The intensification of Ontario’s communities through recent policies such as the Greater Golden Horseshoe Growth Plan (GGH) will reduce the amount of local natural spaces for residents. Presently many of Ontario’s youth experience the natural world primarily by visiting environmental education centres. This study used sequential exploratory mixed methods to discover the perceptions of environmental educators concerning the realities of their daily practice. The first phase of the study utilized a grounded theory approach to construct an understanding of environmental education in Ontario. The interrelated themes of increasing environmental consciousness, evaluation of programs and centres, influence of visiting adults on program effectiveness, and programming were revealed. The second phase utilized the themes derived to construct an online survey in order to measure the actual practice of environmental educators compared to their perceived best methods. The results indicate that the scarcity of effective program and institutional evaluation, ineffective communication between supervising adults, and the conflict over pedagogical aims lead to some centres potentially only achieving mediocre increases in the environmental consciousness of the participants. The need for explicit, accessible areas where youth can engage in repetitive unstructured activities in the natural world is highlighted as an area for community stakeholders to focus their efforts on if pro-environmental behaviour is a desired trait in residents.

This study investigates the impact that Latvian exile literature has had on research in Latvia between 1992 and 2006. Latvian exile literature refers to the publications that were authored and published by Latvians who emigrated to Western countries after World War II and were issued between 1945 and 1991. Mixed methods research was conducted, incorporating citation analysis, questionnaires and interviews. Nine subject fields from the social sciences, arts and humanities were examined: philosophy and psychology, religion and theology, political science, education, folklore and ethnography, the arts, linguistics, literature, history. For the citation analysis, 33,866 citations from 1241 publications were collected. In the survey, 79 questionnaires were received from Latvian researchers and 31 questionnaires from the librarians working in Latvian academic, special and the main regional libraries. After the data analyses of citations and questionnaires were conducted, the results were presented to 15 researchers in Latvia (experts in their subject fields) for their assessment and comments. The overall results show that Latvian exile literature has had the greatest impact on research in folklore, history and literature. Exile impact was observed through both exile publications and communication with exile people. It appears that in other disciplines exile literature has had little or no impact. The reasons for this are thought to be: the lack of exile publications that could make an impact, and the irrelevance of existing publications to research in Latvia. In general, exile academic publications have been the most influential on research. The citation results also demonstrate the impact that restrictions of the soviet period (1945-1991) had on the research in Latvia, particularly through the double obsolescence of citations in all subject fields.

The intensification of Ontario’s communities through recent policies such as the Greater Golden Horseshoe Growth Plan (GGH) will reduce the amount of local natural spaces for residents. Presently many of Ontario’s youth experience the natural world primarily by visiting environmental education centres. This study used sequential exploratory mixed methods to discover the perceptions of environmental educators concerning the realities of their daily practice. The first phase of the study utilized a grounded theory approach to construct an understanding of environmental education in Ontario. The interrelated themes of increasing environmental consciousness, evaluation of programs and centres, influence of visiting adults on program effectiveness, and programming were revealed. The second phase utilized the themes derived to construct an online survey in order to measure the actual practice of environmental educators compared to their perceived best methods. The results indicate that the scarcity of effective program and institutional evaluation, ineffective communication between supervising adults, and the conflict over pedagogical aims lead to some centres potentially only achieving mediocre increases in the environmental consciousness of the participants. The need for explicit, accessible areas where youth can engage in repetitive unstructured activities in the natural world is highlighted as an area for community stakeholders to focus their efforts on if pro-environmental behaviour is a desired trait in residents.

Breast cancer is the most common cancer diagnosis of women, with an estimated 232,670 new cases in 2014. With 89.2% of breast cancer patients surviving five years or longer, studies are needed to investigate the long-term impact of breast cancer on women and families (National Cancer Institute, 2014). The purpose of this study was to examine, using a mixed methods approach, the impact of chemotherapy on mothering occupations for patients diagnosed with breast cancer. Thirty-one women (mean age=39.6, SD=5.79), with breast cancer of any stage, who were currently undergoing chemotherapy and had at least one child under the age of 18 living in the home, were recruited from a comprehensive breast cancer care center. These participants completed the Fatigue Symptom Inventory Then Test, the Parent Disability Inventory, the FACT-G quality of life inventory, and a demographic questionnaire. Of these 30 participants, ten participants were selected using purposeful sampling to participate in semi-structured interviews focusing on the impact of chemotherapy on mothering occupations. Qualitative data were analyzed using a grounded theory approach (Corbin & Strauss, 2008) and quantitative data were analyzed using SPSS version 22 to determine descriptive statistics and correlations among variables. After analysis, the central category that emerged from the data was “Keeping life the same while weathering cancer treatments,” which was developed from categories of learning, adapting, accepting support, growing and normalcy. Quantitative analyses found a correlation between fatigue and parent disability (Spearman rho correlation = -0.476, p < 0.05), quality of life and fatigue interference (-0.481, p < 0.001) and parent disability and quality of life (0.745, p<0.001). Implications for future occupational therapy practice are discussed.

Collaboration has been proposed as an inclusive forum for bringing together state and non-state stakeholders to deliberate and negotiate solutions to complex environmental problems. A key aspect of collaborative approaches is the potential to help stakeholders share and integrate expert science and local knowledge with their beliefs and values. This process creates a vernacular knowledge that is necessary to address the quasi-scientific characteristics of complex environmental problems. Stakeholder networks have an important role in collaborative processes, and the creation and sharing of knowledge. The manner in which stakeholder networks form, function, and contribute to the creation and sharing of knowledge, both internally and externally, is not well understood from both a theoretical and empirical perspective. The purpose of this research is to provide insight concerning this gap in the literature by addressing three research objectives: (1) to develop a conceptual framework for evaluating the creation and sharing of vernacular knowledge by a stakeholder network within collaborative problem-solving processes; (2) to use the conceptual framework to evaluate the contribution of stakeholder networks to the creation and sharing of vernacular knowledge in an actual example of a collaborative problem-solving processes; and (3) to develop recommendations for the design of collaborative problem-solving processes in order to facilitate the creation and sharing of vernacular knowledge using stakeholder networks. A case study was used to evaluate a multi-stakeholder problem-solving process that has involved stakeholder network representatives at the watershed and provincial scales in Ontario, Canada. This was undertaken through an extensive literature review, and the analysis of data collected through participant observation, survey questionnaire, and a review of publicly available documents using a mixed methods research approach. The research focused on the evaluation of the formation and function of an agri-environmental network composed of representatives from key provincial farm organizations and the provincial agricultural ministry. This research seeks to provide insight concerning the role of stakeholder networks in the creation and sharing of vernacular knowledge within collaborative problem-solving processes, and provide insights for both theoretical and practical applications of collaborative approaches to problem-solving. This addresses questions in the literature regarding the effectiveness of stakeholder networks to contribute knowledge to problem-solving within forums that are intended to be collaborative in nature, but may also include elements of a regulatory approach. Further, this agri-environmental network has supported the development and function of a diverse group of farm community representatives involved in a prescribed environmental problem-solving process. The research demonstrates that this network has been effective in contributing to the creation and sharing of vernacular knowledge in a coordinated fashion at the local and provincial scale. This responds to questions in the literature concerning how stakeholder networks communicate and cooperate across different scales and administrative, physiographic and political boundaries. The study also provides recommendations for practice concerning the selection of community representatives, the creation of vernacular knowledge, and the promotion of stakeholder network involvement as part of collaborative approaches to problem-solving. Although the research results are situated in an Ontario context, the results of the study can be applied in other jurisdictions where stakeholder networks exist or may emerge to participate in collaborative approaches to environmental problem-solving.

Little research has identified the proactive psychosocial attributes and tactics that deaf individuals can use to maximise their potential with hearing peers. A comprehensive and systematic framework of psychosocial skills has also been absent in deafness-related research. / This study featured data gleaned from 49 participants from Australia, England, and the USA who were mostly highly educated, and vocationally and socially successful. These participants formed three groups: Oral Deaf (n=22), Hearing (n=19), and Culturally Deaf (n=8). All participants were over the age of 25 and self-regarded as maximising their potential in mainstream society. All hearing participants had had a close relationship with a deaf individual for more than one year and reported not having a disability. All deaf participants nominated whether or not they were culturally Deaf (CD) and reported not having an additional disability to deafness. / Most deaf participants reported pre-lingual deafness (n=18). All but one deaf participant reported greater than severe-to-moderate bilateral deafness. Eighteen (60%) deaf participants wore hearing aids, ten had a cochlear implant, and two had no assistive sensory device. Twenty-four (80%) deaf participants relied on speech-reading and all but one always used their voice to communicate. Nineteen (63%) deaf participants were educated solely in a mainstream school but only three (10%) were educated solely in a School for the Deaf. The majority (64%) of Oral Deaf (OD) participants had not learned Sign Language (SL) and only three continued or were fluent with SL. All CD participants used SL. Data trends also suggested that two CD participants were ‘purely’ CD, whereas the six other CD participants likely were ‘bi-cultural’. / This exploratory research used a framework of psychosocial themes used in a study with vocationally successful participants with a Learning Disability by Reiff, Ginsberg and Gerber (1995). These themes were grouped into Internal Decisions (Desire, Goal Orientation, and Reframing) and External Manifestations (Persistence, Goodness of Fit, Learned Creativity, and Social Ecologies). Control was the eighth theme that embraced all other seven themes. Reiff et al.’s framework was modified for the current study’s purposes so that the combined effect of the three thematic categories of Control, Internal Decisions, and External Manifestations equals Potential Maximisation. Potential Maximisation was therefore defined as the measure of a participant’s psychosocial attributes and tactics used in social and vocational contexts. / Screening surveys were used to glean demographic data and to determine the participants’ eligibility. Eligible deaf and hearing participants were then administered follow-up surveys. These follow-up surveys included identical items that were scored for the purposes of between-group statistical analyses. The follow-up survey for deaf participants featured additional deafness-specific items that were not in the follow-up survey for hearing participants. The follow-up survey items were allocated to themes in Reiff et al.’s (1995) framework. / Mixed-methods were administered on the data. Between- and within-group analyses were also conducted. Three between-group comparisons featured statistical analyses on each of the four variables of Control, Internal Decisions, External Manifestations, and Potential Maximisation. The results of the ANOVAs and t-tests (2-tailed) showed no significant differences in the mean scores for each of four variables. These trends indicated that 1) the deaf and hearing participants used similar or identical psychosocial attributes and tactics to maximise their potential, and that 2) hearing status and 3) deaf identity were not factors influencing the maximisation of psychosocial potential. / Three within-group analyses were then conducted. These included case studies, composite pictures, and reporting qualitative data trends. The case studies showed that the highest scoring participant provided comparatively numerous, richer, and detailed psychosocial attributes and tactics than the lowest scoring participant. The composite pictures further showed remarkable similarities, which, again, highlighted the participants’ use of similar psychosocial attributes and tactics. Qualitative data trends particularly illustrated that deaf participants also used additional psychosocial attributes and tactics for circumventing deafness-related challenges.

This mixed methods study, a concurrent triangulation design, explored Tinto's integration theory as it relates to nontraditional students. The study explored the relationship of academic and social integration, defined by classroom active learning strategies and sense of belonging, with persistence. The study also expanded upon the idea of socio-academic integrative moments which might occur when social and academic integration converge or overlap. Consistent with Tinto's model, factors including initial institutional commitment, initial goal commitment, and subsequent institutional commitment were also analyzed. Multiple regression analysis of data obtained from a 38-question survey (n=299) revealed one common predictor of persistence among the three research questions: initial commitment to the educational goal. Qualitative data, interpreted from a diverse group of 10 nontraditional students, confirmed the quantitative findings and revealed that, in relation to persistence, initial commitment to the educational goal seemed to transcend all other theoretical factors including institutional commitment, social integration, academic integration, and student entry characteristics such as race, gender, parents' educational attainment, first-generation status, and high school GPA. In addition, focus group findings indicated the presence of socio-academic integrative described as academically-focused social integration. Recommendations for further exploration into the integrational convergence or non-linearity of Tinto's model are included. Recommendations for practice and future research prompt additional exploration into nontraditional student persistence including suggestions to identify factors related to meaningful integration for nontraditional students and how those factors might influence persistence.

Long-term conditions (LTCs) such as diabetes, cardiovascular diseases, respiratory diseases and cancers are recognised as the greatest challenge facing public healthcare systems globally in the 21st century. Healthcare provision for people with LTCs is shifting towards a model that puts patients at the centre of their own care through supported self-care. Self-care support has emerged as a distinct concept in the management of LTCs and is now considered an inseparable component of high quality healthcare provided by healthcare professionals. People with LTCs are regular users of community pharmacy where dispensing and other services provide opportunities for self-care support. While self-care support as a concept has been explored extensively in health disciplines like nursing, medicine and health psychology, there is a paucity of published literature in community pharmacy. The main aim of this programme of work was to explore the place and contribution of community pharmacy in self-care support of LTCs. A preliminary scoping literature review captured and synthesised the overarching components of self-care support of LTCs into a single theoretical framework consisting of collaborative care planning, self-care information and advice, self-care skills support and training, self-care support networks and self-care technology. The research programme of work employed a mixed methods design consisting of three Work Streams. The qualitative arm of the programme consisted of semi-structured interviews with 24 patients with LTCs and 24 community pharmacists in England and Scotland; these informed the quantitative arm, which was a cross-sectional, online survey of 10,000 community pharmacists in England. The survey instrument was informed and developed from the findings of the pharmacists’ interviews in combination with existing literature. Data collection and analysis in the three work streams incorporated the theoretical framework of self-care support. The qualitative data analyses were undertaken thematically, while quantitative data were analysed using a range of descriptive and inferential statistics. Interviews with patients explored their ‘lived experience’ with LTCs and found that self-care was an integral part of daily living; patients engaged in self-care in a variety of ways to attain normality in their lives. Patients used a wide range of resources for self-care support; family/carers, friends and healthcare professionals (mainly doctors and nurses). Patients viewed and used community pharmacy mainly for the supply of prescribed medicines and suggested that community pharmacy played minimal roles in self-care support. The interviews and survey of community pharmacists showed that pharmacists recognised the broad range of activities and principles of self-care. However, in terms of pharmacists’ contributions to self-care support, their perspectives were narrower and focussed on providing information and advice on medicines-use to patients, while other activities such as lifestyle advice were provided opportunistically. They indicated that they were already providing medicines-focussed self-care support through the services available in community pharmacy. The theoretical framework allowed detailed exploration of how community pharmacists operationalised the different elements of self-care support of LTCs. Collaborative care planning was viewed as important but not within the remit of community pharmacy. Self-care information and advice was unidimensional and provided opportunistically and one-off, using the paternalistic biomedical model. Pharmacists valued the roles of patients’ personal communities but were not proactive in signposting to other support networks. Self-care skills training and support and the use of self-care technologies were limited. Barriers to providing self-care support were priority accorded to dispensing activities, the structure of the community pharmacy contract, lack of incentives to provide self-care support and patients’ expectations and lack of awareness of community pharmacy’s role in LTCs management. The theoretical framework of self-care support of LTCs provided novel insights into the perspectives of patients and community pharmacists. The findings highlighted the need for a coherent LTC strategy if community pharmacy is to align with the self-care support paradigm. Recommendations are made for a comprehensive package of care, underpinned by self-care support. A case is also made for incorporating the often ‘unheard’ patient voice into community pharmacy research and interventions.

The attainment of ethnic minority students in their host countries has been occupying a significant part of the international literature for many years. However, results suggest that no generalisations can be made on whether an ethnic minority group underachieves in a particular country and the reasons behind their attainment levels, unless that specific group has been investigated in the country in question. Cyprus joined the EU in 2004 and since then the demographic composition in the island changed dramatically; a change reflected in schools. The literature on ethnic minority group attainment in secondary schools in Cyprus is virtually non-existent and, as such, in this PhD programme the aim was to examine the attainment of ethnic minorities compared to native students and the reasons behind the observed patterns. In order to answer the research questions a series of studies were carried out. Initially, two quantitative studies were conducted. These studies used trimester grades as a proxy of attainment and Rasch analysis to turn these ordinal student grades into a linear scale. Descriptive statistics and multiple regression analyses were then run to check for trends and significant associations. Two qualitative studies then followed. Firstly, a focus group study was conducted utilising the help of six young female teachers, all teaching classics to create a homogeneous group. Then followed an interview study utilising semi-structured interviews on sixteen teachers. For both studies a thematic analysis was undertaken on the transcribed discussions. Another quantitative study then followed which employed an enhanced methodology to the first two studies and richer data. The final study was a mixed methods study and concentrated on school absences. Results demonstrate the reality in lower secondary schools in Cyprus for the first time. The minority group Georgians, the first time that this group is met in the literature, and a combination of other smaller groups put together in a group called ‘Others’, are shown to achieve significantly lower than natives. Ethnic background, gender, generation status, absences, the socio-economic status of the family and the character of the local educational system were shown to be related to student attainment. The widely held belief that ethnic minority students do even worse in those subjects that are more language-dependent is disproven; rather it is the content of the subject that is felt to be more influential on attainment. Also, the recently emerging consensus that unexcused absences are more strongly associated with attainment than excused absences is not upheld in this study; a more detailed classification of unexcused absences might be responsible for this. Finally, it is interesting to note the differential influence of different absence variables on different school subjects. Findings highlight the need for change and improvement in the educational practice in Cyprus and add to both the local and international literature. The specific factors identified can form the basis on which to base suggestions for improvements and further research.

Risk management in hospitals is an approach intended to improve the quality of services by identifying active and latent factors that put patients at risk of physical and psychological harm when in hospital, and then acting to identify, monitor and control those risks, and effectively manage their impact. The object of this report is to describe important risk management competencies for medical practitioners working in South African hospitals, these practitioners’ current proficiency levels and the competencies with the biggest gaps in practice. The report is intended to present a risk management competency model for medical practitioners working in SA hospitals. This study was conducted in two phases of which Phase 1 was a qualitative research seeking to identify the competencies using literature review and in-depth interviews with medical experts. The second phase was quantitative, characterised by a survey utilising a questionnaire comprising competencies derived from Phase 1. The sample size for Phase 2 was 90 respondents drawn from three population groups and including medical practitioners, professional nurses and members of the hospital management team. The research identified risk management competencies that were later ranked according to their importance using weighted mean averages. A gap analysis was conducted to assess the difference between what practitioners should know and what practitioners actually do in the hospitals in relation to risk management. A new model of “risk management competencies for medical practitioners” has been developed consisting of the knowledge, skills, behaviour and attitude competency domains that have never been previously identified. This model can be used to update certification requirements for independent medical practitioners and professional development programmes for medical practitioners as well as update curricular offerings of the medical schools / Dissertation (MBA)--University of Pretoria, 2014. / zkgibs2015 / Gordon Institute of Business Science (GIBS) / Unrestricted