Extreme smoke events: climate change and human health in western Montana

Abstract not available

Assessing Health Care Resilience in Mozambique: A mixed methods analysis of COVID-19 impact on maternal and child health service delivery in urban districts of Manica and Maputo provinces.

Thesis (Master's)--University of Washington, 2023Background:COVID-19 disrupted health care services around the world. Maternal and child health care is of particular concern in Mozambique, given that neonatal disorders are a leading cause of death and that studies from 2021 demonstrate significant reductions in maternal and child health services during the pandemic. This study aims to provide a sub-national assessment at how services were affected throughout the pandemic and characterize facilitators and barriers to service delivery. Methods: We utilized a two-phased mixed methods explanatory-convergent design. In phase one, we extracted electronic routine data for 9 selected maternal and child health care indicators across all districts within Manica and Maputo provinces from 2018 to March 2022. Quantitative data were analyzed by time-series and LOESS regression graphs using R. In phase two, two districts and four health facilities were purposively selected for analysis involving semi-structured interviews (n=4) and focus group discussions (n=8). Qualitative data were analyzed by iterative coding and thematic analysis. Results: Our quantitative results demonstrated reductions in critical maternal and child health services during the pandemic, but impact varied across location and sector. First family planning visits showed the greatest reductions, dropping 14.7% in 2020-2021 from 2018-2019. Immunizations (Polio3 [-6.9%], and DTP3 [-7.5%]) also dropped, while first and fourth antenatal visits (+3.6% and +17.0%) and institutional births (+0.9%) increased in average services delivered. Qualitative data revealed multiple perceived barriers to service delivery, including insufficient personal protective equipment, insufficient human resources, unmet heath facility infrastructure needs and isolation spaces, insufficient financial support of providers, and fear of contracting COVID-19 in health centers. Facilitators included bi-directional communication between health facility, district and province, adapted communication mechanisms, teamwork, and provider self-efficacy. Conclusion: Reductions in many MCH services, particularly family planning, and immunizations were confirmed during 2020-2021 compared to pre-pandemic years, but with trends showing recovery in early 2022. Multiple system-level barriers to service delivery were identified by providers in urban districts of Manica and Maputo Provinces which affected perceived quantity and quality of care. Strengthening health system infrastructure, material and human resource support of providers may help to improve resilience to future pandemics or emergencies

Centres for Teaching and Learning Across Canada: What’s Going On?

Post-secondary institutions, especially those with a research focus, face a challenge in ensuring consistent and high-quality teaching, in part because many members of the teaching faculty have backgrounds in research instead of teaching. A common part of meeting this challenge is the presence of Centres for Teaching and Learning (CTLs) on university campuses. This study examines the situations of CTL directors at research and teaching-intensive post-secondary institutions across Canada, with an aim to develop an understanding of the current context in which Canadian CTLs are operating, as well as the experiences of those who lead the CTLs. The qualitative study consisted primarily of 60- to 90-minute individual semi-structured interviews. The findings of these interviews were coded into four main categories: the evolving purpose of CTLs, key drivers of change, common challenges, and future trends. The implications for this research are two shifts: one mirroring a shift in education development to embracing Boyer’s work and secondly moving from a service to a leadership orientation. A thriving CTL is an indication of a university culture that values teaching, learning and scholarship. Les établissements d’enseignement post-secondaire, en particulier ceux dans lesquels l’accent est mis sur la recherche, doivent faire face au défi d’assurer un enseignement cohérent et de haute qualité, en partie du fait qu’un grand nombre de professeurs ont des antécédents en recherche plutôt qu’en enseignement. Pour relever ce défi, un des éléments communs est la présence de centres d’enseignement et d’apprentissage (CEA) sur les campus universitaires. Cette étude examine la situation des directeurs de ces centres dans des établissements d’enseignement post-secondaire canadiens où la recherche et l’enseignement sont intenses, dans le but de comprendre le contexte actuel dans lequel les CEA canadiens fonctionnent, ainsi que les expériences de ceux qui dirigent ces CEA. L’étude qualitative a consisté principalement d’entrevues individuelles semi-structurées de 60 à 90 minutes. Les résultats de ces entrevues ont été codés selon quatre catégories principales : l’évolution de l’objectif des CEA, les principaux moteurs de changement, les défis communs et les tendances futures. Les implications de cette recherche sont de deux sortes : la première reflète les variations dans le développement de l’éducation afin d’adopter le travail de Boyer, et la seconde indique le passage d’une orientation de service à une orientation de leadership. Un CEA florissant est le signe d’une culture universitaire qui accorde de l’importance à l’enseignement, à l’apprentissage et à l’avancement des connaissances