Introduction: The Family Health Team (FHT) is an Ontario-based initiative that aims to provide primary care through multidisciplinary teams of healthcare professionals. Little is known about variability between and within teams, and whether certain organizational characteristics are associated with quality of patient care. Objectives: (1) To describe FHT-level organizational characteristics for seven FHTs in Southeastern Ontario. (2) To examine the role of physician-level organizational characteristics in predicting: (a) Up-to-date colorectal cancer screening and (b) episodic patient-centredness for patients within seven FHTs in Southeastern Ontario. Methods: This study employed linked datasets obtained from surveys of seven FHTs, 115 health care providers (including 41 family physicians) and 998 patients, as well as a chart abstraction. Statistical analyses included performing subject-specific multilevel multivariate modeling. Results: (1) FHTs varied on characteristics including length of time of practice operation, number of patients, existence of personnel policies, team makeup and team climate. (2) (a) Patient uptake of colorectal cancer screening was associated with average duration of regular routine visit OR=0.88 per minute (95% CI 0.83-0.94), patient gender male OR=2.00 (95% CI 1.22-3.28), general checkup in past 2 years OR=9.03 (95% CI 5.18-15.73), travel time less than or equal to 20 minutes OR=1.53 (95% CI 0.94-2.48), and usually see regular provider OR=0.40 (95% CI 0.19–0.87). Patient uptake or physician recommendation of colorectal cancer screening demonstrated similar associations, with the absence of travel time and the addition of team climate (family physician and nurses) OR=5.88 (95% CI 0.98-35.24), patient occupational status employed vs. retired OR=0.49 (95% CI 0.23–1.02), patient occupational status not employed vs. retired OR=0.42 (95% CI 0.16–1.13), and patient smoking status never vs. ever OR=0.59 (95% CI 0.37–0.96). (b) Episodic patient-centredness was associated with patient born in Canada 0.1119 (95% CI -0.0040-0.2278), seeing regular healthcare provider today 0.1449 (95% CI 0.0426-0.2472), physician-patient gender concordance 0.1019 (95% CI 0.0128-0.1910), and appointment length 0.006929 (95% CI 0.003554-0.010304). Discussion: Further research is needed to examine predictors of the quality of patient care at the practice, physician and patient levels. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2012-09-27 15:21:12.794

No description available.

It has become a fairly common practice in Natal to borrow ideas from the English educational scene. No doubt this is to our advantage but perhaps not necessarily always so. It is possible that an idea is copied and pursued diligently here yet meanwhile, back at its source of development in England, the idea is fast loosing favour. It is necessary to sift the good from the bad before we borrow, and that can only be done by surveying the field thoroughly. The author of this thesis after spending a number of years in primary education was fortunate enough to receive a study grant from the Natal Education Department which enabled him to visit England and other countries, and study at first hand the primary schools there. The primary aim of this thesis. is, therefore, to examine some of the recent developments in primary education in England, to evaluate them and to consider the feasibility of adapting and utilising them in the primary schools of Natal. These developments offer an alternative approach to education and one that is closer to what we now know about children and the nature of the learning process. The English primary school offers hope to those who believe that because change is difficult, it is either an impossibility or it takes generations to bring about. This study should supply the answer to the question: "What is happening in British primary schools?", which Brian Young poses in Children At School - Primary Education in Britain Today (1). It may in addition minimise the chances of the merely faddish aspects being slavishly copied and avoid change for the sake of change. It may also be of assistance to those concerned with policy making in primary education, particularly in Natal, especially if they are seriously interested in exploring alternatives to existing patterns of instructions. The basic assumption underlying the whole study is that each child is an unique individual who is characterised by an unmatched set of gifts and limitations. While the approach adopted is a child-centred one, a confrontation with exclusive choices is avoided. It is not a question of the child or the teacher, children or subjects, subjects or an integrated programme, the individual or society, or freedom or discipline. The question: "How far do we need a concept of the educated man as well as the notion of the educated child?" (2), is very relevant to this study. Part One of this thesis is a discussion of. the various factors from which present-day practices have evolved. No historical account of the developments is undertaken, but a brief survey of the old elementary school is followed by a resume of the changing educational demands of a society which has undergone extensive changes in the last 75 years. Immense scientific and technological developments and the concomitant social and economic upheavals have called for new curricula, subject content and teaching methods. The role played by the progressives, a small group of avant-garde educationists whose views were considered eccentric in their time, is discussed in detail. The direct and indirect influence of educationists, philosophers and psychologists is more difficult to establish. This and the impact of official educational reports and Acts are also studied. Part Two concerns the purpose of English primary education. It is no theoretical dissertation on the aims of education. It rather attempts to establish what the primary school seeks to achieve for its pupils. The concept of 'being educated' is analysed and is followed by a discussion of what are termed immediate aims. Here attention is focused on the belief that primary education is to serve solely as a preparation for the education that is to follow and on the acquisition of skills such as reading, writing and arithmetic, and the ability to speak properly and listen attentively. Next follows a discussion of so-called long-term aims. Particular attention is given to the preparation of children for the society in which they will one day be adults; prerequisites such as adaptability and a critical mind are highlighted. The freedom of the individual and his place in society is examined. Finally, the opinions of teachers as reflected in a Schools Council exploratory study of aims, influences and attitudes, are briefly analysed. A comprehensive survey of every primary school in England by Her Majesty's Inspectorate revealed certain trend-setting schools. Part Three is a study of some of the recent developments that reflect the ethos prevalent in these schools. the blend of freedom and support where teachers and headteachers are relatively free to decide what to teach, how to teach it and the support they receive from a variety of sources, is discussed in detail. The move to what has become known as open or informal schooling and other features of these schools, such as the integrated day, team teaching and open plan schools are described. Part Four of this study concerns those aspects of English primary education that could with success be adapted and introduced into the primary schools of Natal. The features that are considered are the introduction of a more child-centred approach, the appointment of experts in primary education to decision- and policy-making positions, the in-service education of teachers, the fuller utilization of teachers' centres and the building design of primary schools. / Thesis (M.Ed.) - University of Natal, Durban, 1976.

Oxygenic photosynthesis is responsible for virtually all of the biochemical production of organic matter in both marine and terrestrial ecosystems. Despite the large amount of research on phytoplankton, macroalgae have received less attention despite them being, on a per-area basis, one of the most productive ecosystems on earth. Furthermore, there has been a tendency of studies to measure primary production in single thalli, or monospecific stands. The lack of studies examining in situ production of whole assemblages using photorespirometry, as is common practice in soft-sediment systems, may be related to a lack of suitable apparatus. This research aimed to develop unique techniques and an apparatus for measuring primary production of intact macroalgal assemblages in laboratory and field conditions. Photorespirometry chambers were developed and tested on in situ macroalgal assemblages, giving information on the role of species identity, biodiversity, irradiance and community structure on overall primary production. Furthermore, the successful application of these methods was used to model annual primary production over local and regional scales, as well as the potential effects of human disturbance on production. In this study, photosynthesis-irradiance relationships (P-E curves) of intact intertidal algal assemblages showed no signs of saturation at high irradiance levels, as is typically seen in single species curves. Furthermore, diverse macroalgal assemblages showed a two-stage rise in production, with a significant enhancement of production at high irradiance. Evidence from this study suggests that the three-dimensional structure of natural assemblages, functional diversity and their interaction with a complex light environment is responsible for the unique P-E curves. The increased efficiency of light use in complex assemblages suggests an important role of species complmentarity in enhancing production with species diversity. This research also shows the potential consequences of disturbance on macroalgal assemblages, with the loss of several species causing a major decline in net production. The methods developed in this thesis have allowed simple modelling of annual rates of primary production and the parameters driving production of macroalgae over long time-scales. Respiration rates have a particularly large influence on production models and indicate that increasing temperature due to climate change could have significant consequences for net carbon fixation of macroalgae. This research gives valuable insight into the production of marine macroalgae and reinforces the notion that they are amongst the most productive systems on earth. These results revealed the importance of examining natural communities, as opposed to randomised assemblages and suggest a vital role of species diversity and community composition. Although there was no functional redundancy of the canopy forming species there did appear to be significant redundancy within the subcanopy assemblage. The identity of subcanopy species had little effect on production, but over longer temporal scales, as species come and go, they may help buffer the communities in terms of primary production. Furthermore, the relationship between biodiversity and ecosystem function (primary production), although driven by diversity, is moderated by resource levels. The complex relationship between irradiance, diversity and production shows the importance of resource levels in the enhancement of function with increasing biodiversity. Due to fundamental differences in terrestrial and marine systems, I was able to examine the effects of discrete levels of irradiance on production, which indicated an important role of complementary light use. This study represents advancements not only in the understanding of primary production in macroalgal assemblages, but also has implications for how diversity may enhance function in other autotrophic systems. The important role of enhanced efficiency of photon capture in multi-canopy layer communities may prove an essential process in ecosystems as diverse as macroalgal beds and tropical rain-forests.

No description available.

Rothbaum, Weisz, and Snyder's (1982) dual-process model of control proposed that in addition to attempts to change one's environment (primary control, PC) or psychologically adjust to one's circumstances (secondary control, SC), the higher-order capacity to alternate between these processes in congruence with performance (optimization) served to foster development in achievement settings. The present five-phase longitudinal study conducted over an academic year explored how college students (n = 568) shift between PC and SC over time in response to actual performance feedback, as well as the differential effectiveness of congruent emphasis shifts for development based on the perceived ability to shift in a strategic manner. Dependent measures included academic achievement (course test scores), motivation (achievement orientation, perceived success and value, expectations), emotions (enjoyment, anxiety, boredom), health status (global health, illness symptoms), and overall adjustment (perceived stress, self-esteem, depression). Hypotheses were evaluated using phase-specific and cross-lagged structural equation models assessing moderation effects for perceived congruence ability. Results showed that students shift toward PC after success and toward SC following failure, and suggest an elaborated theoretical model of how PC and SC contribute to beliefs and behaviour involving strategic and congruent emphasis shifts. These findings also demonstrate that some individuals better recognize when this behaviour is most effective for their performance and well-being and strategically make congruent emphasis shifts to improve their subsequent development. In sum, this study highlights the benefits of one's ability to make strategic emphasis shifts between PC and SC in an academic achievement setting, and provides empirical support for this effective yet relatively unexplored facet of Rothbaum et al.'s model.

Rothbaum, Weisz, and Snyder's (1982) dual-process model of control proposed that in addition to attempts to change one's environment (primary control, PC) or psychologically adjust to one's circumstances (secondary control, SC), the higher-order capacity to alternate between these processes in congruence with performance (optimization) served to foster development in achievement settings. The present five-phase longitudinal study conducted over an academic year explored how college students (n = 568) shift between PC and SC over time in response to actual performance feedback, as well as the differential effectiveness of congruent emphasis shifts for development based on the perceived ability to shift in a strategic manner. Dependent measures included academic achievement (course test scores), motivation (achievement orientation, perceived success and value, expectations), emotions (enjoyment, anxiety, boredom), health status (global health, illness symptoms), and overall adjustment (perceived stress, self-esteem, depression). Hypotheses were evaluated using phase-specific and cross-lagged structural equation models assessing moderation effects for perceived congruence ability. Results showed that students shift toward PC after success and toward SC following failure, and suggest an elaborated theoretical model of how PC and SC contribute to beliefs and behaviour involving strategic and congruent emphasis shifts. These findings also demonstrate that some individuals better recognize when this behaviour is most effective for their performance and well-being and strategically make congruent emphasis shifts to improve their subsequent development. In sum, this study highlights the benefits of one's ability to make strategic emphasis shifts between PC and SC in an academic achievement setting, and provides empirical support for this effective yet relatively unexplored facet of Rothbaum et al.'s model.

No description available.

This thesis is a report of a longitudinal study which explores the impact of the English National Curriculum (1990) on the work of teachers at Key Stage 2. It is based on teachers' experiences viewed in relation to a theoretical template of questions. The questions - refined during a process of iteration throughout the research - provided a conceptual framework which kept it focused and manageable. Data - obtained from interviews, document study and observation - derived from five cases were subjected to qualitative analysis which involved progressive reflection, the use of matrices to sort and sift and the identification of similar phrases, patterns, themes and differences, both between and across the range of participants, and across the various cases. Key patterns and differences emerged which were then cross matched with each subsequent case in a process of refocusing and refinement. Preliminary findings were discussed with recognised experts chosen for their connection with English teaching at Key Stage 2 or for their role in developing the statutory Order. Several issues emerged prompting questions about teachers' experience of: • subject knowledge across all four language modes of English; • the complexities involved in teaching pupils to read; • process approaches to teaching writing; • the part that metatextual and metalinguistic understanding plays in learning; • teaching techniques which support the teaching of speaking and listening; • the relationship between standard English and language variation; which were viewed within the context of the National Literacy Strategy (March, 1998) in order to reach conclusions and frame recommendations for theory, practice and policy. In summary, these relate to teachers' ability to deal with the complexities involved in English teaching, particularly with regard to raising standards in literacy and the role that speaking and listening plays in this, and the implications which this has for Initial Teacher Training and for Continuing Professional Development.

This thesis is based on a case study of the predicament of new primary teachers in a time of rapid and multiple change. It examines the proposal that emerging teachers should be supported as intellectuals in responding to the inherited collision of education policy and practice within postmodernity. Action research methodology was employed to investigate a small scale attempt to support student teachers as intellectuals in their final period of the BEd. Some participants were followed into the first year of teaching, using an ethnographic and autoethnographic methodology to evaluate and elaborate the initial proposal. The study shows that emerging teachers could function as intellectuals but there was little political or professional support for this. In particular there were neglected elements in both preparation and induction periods concerning professional purpose, vocation and orientation. The study contributes to our understanding of the dilemmas of tutoring emerging teachers as intellectuals. It also contributes to our understanding of the predicament of new teachers, which is typified as caught between the rock of the state and the increasingly hard place of the school. In this situation clarity of ideals and beliefs are required, and personal and social strategies are needed to carry these through in the problematic contexts of both policy and practice. It is recommended that the imbalance of preparation and induction programmes is reconsidered in order to allow for these neglected elements. Finall y the study offers a cultural rationale for professional purpose and vocation based on principles of equality, quality, diversity and democracy.