This thesis evaluated the effects of two types of training on nurses’ ability to safely and efficiently administer IV medications using a smart infusion pump. A high fidelity simulated nursing unit was created in which nurses recruited from the University Health Network programmed a series of infusions after receiving training. A training script modeled after the pump vendor’s training sessions was created and tested first on 24 nurses. The results were analyzed for deficiencies in safety and efficiency from a human factors and education perspective and a new training script was created and tested on a group of 23 nurses. No significant differences were found between training groups on measures related to safety, but significant differences were found in nurse efficiency and behaviour in some aspects of pump programming. This study sets a precedent for human factors evaluation being used in tandem with existing training practices and lays the groundwork for further exploration on this topic.

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Current understandings of aging and the life course are largely based on taken-for-granted hetero-normative assumptions. Gay men lack aging road maps that are unique to their life course experiences and which consider the changing contextual and social conditions that shape their participation choices in family and community roles. This is particularly so for gay men aging in rural environments as most studies of aging gay men focus on the urban experience. This study adds to understandings of aging and the life course by examining the lives of three gay men aging in rural environments. I use a life history approach to shed light on how sexual identity development and marginalization within rural environments intersect with shifting social contexts to shape the aging process in terms of engagement in social role opportunities, namely, community and family participation. As a life course researcher, I pay particular attention to the tensions between individual agency and structural constraints and how they are revealed through the life histories. Epistemological and methodological assumptions based on social constructivism, critical and queer theory inform the study while my own lived experiences as a gay man and an occupational therapist practitioner and educator ground the study. Cross-cutting themes identified in the life narratives reveal connections between sexual identity development and the coming out processes with patterns of social relationships and the gay aging process. These themes are then discussed in terms of their relevance to broader aging and life course constructs including generativity, social capital and gay aging; agency and structure in identity development; and expanded notions of family and social support for gay men. Findings from this study have implications for current explanations of ageing and life course processes; challenge limiting stereotypes of older gay men; inform health and social service professionals who work with older gay people; and provide examples of alternative queer life pathways for gay people of all ages.

Master of Science / Department of Human Nutrition / Mary Meck Higgins / Because of the ever-changing nature of the economy and the food environment, research as recent as 2010 may not be relevant to today’s discussion on food insecurity, food deserts, obesity rates, and nutritional quality in the U.S. population’s diet. Today, people of low socioeconomic status in the U.S. are at risk for overweight, obesity, and chronic illnesses such as type 2 diabetes, hypertension, and certain cancers. In this report, I investigate published research about low-income populations in the U.S. relative to the food environment and describe implications for healthcare professionals implementing interventions with these populations, discussed in the following categories: Dietary Intake Quality and Socioeconomic Status; Food Insecurity; Barriers to Quality Food Access in the U.S. Food Environment; Communities Alleviating Food Insecurity; Food-Related Perceptions, Attitudes, and Behaviors; Homelessness and Food-Related Behaviors; Why Do People Buy What They Buy?; Nutrition Assistance Programs and Policies; Current U.S. Food Costs; and Comparing the Nutritional Value Versus Price of Foods. Although the literature on the subject of low-income diet quality is thorough, much of it needs to be updated with current data on food prices, food environments, and U.S. diet quality. For this purpose, I compiled the most recent data from the National Bureau of Labor & Statistics on food prices to discuss the elevated food prices of healthful foods as opposed to less healthful foods. I also created a one-month menu based on the U.S. Department of Agriculture’s Thrifty Food Plan budget allowance in order to follow a healthful diet in this harsh economic climate utilizing the Dietary Guidelines for Americans 2010 and the Affordable Nutrients Index.

No description available.

In the 21st Century and beyond, it is clear that science and technology will be a catalyst in strengthening economic competitiveness and fostering social cohesion. However, some minoritized students are not engaged in science or related careers in science such as medicine. This study addresses the systemic issue of equitable and accessible science education as a requisite for career acquisition such as medicine. Mentoring is presented as a sociocultural participatory activity for engaging students in science learning. The purpose of this study is to assess the University of Toronto Faculty of Medicine Summer Mentorship Program (SMP) and to use the data to theorize on the mentoring phenomenon. In 1994, the SMP was established as a means of ameliorating the traditionally low participation of Aboriginal and Black students in medicine and other health sciences. For the first 10 years (1994 – 2004), 250 participants enrolled in the program. Recently, ten past mentees of the program matriculated into various medical schools (5 in the Class of 2008 at the University of Toronto, this is significant, as the norm is usually 0 or at most 2). The study utilized a qualitative approach, requiring the collection of semi-structured one-on-one interview data and an interpretive phenomenological methodology to evaluate the data. There was an increased level of school and community involvement when students returned to high school and an increased awareness of the academic and career choices available to protégés. Mentees indicated that the influence of the SMP followed them much further than the end of the summer and considered it to be an important and defining moment in their educational journey. Communication could be improved so that mentors get a sense of their own impact and for professional development. Recommendations include conducting a study more focused on the impact of the SMP on Aboriginal students who completed the program. Finally, from a theoretical perspective, further work is recommended in order to fine-tune the proposed Mentoring Oriented Teaching and Learning Strategy (MOTALS) framework that incorporates students as natives in a welcoming community of science practice rather than immigrants in a strange land of non-contextual science knowledge.

Using critical feminist theories and methodologies, my research investigates the power relations and influences at play within the field of children's environmental health. I begin with the research question of how a parent's everyday purchase of a toy or other children's product is "hooked into" extra-local governance (agenda-setting, rule-making and monitoring). Focusing on Bisphenol A and phthalates as an example, in-depth interviews were conducted with six government officials (three federal and three municipal), three non-governmental organization (NGO) representatives, a politician, six higher education faculty members and a parent, as well as two focus groups of 23 parents. Legislation and other relevant documents from governments, NGOs, industry and media were analyzed together with reports of their activities and attitudes to theorize "how things work" in the identification and management of toxic substances in products for sale, with a special interest in how this affects children's environmental health. My research revealed the influence of neo-liberalism, corporate power and over-reliance on strictly evidence-based biomedical reductionism in slowing down assessment and regulation of chemicals while many health professionals and grassroots activists have called for swifter responses based on the precautionary principle, as favoured by European governments. That is, politics and bureaucracy, with the approval of industry, over the past two decades, have clung to reductionist science as the only paradigm for understanding toxicity, thus slowing down regulatory processes. Although the historical and epistemological power relations mapped in my research work together to legitimize scientific certainty rather than the precautionary principle, I argue that the resulting regulatory logjam has been and could be addressed by reference to European examples, knowledge produced by collectives and the establishment of upstream and equity-based public health strategies with public input into the process.

In the 21st Century and beyond, it is clear that science and technology will be a catalyst in strengthening economic competitiveness and fostering social cohesion. However, some minoritized students are not engaged in science or related careers in science such as medicine. This study addresses the systemic issue of equitable and accessible science education as a requisite for career acquisition such as medicine. Mentoring is presented as a sociocultural participatory activity for engaging students in science learning. The purpose of this study is to assess the University of Toronto Faculty of Medicine Summer Mentorship Program (SMP) and to use the data to theorize on the mentoring phenomenon. In 1994, the SMP was established as a means of ameliorating the traditionally low participation of Aboriginal and Black students in medicine and other health sciences. For the first 10 years (1994 – 2004), 250 participants enrolled in the program. Recently, ten past mentees of the program matriculated into various medical schools (5 in the Class of 2008 at the University of Toronto, this is significant, as the norm is usually 0 or at most 2). The study utilized a qualitative approach, requiring the collection of semi-structured one-on-one interview data and an interpretive phenomenological methodology to evaluate the data. There was an increased level of school and community involvement when students returned to high school and an increased awareness of the academic and career choices available to protégés. Mentees indicated that the influence of the SMP followed them much further than the end of the summer and considered it to be an important and defining moment in their educational journey. Communication could be improved so that mentors get a sense of their own impact and for professional development. Recommendations include conducting a study more focused on the impact of the SMP on Aboriginal students who completed the program. Finally, from a theoretical perspective, further work is recommended in order to fine-tune the proposed Mentoring Oriented Teaching and Learning Strategy (MOTALS) framework that incorporates students as natives in a welcoming community of science practice rather than immigrants in a strange land of non-contextual science knowledge.

Using critical feminist theories and methodologies, my research investigates the power relations and influences at play within the field of children's environmental health. I begin with the research question of how a parent's everyday purchase of a toy or other children's product is "hooked into" extra-local governance (agenda-setting, rule-making and monitoring). Focusing on Bisphenol A and phthalates as an example, in-depth interviews were conducted with six government officials (three federal and three municipal), three non-governmental organization (NGO) representatives, a politician, six higher education faculty members and a parent, as well as two focus groups of 23 parents. Legislation and other relevant documents from governments, NGOs, industry and media were analyzed together with reports of their activities and attitudes to theorize "how things work" in the identification and management of toxic substances in products for sale, with a special interest in how this affects children's environmental health. My research revealed the influence of neo-liberalism, corporate power and over-reliance on strictly evidence-based biomedical reductionism in slowing down assessment and regulation of chemicals while many health professionals and grassroots activists have called for swifter responses based on the precautionary principle, as favoured by European governments. That is, politics and bureaucracy, with the approval of industry, over the past two decades, have clung to reductionist science as the only paradigm for understanding toxicity, thus slowing down regulatory processes. Although the historical and epistemological power relations mapped in my research work together to legitimize scientific certainty rather than the precautionary principle, I argue that the resulting regulatory logjam has been and could be addressed by reference to European examples, knowledge produced by collectives and the establishment of upstream and equity-based public health strategies with public input into the process.

This thesis investigates the potential for Knowledge Building in large size Pharmacy classrooms. Knowledge Building is the social creation and continual improvement of ideas (Scardamalia & Bereiter, 2003). The pedagogy and technology that underlie it are based on a complex system involving 12 interdependent principles. This research examines principle-based classroom designs, targeting two Knowledge Building principles--epistemic agency and collective responsibility for community knowledge. Successive design changes were implemented to a self-care course for undergraduate Pharmacy students (n = 182), using case study methodology. The goal underlying design changes was to develop a more dynamic classroom environment involving all students and empowering them to take charge of knowledge advancement at high cognitive levels, through assuming greater agency and collective responsibility for their knowledge advances. Design features that were incorporated into class procedures included class panels to discuss cases, student-generated self-assessment examination questions, and online discussion views in a virtual learning community, Knowledge Forum. Surveys, student comments, self-assessments, field notes, online discourse and course exam scores were used to determine effects of principle-based design changes. Results, taken as a whole, indicate that each new design feature contributed to advances with no negative effects uncovered. Raters blind to authorship of student- versus instructor-generated exam questions could not distinguish between them. Analysis of student commentary indicated advances in line with the broad network of Knowledge Building principles, as well as those specifically targeted in design improvements. Advances in performance on exams, surveys, and in student discourse further contributed to the overall picture of positive effects. Design strategies appropriate for large classroom implementation are shown to facilitate a shift from learning as an exclusively individual enterprise, to the creation of a Knowledge Building Community with students assuming levels of responsibility and agency normally assumed by the teacher.