by one profession but instead the caring concept embraced and the caring dais shared by other professions

Understanding Anishinaabek G'giikendaaswinmin (knowledge) on N'bi (water), Naaknigewin (law) and Nokomis Giizis (Grandmother Moon) in the Great Lakes Territory for Water Governance

The Canadian settler state lacks a gender balance in N’bi governance and decision making. Little documentation articulates Anishinaabek understandings of reconciliation and how reconciliation can assist with reconciling different legal orders and governance structures which includes Nokomis Giizis (grandmother moon). Drawing on Anishinaabek from the Great Lakes territory, this research explores how does Anishinaabek law construct the role of women in N’bi decision making; can the broader discourse in Canada about reconciliation assist with improving humanity’s relationship to N’bi; how can the concept of reconciliation assist with reconciling different legal orders, and governance structures; what are the relationships and responsibilities between Anishinaabek and Nokomis Giizis and how can these relationships inform N’bi governance including women’s roles. This study utilized an Anishinaabek Research Paradigm (ARP) that employs Indigenous Intelligence as a conceptual framework for qualitative Anishinaabek analysis of data throughout the study. G’giikendaaswinmin shared through conversations, key informants and a focus group are provided into three separate manuscripts. Manuscript One: Indigenous Water Governance: Anishinaabek naaknigewin (law) Constructs the Role of Anishinaabek kweok (women) in N’bi (water) Decision Making supports and expands on existing literature of kweok as N’bi carriers with roles and responsibilities to and specific knowledge of N’bi. It demonstrates that men have a role in N’bi governance and reveals how Anishinaabek naaknigewin constructs the role of kweok in N’bi decision making. Manuscript Two: N’bi Can Teach us about Reconciliation demonstrates how N’bi can teach humanity about reconciliation which could address environmental conflict. It reveals that Anishinaabek understanding of reconciliation is different than mainstream society and is about relationships between Anishinaabek and non-Indigenous but also about relationships with N’bi. Manuscript Three: Relationships and Responsibilities between Anishinaabek and Nokomis Giizis (Grandmother Moon) can Inform N’bi (water) Governance establishes that Anishinaabek understand the relationships and responsibilities to Nokomis Giizis through the cycles of both kweok and Nokomis Giizis that is guided through Anishinaabek naaknigewin. In brief, this study supports and expands that kweok need to be involved in water governance based on their knowledge and relationships with N’bi and Nokomis Giizis

Understanding Anishinaabek G'giikendaaswinmin (knowledge) on N'bi (water), Naaknigewin (law) and Nokomis Giizis (Grandmother Moon) in the Great Lakes Territory for Water Governance

The Canadian settler state lacks a gender balance in Nbi governance and decision making. Little documentation articulates Anishinaabek understandings of reconciliation and how reconciliation can assist with reconciling different legal orders and governance structures which includes Nokomis Giizis (grandmother moon). Drawing on Anishinaabek from the Great Lakes territory, this research explores how does Anishinaabek law construct the role of women in Nbi decision making; can the broader discourse in Canada about reconciliation assist with improving humanitys relationship to Nbi; how can the concept of reconciliation assist with reconciling different legal orders, and governance structures; what are the relationships and responsibilities between Anishinaabek and Nokomis Giizis and how can these relationships inform Nbi governance including womens roles. This study utilized an Anishinaabek Research Paradigm (ARP) that employs Indigenous Intelligence as a conceptual framework for qualitative Anishinaabek analysis of data throughout the study. Ggiikendaaswinmin shared through conversations, key informants and a focus group are provided into three separate manuscripts. Manuscript One: Indigenous Water Governance: Anishinaabek naaknigewin (law) Constructs the Role of Anishinaabek kweok (women) in Nbi (water) Decision Making supports and expands on existing literature of kweok as Nbi carriers with roles and responsibilities to and specific knowledge of Nbi. It demonstrates that men have a role in Nbi governance and reveals how Anishinaabek naaknigewin constructs the role of kweok in Nbi decision making. Manuscript Two: Nbi Can Teach us about Reconciliation demonstrates how Nbi can teach humanity about reconciliation which could address environmental conflict. It reveals that Anishinaabek understanding of reconciliation is different than mainstream society and is about relationships between Anishinaabek and non-Indigenous but also about relationships with Nbi. Manuscript Three: Relationships and Responsibilities between Anishinaabek and Nokomis Giizis (Grandmother Moon) can Inform Nbi (water) Governance establishes that Anishinaabek understand the relationships and responsibilities to Nokomis Giizis through the cycles of both kweok and Nokomis Giizis that is guided through Anishinaabek naaknigewin. In brief, this study supports and expands that kweok need to be involved in water governance based on their knowledge and relationships with Nbi and Nokomis Giizis

An In-Depth Investigation Of How An Undergraduate Mathematics Major Student Learns The Concept Of Proof

Mathematical proof is of high importance in the advanced proof-based courses which mathematics majors must take in order to graduate. Investigating how a competent student learns the concept of proof may be very beneficial in the pedagogical approaches of proof courses. In this study, the Self-Regulated Learning (SRL) theory and the Action-Process-Object-Schema (APOS) theoretical framework were employed. A competent mathematics major student was observed during two semesters – Bridge to Higher Math and Analysis. The observational data was triangulated through follow up discussions after class observations and a final interview at the end of the semester. The results of data analysis indicated that the participating student was successful in writing valid proofs in the Bridge to Higher Math course but only memorized the proofs in the Analysis course. Results showed that a mismatch in the student’s learning style and the instructor’s teaching style in the Analysis course negatively affected the student’s level of self-regulation and thus attributed to him not moving past the Action conception stage of understanding for the content covered in the course. A lack of conceptual understanding was also a difficulty that arose for the student when learning proof concepts. There was a positive correlation between the student’s level of self-regulation and course grade. The student’s responses to the SRL questionnaire were used to develop a generalized linear regression model to estimate the student’s success based on his/her level of self-regulation. Self-efficacy proved to be the only significant component for the model. From the view of APOS theory, his conception of a proof was at mostly at the Process conception stage of understanding in the Bridge to Higher Math course and was predominately at the Action conception stage of understanding in the Analysis course. Suggestions on how to incorporate self-regulated learning in the classroom and APOS theory in the pedagogical approaches for proof courses were made

More than print: The home and school literacies of three fourth-graders

Through ethnographic case studies of three fourth-grade children, this study investigates the relationships between children\u27s home and school literacies. The data were collected through participant-observation in the children\u27s homes and at school; interviews of children, parents, and teacher; and analysis of children\u27s products and processes (such as written work and hand-made crafts). The study defines a literacy as a meaning-making system which can be used functionally, communicatively, reflectively, flexibly, and pleasurably. Schools typically focus on print literacy and do not always recognize or value the range of literacies children bring with them from home. This research shows children using not only print literacy, but interactive and mechanical literacies, among others. It suggests that children acquire literacies informally, in context, and through interaction. The findings suggest that schools broaden their concept of a literate environment to include more than print and to promote interactive ways of working--to become learning homes where children\u27s home literacies are used in meaningful ways--both for their own value and as bridges to other literacies