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Achieving Consensus in the Management of Intrahepatic Cholestasis in Pregnancy: A Delphi Study
No full textoai:ojs.laurentian:article/4The incidence of intrahepatic cholestasis (ICP) in pregnancy, a liver condition, is increasing, suggesting a greater awareness of the disease. While this condition is an annoyance for a mother, typically causing intense itchiness of the hands and soles of the feet, she will return to normal after delivery. However, this condition has the potential to cause premature delivery, fetal distress and fetal death, so appropriate management is very important. Currently, guidelines available in North America conflict with guidelines in the United Kingdom. The purpose of this research is to establish evidence-based, current practice guidelines for managing cholestasis in pregnancy within a local context. A modified Delphi technique will be utilized with the goal of achieving consensus among local obstetricians about the management of ICP. It is anticipated that two rounds of questionnaires will be disseminated to the group. The content of the questionnaires and the resulting guideline, will take into consideration the unique health care environment and resources in one northeastern Ontario community.La fréquence de cholestase intrahépatique pendant la grossesse, une affection hépatique, augmente, ce qui suggère une plus grande prise de conscience de la maladie. Bien que cette condition soit un ennui pour une mère, causant habituellement intenses démangeaisons des mains et la plante des pieds, elle va revenir à la normale après l\u27accouchement. Cependant, cette condition a le potentiel de causer l\u27accouchement prématuré, la détresse fœtale et la mort fœtale, ainsi, une gestion appropriée est très importante. Les lignes directrices disponibles en Amérique du Nord s’opposent aux lignes directrices du Royaume-Uni. Cette recherche a pour objet d\u27établir des lignes directrices fondées sur des données factuelles pour gérer la cholestase pendant la grossesse dans un contexte local. Une technique Delphi modifiée sera utilisée dans le but de parvenir à un consensus parmi les obstétriciens locaux sur la gestion du CIG. Il est prévu que deux séries de questionnaires seront diffusées au groupe. Le contenu des questionnaires et des lignes directrices qui en découlent prendront en considération l\u27environnement médical et les ressources dans une communauté du nord-est de l’Ontario
Anglophone culture, Francophone culture, family behaviours, and childhood obesity in Sudbury, Ontario
No full textIn general, Francophones in Ontario are more likely than their Anglophone counterparts to suffer from overweight and obesity. It has also been established that Francophones, Canada-wide, eat fewer daily servings of fruits and vegetables than Anglophones and tend to consume more kilocalories from fat (Batal et al., 2013). Despite these trends, comparative investigations amongst Francophone and Anglophone children in Ontario have not been completed. Therefore, the purpose of this literature review will be to investigate research evidence regarding Francophone children in Ontario and whether they are more likely or less likely to suffer from overweight or obesity than Anglophone children in Ontario. In addition, we will examine research on cultural factors that may be different between the two linguistic groups and which may contribute to the prevalence of obesity. This literature review will present an overview of childhood obesity in Northern Ontario and Francophone and Anglophone culture as well as identify the gaps within the literature for that require further research attention.En général, les francophones de l\u27Ontario sont plus susceptibles que leurs homologues anglophones de souffrir de surpoids et d\u27obésité. Il a également été établi que les francophones, à l\u27échelle du Canada, mangent moins de portions quotidiennes de fruits et de légumes que les anglophones et ont tendance à consommer plus de kilocalories en gras (Batal et al., 2013). Malgré ces tendances, les enquêtes comparatives menées par des enfants francophones et anglophones en Ontario n\u27ont pas été complétées. Par conséquent, le but de cette revue de la littérature sera d\u27enquêter sur les résultats de la recherche concernant les enfants francophones en Ontario et s\u27ils sont plus susceptibles ou moins susceptibles d\u27être en surpoids ou d\u27obésité que les enfants anglophones en Ontario. En outre, nous examinerons la recherche sur les facteurs culturels qui peuvent être différents entre les deux groupes linguistiques et qui peuvent contribuer à la prévalence de l\u27obésité. Cette revue de la littérature présentera un aperçu de l\u27obésité infantile dans le Nord de l\u27Ontario et de la culture francophone et anglophone, ainsi que d\u27identifier les lacunes de la littérature qui nécessitent une attention accrue à la recherche
Scotland
No full textI spent 14 days of intensive photographic research taking 10 000 photographs while travelling around the coast of Scotland. This includes the incredible architecture in ancient cities; amazing, magical landscapes of heather shrouded moorlands, expansive glens with grass covered hills and lowlands, and black and red mountains; and magnificent castles. Scotland is a part of my cultural heritage. This series of photographs is a merging of my artistic and academic skills as a visual arts researcher. It is similar to grounded theory (Glaser & Strauss, 1967) used for my academic research wherein I let Scotland tell me what photographs needed to be taken and my photographic eye knew when to take the photograph from my years of experience as a photographer.
Each of the photographs tells a visual story. As I continuously edited my photographs for months while making files in folders I asked myself: What was my experience of Scotland? How can I represent this experience so that it has the feeling of what each inspiring photograph had when I took the shot? It is a reliving and recreating of experience while working with specialty silver papers and creating triptychs, diptychs and other layouts to photographically tell the stories. These 19-limited edition colour archival quality giclée photographic prints are the result of my photographic Scotland experience. An exhibition is a publication and the exhibition of these photographs is supported by LURF
Impact of Advanced Access Scheduling on Patient Care Choices and Health Behaviours in a Nurse Practitioner-Led Clinic
No full textThe Nurse Practitioner-Led Clinic (NPLC) is a new model of primary healthcare. The wholistic approach of nurse practitioner (NP) led care in an NPLC that implements Advanced Access scheduling has the potential to enhance timely access to care and improve health outcomes. The purpose of this study was to determine the experience of patients in one NPLC as well as their healthcare behaviours related to Advanced Access scheduling. A previously developed survey with items related to appointment access, health behaviours and satisfaction was mailed once to patients at a NPLC in northern Ontario. 535 patients replied for a response rate of 29%. A majority (85.4%) were able to access same-day appointments. Access to same-day appointments was associated with less likelihood of attending a walk-in-clinic or emergency department in addition to self-reports of improvements in lifestyle and better control of medical condition(s). Advanced access scheduling contributes to optimal patient care in an NPLC setting. The NP role in lifestyle counselling and wholistic care in the NPLC model contributes to improved self-reported health. Access to an appointment at a point of ‘readiness’ may positively contribute to lifestyle changes and overall health of patients.La clinique dirigée par l\u27infirmière praticienne est un nouveau modèle de soins de santé primaires. L\u27approche holistique de l\u27infirmière praticienne a conduit les soins dans une tel clinique, qui met en œuvre la planification de l\u27accès avancé, a le potentiel d\u27améliorer l\u27accès opportun aux soins et d\u27améliorer les résultats de la santé. L’objet de cette étude était de déterminer l\u27expérience des patients dans une seule clinique dirigée par l’infirmière praticienne ainsi que leurs comportements en matière de santé liés à la planification de l\u27accès avancé.
Un sondage précédemment élaboré portant sur des questions liées à l\u27accès aux rendez-vous, aux comportements liés à la santé et à la satisfaction a été envoyé par la poste aux patients d\u27une clinique du nord de l\u27Ontario. 535 des patients ont répondu pour un taux de réponse de 29%.
Une majorité (85.4%) ont pu accéder à des rendez-vous le même jour. L\u27accès aux rendez-vous le même jour a été associé à une probabilité moin élevée de se rendre à une clinique sans rendez-vous ou à un service d\u27urgence en plus des rapports d\u27amélioration du mode de vie et d\u27un meilleur contrôle de l\u27état de santé.
La planification avancée de l\u27accès contribue à la prise en charge optimale des patients dans un contexte des cliniques dirigées par l’infirmière praticienne. Le rôle de l’IP dans les conseils de mode de vie et les soins holistiques dans le modèle de ces cliniques contribue à l\u27amélioration de la santé autodéclarée. L\u27accès à un rendez-vous au point de « préparation » peut contribuer positivement aux changements de mode de vie et à la santé générale des patients
L’évaluation formative en écriture: quels sont les obstacles?
No full textThrough the results of a generalizability study, Heritage, Kim, Vendlinski & Herman (2009) show that teachers are better at determining the quality of student work than they are at deciding the next steps in instruction to support learning. The present research starts from this evidence and seeks to better understand the obstacles that limit teachers’ formative assessment decisions in writing. A questionnaire was used to help teachers determine the strengths and areas of need of their students’ work and to plan the next instructional steps to support learning. An individual retrospective interview was also used to better understand teachers’ thinking behind the answers they provided on the questionnaire. Content analysis was used to analyze questionnaire answers and interview transcriptions. Research results show that the formative assessment process is complex and multidimensional and raise fundamental questions regarding teachers’ professional knowledge and skills in this domain.L’étude de généralisabilité de Heritage, Kim, Vendlinski et Herman (2009) démontre que la composante de l’évaluation formative la plus difficile pour l’enseignant ne réside pas dans sa capacité à porter un jugement sur la qualité d’un travail, mais plutôt dans sa capacité à prendre des décisions pour déterminer comment s’y prendre pour aider l’élève à progresser. La présente recherche part de ce constat et cherche à mieux comprendre ce qui fait obstacle à la prise de décisions d’évaluation formative en amenant des enseignants à porter un jugement d’évaluation sur la qualité de travaux d’écriture de leurs élèves et à planifier les prochaines étapes de l’apprentissage. Un questionnaire a été utilisé afin d’avoir accès aux jugements et aux décisions d’évaluation des enseignants tandis qu’un entretien individuel rétrospectif a permis de rendre explicites les processus mentaux qui ont guidé leurs réponses. Une analyse de contenu a été effectuée sur les réponses au questionnaire et sur l’ensemble des verbatims. Les résultats de la recherche suggèrent que la mise en pratique de la démarche d’évaluation formative en salle de classe est un processus complexe et multidimensionnel qui soulève des questions fondamentales relatives aux connaissances et compétences professionnelles des enseignants
Protecting the mental health of Ontario seniors
No full textBackground: Chronic disease management has been the emphasis of research with elderly populations. Building upon this work, there is a need to examine protective practices and supports for the mental health of older adults. There are no Canadian empirical studies that examine those factors in relation to positive mental health.
Aim: This study identified associations between protective factors and self-rated mental health for senior, community-dwelling Ontarians.
Methods: A secondary analysis was undertaken to examine a subset of variables from the population-based Canadian Community Health Survey (2012) data. Statistical analysis correlated a range of extracted individual, social, and environmental variables for two major age groups of Ontarian seniors (N = 6,121), those aged 65 to 79, and those 80 years and older.
Results: Positive mental health was significantly associated with marital status, co-habilitation, income, perceived health, life stress, and health behaviours. This grouping of personal and social characteristics lost significance for positive mental health among seniors aged 80 years and older. Regardless of the seniors’ age, flourishing mental health was predicated upon physical activity, positive self-rated physical health, and finally, limited life stress.
Conclusion: Based on provincial data, trends in self-rated positive mental health suggest that key factors ought to be integrated into the delivery of coordinated and interdisciplinary services to protect the mental health of seniors.Contexte: La gestion des maladies chroniques a mis l\u27accent sur la recherche auprès des populations âgées. Sur la base de ce travail, il est nécessaire d\u27examiner les pratiques de protection et de soutien pour la santé mentale des personnes âgées. Il n\u27existe pas d\u27études empiriques canadiennes qui examinent ces facteurs en rapport avec la santé mentale positive.
Objectif: Cette étude a identifié des associations entre les facteurs de protection et la santé mentale auto-évaluée pour les Ontariens seniors et vivant dans la communauté. Méthodes: Une analyse secondaire a été entreprise pour examiner un sous-ensemble de variables provenant des données de l\u27Enquête sur la santé dans la collectivité (2012) basée sur la population. L\u27analyse statistique a corrélé une gamme de variables individuelles, sociales et environnementales extraites pour deux grands groupes d\u27âge des aînés d\u27Ontarie (N = 6 121), ceux âgés de 65 à 79 ans et ceux de 80 ans et plus.
Résultats: La santé mentale positive a été significativement associée à l\u27état matrimonial, à la cohabilitation, au revenu, à la santé perçue, au stress de la vie et aux comportements de santé. Ce groupe de caractéristiques personnelles et sociales a perdu de l\u27importance pour la santé mentale positive chez les personnes âgées de 80 ans et plus. Indépendamment de l\u27âge des aînés, la santé mentale prospère repose sur l\u27activité physique, la santé physique auto-évaluée positive et enfin le stress vital réduit.
Conclusion: Selon les données provinciales, les tendances de la santé mentale positive auto- évaluée suggèrent que les facteurs clés devraient être intégrés à la prestation de services coordonnés et interdisciplinaires pour protéger la santé mentale des aînés
Voicing our Realities: Sharing Stories with First Nations Mothers Attending University
No full textPromoting empowerment and growth for First Nations mothers is critical when attempting to improve the post-secondary educational attainment of Indigenous Peoples. Based on the literature, Indigenous Peoples of Canada have lower rates of University-level education across all Indigenous groups (First Nation, Métis, and Inuit). The literature also shows that Indigenous Peoples cite personal and family responsibilities as a barrier to their educational attainment more often than any other barrier. Approximately one in ten First Nations and Inuit teenage girls between the ages of 15 and 19 years were parents in 2011. Fertility rates in the same group are six times higher than that of other Canadian teens. The statistics go on to explain that early motherhood increases the vulnerability of young First Nations women who are already disadvantaged socio-economically by their cultural background and gender. The data for this project was collected through the use of autoethnography and Indigenous storytelling as methods. Together, we explore the literature and the shared stories, while discussing the preliminary project findings through a decolonizing lens. Key points discussed include the balancing of identities, the implications of the imposter syndrome for First Nations Peoples, the process of navigating the post-secondary institution, and the importance of restoring culture while finding autonomy within academia. This research aims to contribute to the literature on Indigenous education while creating the groundwork for future research which may help to inspire future generations of First Nations mothers to attend post-secondary education
Indigenous Epistemologies, Worldviews, and Theories of Power
No full textThe current project aims to identify and explore concepts of power from an Indigenous understanding. The topic of power is informed by vast literature that reaches back into the beginnings of western philosophy. The conceptions that result are based on a western worldview that does not incorporate cultural differences. An Indigenous theory of power can be used to inform strategies toward achieving a more equal distribution of power, and encourage successful Indigenous-settler reconciliation. Within the academic setting, Indigenous scholars are developing Indigenous research initiatives aimed at decolonizing methodologies and achieving intellectual self-determination (Smith, 2012, p.120). Utilizing a decolonization framework saturated with reflexivity, Indigenous research methods in conversation with grounded theory will be applied to identify an Indigenous worldview of power. Researcher reflexivity, relationships with community and research-based support systems are requisite to a decolonization research framework (Smith, 1999, p.138). Data collection will occur at M’Chigeeng First Nation and the Chief of that community has been recruited as community partner to this project. Together we aim to answer Indigenous questions to improve Indigenous lives with research based on standards for how we should structure our relationships with each other and with all of creation (Wilson, 2001, p.177). Indigenous research methods combined grounded theory allows the project to bridge worldviews, while allowing for relationships to guide the process. A literature analysis, interviews, sharing circles and review of historical records will be used
The Mythological Origins of Desire and Marketing Hyperreality
No full textThis paper criticizes the profit-driven hyperreality foisted upon consumer goods. The author references Lacan’s interpretation of Plato’s myth on the self-sufficient, solitary and spherical origins of humankind contained within the ancient work, Symposium. The division of these once-whole entities, as described by Plato, resulted in humans being instilled with an insatiable desire for completeness. The author reasons that contemporary marketing strategies prevail upon this desire: transmuting what is real (the product or service) into the hyperreal