published_or_final_version / abstract / toc / Education / Doctoral / Doctor of Philosophy

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Background: Socioeconomic factors and gender may influence the quality of care received by patients with diabetes. Millions of people are diagnosed with diabetes and rates are expected to increase. The management of diabetes in primary care is important in optimizing health for all. Objectives: To investigate whether the selected diabetes quality of care indicators (haemoglobin A1c, low-density lipoprotein, blood pressure, abumin to creatinine ratio (ACR), and prescribed medication) are significantly different between those persons living in least and most materially and socially deprived neighbourhoods. Methods: A cross-sectional study design with a population sample of patients with diabetes from a primary care practice in Southeast Ontario. De- identified patient data from electronic medical records were retrieved from the Canadian Primary Care Sentinel Surveillance Network. Combined material and social deprivation scores were based on the Pampalon Deprivation Index. Results: The patients with diabetes largely resided in either the most or the least deprived neighbourhoods. Patients with diabetes living in the most deprived neighbourhoods were less likely than patients with diabetes living in the least deprived neighbourhoods to have their low-density lipoproteins within normal range (RR=0.84; CIs 0.73-0.98; p-value=0.026). There was no difference in management of diabetes between least and most deprived patients with diabetes regarding haemoglobin A1c, blood pressure, ACR, and medication prescribed; these were positive result for the clinical practice. Women with diabetes were less likely than men with diabetes to have their low-density lipoproteins under control (RR=0.71; CIs 0.62-0.81; p-value <0.001) and be prescribed ACE inhibitors or ARBs (RR=0.79; CIs 0.69-0.90; p-value <0.001). However, women with diabetes were more likely to have their most recent haemoglobin A1c within normal range (RR=1.24; CIs 1.10-1.40; p-value <0.001) and have their most recent ACR within normal range (RR=1.25; CIs 1.05-1.50; p-value=0.015). Conclusion: This study found that the quality of care for patients with diabetes was not influenced by whether a person lived in a deprived neighbourhood or not. However, the study identified some important gender differences related to whether a person’s diabetes was under control. The reason for these differences is unknown. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2013-09-27 13:37:55.755

The study investigated the perceptions of children and parents relating to the Forest School initiative. The aims of the research were to explore children’s and parents’ perceptions of Forest School and consider the potential influence Forest School can have on children’s learning and development. The study explored these views within a setting that had implemented the Forest School initiative at a whole primary school level for a number of years. A qualitative approach was taken and the study used thematic analysis of key concepts and codes. Emerging themes were drawn from children’s and parents’ comments and main themes were identified. The study found that children were able to communicate the fun, excitement and enjoyment they had experienced when talking about Forest School as an initiative. Children conveyed a caring attitude and respect for nature and the outdoor environment and that it was important for them to look after their surroundings. Parents expressed that they valued the initiative and that supporting their children’s education at home was important. However, they felt that children took the Forest School initiative for granted and perhaps saw it as a privilege. In relation to children’s learning, a key theme was children’s apparent enthusiasm and desire to learn. The Forest School experience enabled children to develop and reinforce a multitude of key skills. With regard to children’s development, references were made to a growing sense of awareness and maturity. Concepts of trust and responsibility were conveyed with some reference to a growing sense of freedom being afforded to children as they get older. Further research could seek to establish which professionals are aware of the existence of Forest School and gain their perceptions of its potential benefits. Also, further exploration focusing on the difference in Forest School experiences between the Foundation Phase and Key Stage 2 could provide interesting results. This takes into account the perceived impact the Forest School initiative appears to have contributed to, in relation to the children’s and parents’ perspectives and the context of this study.

Whilst outcomes for Children Looked After have extensively been discussed (Millward, Kennedy, Towlson, & Minnis, 2006; Rees, 2012), and the importance of school in the lives of these children acknowledged (Greig et al., 2008), less attention has been paid to the views and experiences of teachers of Children Looked After (Goddard, 2000). It is accepted that Emotional Labour (Hochschild, 1983) is commonplace in the teaching profession (Isenbarger & Zembylas, 2006) but no research has investigated how, and to what extent, teachers experience Emotional Labour during interactions with Children Looked After. The literature review explores research relating to outcomes for Children Looked After and the role of adults in supporting this group of children. The concept of emotion in the teaching profession, teachers’ experiences of emotional management and conceptualisations of Emotional Labour theory are also explored. Fourteen Key Stage Two teachers of Children Looked After participated in the current study by completing semi-structured interviews with a researcher. Results indicate that participants experience Emotional Labour during interactions with Children Looked After and that this may be mediated, to a degree, by factors including role constructions, perceptions of support and self-perceived role facilitators such as perceptions of a professional duty. Findings are discussed in relation to the need for Educational Psychologists to understand better the impact of Emotional Labour on teachers of Children Looked After. Correspondingly, the provision of supervision and systems level support for teachers of this group of children are explored.

The thesis explores issues in the writing development of primary school children where drama was used as a teaching and learning pedagogy. It is based on a case study carried out in 2005-2006 in a Greek primary school Y4 class in Cyprus where the author was teaching and investigates the nature and relationship of the two processes when used together. The project involved twenty drama sessions (over six months), each followed by a writing task that stemmed from the contents and children’s participation in drama. The overall aim was to describe ‘what happens when drama is integrated in a writing classroom’. Informed by the Vygotskian theory of learning, it sought to investigate the impact of using drama on children’s: (a) attitudes and views towards writing, (b). engagement with writing tasks and (c) quality of writing. A qualitative case study methodology and multi-method approach to the design of the study were adopted on the basis of what can best investigate the issues raised by the research questions. Questionnaires, interviews, observations, writing samples, video recordings and researcher’s log were used to collect data throughout the year, before (Sept-Dec) and after (Jan-Jun) drama integration in writing lessons. The collected data were analysed by quantitative and qualitative methods. Findings indicated positive changes in children’s attitudes and views towards writing following the introduction of drama and progressively positive improvements in most children’s engagement in writing. Additionally, analysis of writing samples provided indications of positive contribution of drama towards children’s writing and insights into the interaction between drama and writing content. On a theoretical level, this thesis suggests that the concept of mediation is central in interpreting the interactive relationship between drama and writing. It also indicates the impact of drama as a sociocultural setting on children’s agency in their development as writers and raises questions for further research.