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Undergraduate nursing students' perspectives on and experiences with clinical practice preparedness: a descriptive qualitative study
Get PDFUndergraduate curricula are designed to prepare nursing students for CP courses so that they can demonstrate their knowledge and skills in supportive and supervised learning environments while students. This is particularly important today, given the ever-increasing knowledge in health sciences and the evolving complexity of healthcare environments. However, anecdotal evidence indicates nursing students feel unprepared for CP, and the literature surrounding this phenomenon remains limited. This study, guided by self-efficacy theory, aimed to explore and describe undergraduate nursing students' (UNS) perspectives on and experiences with clinical practice (CP) preparedness (CPP). Following institutional ethical approval, twenty UNS enrolled in years three and four of the undergraduate nursing program participated in semi-structured, video-recorded virtual interviews. Qualitative content analysis was used to analyze narrative data. The findings described the participants' shared views on CPP. Three themes (or types) of preparedness were found: psychological, cognitive, and physical. Two additional themes were found: CP environment and CP sources (including relationships, preclinical learning, and lived experiences). The findings of this study offer novel insight into UNS' views on CPP and contribute to the limited literature on this phenomenon. These insights may help nurse educators facilitate UNS' sense of preparedness and, in turn, success in their clinical practice courses by ensuring adequate support and structure. This guidance will allow the student to focus on attaining course objectives and entry-level competencies.May 202
Reallocating Sediment for Treatment
No full textThe purpose of this practicum is to explore the possibilities of utilizing macrophytes in a Canadian climate to extract mercurial contamination from a large-scale aquatic environment. One of the primary guiding hypotheses, informed by research, is that it is reasonable to assume the mercurial contamination of the English Wabigoon hydrological system, which originated from Wabigoon Lake in the 1960s will, or has reached the drainage basin of Lake Winnipeg.
This presents concerning issues in addition to the known eutrophication of the lake.
The practicum requires an understanding of the specific nature of the contaminant and the processes in which it interacts with the aquatic environment and wider landscape. At the forefront, the processes of methylation and bioaccumulation play significant roles in the effects on our natural environments and will be leading informants on the eventual design goal. Additional research was devoted to exploring treatment systems designed by landscape architects as precedents.
To negate further mercurial contamination of waterways, shores, and living beings, the practicum seeks to utilize the vegetative process of biofiltration to extract contaminants from the sediment and from the watercourse originating in Ontario and draining in Manitoba. The importance of the research relates to communities’ relationships to the river and water system, some of which are more reliant on the waterway and its resources than others. Informed design requirements include species able to perform extraction of contaminants all while allowing for accessibility for harvesting the macrophytes once the extraction process has taken place.
The areas explored for site selection ranges from Wabigoon Lake, Ontario boreal to the south-east Traverse Bay of Lake Winnipeg. Specific sites will be selected for their appropriateness of intervention. On such a large hydrological scale, sites of mercuric sediment concentration are of interest. Due to the processes of sedimentation, hydro-electric dams along the Winnipeg River system are of interest.May 202
Bones at Home Supporting Haptic Learning and Universal Design beyond the Biological Anthropology Laboratory
Get PDFRemote teaching during the COVID-19 pandemic led to a range of pedagogical challenges for anthropology laboratory courses. In biological anthropology courses such as Human Osteology, hands-on experience is essential to achieving learning outcomes, including basic bone and feature (i.e., landmark) identification, identification from fragmentary remains, and age and sex estimation. To address the need for training that includes object-based, tactile (haptic) learning in fields such as biological anthropology and archaeology, all Human Osteology students at Mount Royal University and the University of Manitoba took home plastic model skeletons. The purpose of this study was to evaluate how well remotely educated undergraduates (REUs) met human osteology learning objectives when supported by plastic model skeletons at home. We present the results of a survey designed to test core osteological skills obtained by REUs in comparison with undergraduates educated with in-person laboratory components (IPUs) and experts in the field (zero to four and five or more years of experience). REU scores did not differ significantly from those of IPU or Junior Experts with less than five years of experience. Students performed well in bone identification but were limited in their ability to apply common sex and age estimation methods and to identify incomplete elements. Our findings reinforce the importance of haptic learning and years of experience in human osteological learning. They support the use of take-home models as valuable resources in both remote and in-person undergraduate teaching. This work is a step toward more inclusive universal instructional design that can be applied across various anthropology laboratory courses.Mount Royal University Faculty of Arts Endeavor Fund
University of Manitoba Faculty of Art
Optimizing the design ammonia loading rate of submerged attached-growth reactors in warm and cold conditions
No full textLagoons are commonly used to treat wastewater in North America – primarily by small towns and municipalities. Ammonia in lagoon effluent is known to be toxic to aquatic environments. The ability of lagoons to remove ammonia from wastewater is highly temperature-dependent. Total Ammonia Nitrogen (TAN) -related regulatory limits for lagoon effluent are increasingly stringent. Where additional ammonia removal from lagoon effluent is required, post-lagoon nitrification reactors might be used, such as the Submerged Attached Growth Reactor (SAGR).
The SAGR is a technology owned by Nexom. It is sized using a typical design maximum TKN loading rate (per unit volume of the SAGR). Historic studies have shown that nearly full TAN and TKN removal can be consistently achieved in SAGRs sized using these design parameters at very low sustained water temperatures of even less than 1°C. Some have shown that this is even possible with reduced SAGR volume. This suggests that the design ammonia loading rate values might be increased to optimize the SAGR size.
The current typical design loading rate is 12.8 g-TKN/m³ˑday (0.8lb-TKN/1000ft³ˑday). The chapters in this thesis show that a value of 31.1 g-TKN/m³ˑday (1.96 lb-TKN/1000ft³ˑday) might be used in ‘warm’ conditions with lagoon effluent temperature greater than 20°C, and a value of 21.9 g-TKN/m³ˑday (1.38lb-TKN/1000ft³ˑday) might be used in moderately cold conditions where lagoon effluent temperature might drop to between 3 and 4°C in winter.
The first pilot study, completed in the summer of 2022, observed SAGR operation at influent temperatures greater than 20°C and loaded at an average loading rate of at least 31.1 g-TKN/m³ˑday (1.96 lb-TKN/1000ft³ˑday). The pilot reactor recorded nearly 100% removal of TAN consistently during stable operation.
The second pilot study, completed in the winter of 2022/2023, observed SAGR operation at influent temperatures below 4°C, and loaded at an average loading rate of 21.9 g-TKN/m³ˑday (1.38lb-TKN/1000ft³ˑday). The pilot reactor recorded nearly 100% removal of TAN consistently during stable operation.
The results of these studies indicate that SAGRs might be designed in the future with significant reductions in footprint and, therefore, significant reductions in cost to the end user, many of which are rural municipalities struggling to meet regulatory limits. The consequences of these design size reductions will include increased access to suitable wastewater treatment technology and, therefore, higher quality lagoon discharges to surface water bodies on a broad scale .October 202
Circuit models and AMP algorithms for future-generation wireless communication systems
Get PDFDue to the significant increase in high data rate services and the demands of future wireless networks, researchers in the physical layer community are exploring new trends including i) integrating electromagnetic theory with communication theory, and ii) developing low-complexity digital signal processing (DSP) algorithms. This thesis aims to address gaps in the communication and DSP literatures.
The first part of the thesis incorporates physical limitations of antennas, such as size and mutual coupling, into circuit models for near- and far-field communications. Traditionally, constraints like antenna size and bandwidth are not included in information-theoretic performance analysis. A key finding is that mutual coupling can widen the operational bandwidth of large-scale antenna arrays, revealing a "bandwidth gain" in massive multi-input-multi-output (MIMO) technology.
The second part of the dissertation addresses recent developments in the approximate message passing (AMP) literature, where algorithms rely heavily on some assumptions (i.e., AWGN model, separable denoisers) which are not practical in many engineering applications. We extend the vector AMP approach, initially used for high-dimensional linear regression in compressive sensing, to handle arbitrary independent and identically distributed (i.i.d.) noise priors. Additionally, a bilinear generalized vector AMP algorithm is proposed, tracking the correlation matrices of the linear minimum mean square error (LMMSE) estimation. While this increases complexity, it allows the algorithm to outperform state-of-the-art solutions with discrete-valued priors. The thesis also introduces a non-separable denoiser for estimating permutation matrices, addressing the unlabeled sensing problem. Despite the computational intractability of estimating permutation matrices for even small problem sizes, the proposed unlabeled compressed sensing (UCS) approach approximates the intractable permutation denoiser using two connected assignment denoisers through a belief propagation procedure. Theoretical performance guarantees are provided through state evolution (SE) equations predicting empirical mean square error (MSE) in large systems. Simulations demonstrate the algorithm's effectiveness and superiority over existing methods.
At the intersection of DSP, antenna, and communication theories, this thesis highlights the need to revisit information theoretic concepts from an electromagnetic perspective. It emphasizes the importance of circuit-based models for their ability to define and optimize the physical characteristics and constraints of communication components in an era dominated by data-driven approaches.February 202
Joint beamforming optimization in RIS-aided MIMO wireless systems under mutual coupling and multiple reflections
Get PDFIn a Reconfigurable Intelligent Surface (RIS), Mutual Coupling (MC) is unavoidable as a result of the sub-wavelength structure of its unit elements. In addition, MC inherently leads to multiple reflection effects that are ignored in conventional (approximative) RIS models.
In this thesis, we examine the problem of joint active and passive beamforming in a controllable multi-user reconfigurable intelligent surface (RIS)-assisted downlink and uplink wireless communication system, considering the MC among RIS elements. We formulate a problem to optimize active and passive beamforming jointly under the MMSE criterion. Given the non-convex nature of the problem, we use alternating optimization to decompose the problem into two sub-problems for downlink and uplink transmissions separately. In both transmissions, one sub-problem involves optimizing the phase-shift matrix of RIS. In downlink, the other sub-problem is the optimization of active precoding for the base station (BS), while the equivalent sub-problem in uplink is the optimization of the linear receiver matrix. We optimize the phase shift matrix under a physically-consistent model using the gradient descent algorithm for both transmissions. We use the Lagrange multiplier method to optimize active precoding in the downlink and apply the First Order Necessary Condition (FONC) to optimize the linear receiver in the uplink.
Simulation results are represented for both lossless and lossy RIS scenarios under perfect and imperfect channel state information. We discuss the impact of changing the number of RIS elements and the RIS element spacing on system performance. The results show that, with optimized phase shifts and active precoding, the inherent multiple reflection effect can improve the performance of RIS-aided wireless communications systems.
In our previous analysis, we focused on optimizing joint beamforming within a physically consistent environment by incorporating MC effects. However, we did not explicitly address the optimization of MC itself. This represents a critical aspect that warrants further investigation and consideration for a comprehensive and refined analysis. As mentioned earlier, MC emerges as an inherent feature in RIS particularly with sub-wavelength inter-element spacing. Alongside, the presence of electromagnetic (EM) transmit/receive radiation patterns is also inevitable. The simultaneous presence of these two factors naturally leads to the emergence of non-local RIS structures, which can be effectively described via non-diagonal phase shift matrices. As the second analysis, we focus on optimizing MC and radiation patterns in RIS-assisted multi-user MIMO wireless communication systems. We particularly formulate a novel problem to jointly optimize active and passive beamforming as well as MC and radiation patterns in a physically consistent manner considering reflective and transmissive RIS setups separately. To characterize the physically consistent model, we deploy scattering parameters and propose a novel approach to optimize MC and radiation patterns through an offline optimization method, rather than optimizing on the fly, using two distinct solution approaches for reflective and transmissive models. We present simulation results using both parametric and geometric channel modeling approaches. Our numerical results showcase that the system performance increases with the proposed MC and radiation patterns optimization, and this improvement is achievable without the need for optimizing them on the fly, which can be rather cumbersome.October 202
The utilization of health care resources by children born with a congenital surgical anomaly – the utility of a physician assistant
No full textIntroduction: Children born with a congenital surgical anomaly require surgical correction and
the care of a multidisciplinary team. Medical and surgical innovation has led to improved
survival rates, exposing these children to morbidities, ultimately leading to increased healthcare
costs. Physician assistants (PAs) are medical generalists that extend the services of physicians,
improve access to care and decrease healthcare costs.
Methods: We performed a retrospective cohort study of children born with a congenital surgical
anomaly between 1990-2017 using the Winnipeg Surgical Database of Outcomes and
Management (WiSDOM) and the Necrotizing Enterocolitis Management and Outcomes
(NEMO) database; a 10:1 date-of-birth matched control population was selected using the
Manitoba Centre for Health Policy (MCHP). The median cost of consult services, procedures
and follow-up services was compared for cases versus controls. A comparative advantage
analysis was performed to examine the cost-effectiveness of PAs.
Results: Cases generally had a higher median cost for consults, procedures and follow-up
services compared to controls. For services provided specifically by general surgeons, cases were
found to incur a higher cost primarily for major surgeries. PAs were found to be twice as cost
effective as doctors at providing approximately 75% of the care of these patients.
Conclusion: Children born with a congenital surgical anomaly had higher healthcare costs than
controls. Most of this excess cost is incurred in consult services, major surgeries and follow-up
services provided by specialists other than general surgeons. The implementation of PAs into the
care of these patients is an effective means of reducing these costs
Optical navigation using resident space objects
No full textEstimators are critical to modern society and are present everywhere from automobile cruise control systems to satellite attitude determination and control. Ensuring that estimators produce reliable, trustworthy estimates is key to keeping users safe and systems functioning correctly. While many systems and metrics have been proposed to ensure estimator reliability, these come with disadvantages such as requiring time-consuming Monte Carlo simulations or encapsulating poorly performing estimators rather than addressing core issues. This dissertation examines the various factors that affect estimator reliability, specifically for Kalman Filter variants, and presents a new trustworthiness metric that quantifies a filter’s reliability without requiring Monte Carlo simulations: the covariance trust ratio (CTR).
The reliability factors examined here include the type of Kalman filter used, whether a filter incorporates elements of the measurement source’s state, the type of process noise covariance model used, and the type of measurement sources used. To examine how these factors affect a Kalman filter’s reliability, this dissertation uses two existing methods from the literature, Normalized Estimate Error Squared (NEES) and Normalized Innovation Squared (NIS), in addition to the CTR.
The impact of these reliability factors on a Kalman filter’s trustworthiness are demonstrated using a case study which explores how a spacecraft’s orbital state can be estimated using relative angle and range measurements of Resident Space Objects (RSOs). This case study shows that the CTR is an effective method for quantifying an estimator’s trustworthiness, highlights the effects of the various reliability factors studied here, and demonstrates that these factors can be quantitatively assessed to provide confidence in a filter’s trustworthiness. In order for new estimation methods to become commercially viable, they must demonstrate their reliability and trustworthiness to potential users. The estimator reliability analysis and estimator trust quantification work presented in this dissertation form an enabling technology that may aid in the more rapid adoption of state estimation techniques.October 202
Community ambulation in older adults and people with OA – a model verification using Canadian Longitudinal Study on Aging (CLSA) data
No full textBackground
There are health and well-being benefits of community ambulation; however, many older adults do not regularly walk outside of their home. Objectives were to estimate the associations between latent constructs related to community ambulation in older adults aged 65–85 (65+), and in adults with osteoarthritis (OA) aged 45–85.
Methods
Secondary data analysis of the comprehensive baseline and maintaining contact questionnaire data from the Canadian Longitudinal Study of Aging (CLSA) was completed. Based on a previous model of community ambulation post-stroke, structural equation modeling (SEM) was used to develop measurement and structural models for two groups: older adults 65+ and people with OA. Multi-group SEM was conducted to test measurement invariance across sex and age groups. Measurement models were developed for the following latent factors: ambulation (frequency of walking outside/week, hours walked/day, ability to walk without help, frequency and aids used in different settings); health perceptions (general health, pain frequency/intensity); timed functional mobility (gait speed, timed up-and-go, sit-to-stand, balance). Variables of depression, falls, age, sex, and fear of walking alone at night were covariates in the structural models.
Results
Data were used from 11,619 individuals in the 65+ group (mean age 73 years ±6, 49% female) and 5546 individuals in the OA group (mean age 67 ± 10, 60% female). The final 65+ model had a close fit with RMSEA (90% CI) = 0.018 (0.017, 0.019), CFI = 0.91, SRMR = 0.09. For the OA group, RMSEA (90% CI) = 0.021 (0.020, 0.023), CFI = 0.92, SRMR = 0.07. Health perceptions and timed functional mobility had a positive association with ambulation. Depression was associated with ambulation through negative associations with health perceptions and timed functional mobility. Multi-group SEM results reveal the measurement model was retained for males and females in the 65+ group, for males and females and for age groups (65+, < 65) in the OA group.
Conclusions
The community ambulation model post-stroke was verified with adults aged 65+ and for those with OA. The models of community ambulation can be used to frame and conceptualize community ambulation research and clinical interventions
The impact of COVID-19 on services for Indigenous people who use substances and are living with HIV in Winnipeg, Manitoba
No full textManitoba currently has the second highest rate of HIV in Canada. Among those recently diagnosed, Indigenous people and injection drug users are overrepresented. As the COVID-19 pandemic significantly impacted service delivery, Indigenous people living with HIV (IPLH) who use substances may have been disproportionality negatively impacted. This Master of Social Work thesis focuses on the stories shared within the Gigii-Bapimiin project by IPLH in Winnipeg, Manitoba who use substances and accessed health and social services throughout the COVID-19 pandemic. Stories from those with lived experience as well as service providers were gathered using semi-structured interviews to help facilitate conversation. The goal of the research was two-fold, firstly to advance the understanding of the impact COVID-19 had on service delivery. Secondly, to provide recommendations for change and inform post-pandemic service delivery and policies to optimally support IPLH who use substances in Winnipeg, Manitoba.
A decolonizing Two-Eyed Seeing approach and Indigenous Storywork were used as overarching frameworks to guide this research. A community guiding circle comprised of eight IPLH, many of whom previously or currently used substances, were involved in the research from design to dissemination. Elder Albert McLeod and Knowledge Holder Gayle Pruden ensured the project remained grounded in Indigenous ethical space and helped incorporate ceremony into the research process. Due to its epistemological alignment with Indigenous knowledges, stories were analyzed using thematic analysis. Through this process, three common themes were identified. Firstly, the deeply engrained colonial practices within health and social services and the barriers individuals experienced pre-pandemic having been exacerbated throughout the COVID-19 pandemic. Secondly, neoliberal narratives and polices were the primary contributors to the harms linked to substance use rather than the personal drug use behaviours of individuals. Lastly, successful service delivery existed throughout the pandemic and was identified by participants as having been wholistic in nature and grounded within Indigenous knowledges. These organizations continued to offer support to IPLH in a meaningful way while adhering to public health orders. As a result, recommendations for social work practitioners, policy makers, advocates, and healthcare professionals are provided on how to enhance service delivery for IPLH who use substances.May 202